barriers & how they’re overcome

Geographical: barrier eg location (1)

Depending on where SU lives, access to service they require may be difficult

(2)

Individuals esp. those in remote country areas, may find it difficult to find transport to service provider

(3)

Depending on demographic characteristics of a particular area, services may not be available in that area

Broken down (1)

By telephone help lines where SUs/relatives may get advice

(2)

By providing transport to the service eg free taxis/bus pass

(3)

By provision of health care in the SUs own home/community eg visit from LD nurse, speech therapist

(4)

By info on the internet, chat rooms, blogs giving advice to them/their relatives

Physical: barrier eg transport, environmental factors, navigation & signage (1)

Can things such as not having access to a car

(2)

Being intellectually disabled to the extent an individual is unable to use a phone/catch a bus

(3)

May have to depend on referral from either a 3rd person/professional

(4)

Hospitals/clinics can be noisy, busy & unfamiliar environments which can cause distress/anxiety

(5)

Long waiting times & unclear signage can further increase confusion & discomfort, making it harder for SUs to engage with services

Broken down (1)

3rd party/professional referral

(2)

By providing specialist equipment eg voice activated devices at home

(3)

Utilise LD nurses

(4)

Sensory friendly places (low lights/noise)

(5)

Easy read info (with use of pictures)

(6)

By making reasonable adjustments eg providing quiet waiting areas, clear signage, flexible appointment times & pre-familiarisation sessions - promotes comfort & accessibility

Language: barrier (1)

Uk = multi-cultural society so essential that services/facilities are provided for SUs taking into consideration their cultural needs & background

(2)

Being a foreign National living in NI can present challenges regarding finding access to a whole range of HSC services

(3)

Individuals with learning difficulties will find this extremely difficult & will need extra support

Broken down (1)

By providing info in different languages

(2)

By using translation apps

(3)

By having an advocate translate eg family member or friend

(4)

By having signs in multiple languages

Communication difficulties (1)

Many individuals struggle understanding complex medical language/written info, others may struggle to express their symptoms, emotions or preferences clearly

(2)

Health professionals often rely on verbal explanations - can disadvantage those who process info more slowly or require alternative forms of communication so SUs may feel confused, anxious, excluded from decisions about their own care

Breakdown (1)

By using easy-end materials, visual aids & clear, simple language, professionals should allow extra time during appointments & check understanding regularly

(2)

By involving SLTs & using communication tools eg picture symbols can further support inclusive communication

Psychological: barrier eg fear (1)

Emotional & psychological barriers may prevent SUs from accessing services eg anxiety & embarrassment

(2)

Anxiety regarding medical procedures eg blood tests, injections & needles

(3)

Having a poor past experience with a medical/HSC setting

Broken down (1)

By reducing stigma related to seeking help

(2)

By reassuring SUs that they’re not alone in their needs

(3)

By initiatives in schools/communities to encourage those who need help & support to access it

(4)

By the use of advocacy services

(5)

By training professionals to be patient & to make them aware of needs of people with learning difficulties

Knowledge: barrier eg awareness (1)

Some SUs may not have the language skills/knowledge base to access help & support needed

Example

SUs with LDs such s Down’s syndrome/ASD (when co-morbid) may be unaware of their needs

(2)

Unless someone else intervenes & supports them to access care they may be unable to gain access to valuable HSC services

Broken down (1)

By 3rd party/professional referral

(2)

By use of an advocate eg explaining the info to a family member

(3)

By providing info in user-friendly format eg easy to read with pictures

Negative attitudes & discrimination (1)

Some professionals may make assumptions about a person’s abilities based solely on their LD. can lead to individuals being excluded from decisions-making or spoken to in a patronising manner

(2)

Staff may focus on disability rather than individual, resulting in care that isn’t person centred - can undermine SUs dignity & self-esteem

Broken down (1)

By ongoing raining & education for staff to promote understanding, respect & empathy

(2)

Following principles of mental capacity act, professionals should presume capacity until proven otherwise & support individuals to make informed decisions where possible

Lack of specialist knowledge & understanding (1)

People with LDs often have additional health needs eg higher risk of epilepsy, MH conditions or physical health problems

(2)

Without adequate training, professionals may misinterpret symptoms or fail to provide appropriate care, leading to late diagnoses/preventable health issues

Broken down (1)

By mandatory LD training & involvement of specialist professionals eg LD nurses

(2)

Improved communication between services & use of tools eg hospital passports can ensure that individual needs are recognised & met

Systemic & support related barriers (1)

HSC systems = often complex, involving referrals, paperwork & increasingly digital processes

(2)

SUs with LDs may struggle to understand how to navigate these systems, particularly if they lack family, carers, advocated, can result in misses appointments or unmet needs

Broken down (1)

By providing access to independent advocacy, simplified procedures & assistance with forms - helps SUs understand rights & choices

(2)

Advocacy empowers individuals to have their voices heard & ensures their needs are represented

Financial: barrier (1)

Lack of money may mean SUs are unable to access available HSC services/treatment

Example

A SU who needs to see a GP but has no access to car may be unable to afford transport costs of taxi/bus so may not access service

(2)

Other private health services may not be available to some SUs due to cost eg surgery at private hospital, therapies eg acupuncture or treatment provided by chiropractors

Broken down (1)

By providing care & support free at point in individual’s home

(2)

By fundraising

(3)

By nominal fees for a service

(4)

Getting help from a charity