# data[].attributes.body
Inclusion North

# data[].attributes.headline
Do the test Go for it! A film made by and for women with learning disabilities.Taking the fear out of going for breast screening.

# data[].attributes.subject
Do the test Go for it! A film made by and for women with learning disabilities.Taking the fear out of going for breast screening.

# data[].attributes.attachment_link.readable_text
A film made by and for women with learning disabilities.

Taking the fear out of going for breast screening.

This is a breast screening film for women with learning disabilities, showing clearly what happens during the process of having a mammogram. Whilst breast screening is always an individual choice, the film is intended to take the fear out of going for breast screening and encourage women with LD to come and have the test.

The film can be watched in full, or in short segments, showing different aspects of the screening journey.

Do the test: Go for it (the whole film)

Segment 1: Do the test: trailer

Segment 2: Do the test: what do you call them?

Segment 3: Do the test: Julia's story

Segment 4: Do the test: what is cancer?

Segment 5: Do the test: what is a mammogram?

You can view the films and download from here:
https://vimeo.com/showcase/7542993

# data[].attributes.attachment_link.description
This is a breast screening film for women with learning disabilities, showing clearly what happens during the process of having a mammogram. Whilst breast screening is always an individual choice, the film is intended to take the fear out of going for breast screening and encourage women with LD to come and have the test.

# data[].attributes.headline
Supporting people with intellectual disabilities to have a good life as they grow older 

# data[].attributes.subject
Supporting people with intellectual disabilities to have a good life as they grow older 

# data[].attributes.body
Pavilion

# data[].attributes.attachment_link.readable_text
Christine Towers

Paperback

A self-study guide

£15.95

Description

Supporting People with Intellectual Disabilities to Have a Good Life as They Grow Older is a new self-study guide designed to both support the delivery of training via the companion training pack, but can also be purchased separately to provide a self-study route. With access to online video clips, the guide works through the same content in order to provide opportunities for support staff to learn at their own pace and to enhance their continuing professional development in this vital area.

Growing older is a process with numerous gradual or sudden changes over time. For staff supporting people with learning disabilities, it may be difficult to recognise these changes or know how best to meet their changing needs. People with learning disabilities often age biologically at a younger chronological age than the general population, and many will have very different life experiences of getting older, for example having missed out on work, having a family and developing long-term relationships. These factors can adversely affect self-esteem as well as sources of financial and social support to fall back on as they grow older.

These new resources address a significant gap in the knowledge and practice of supporting people with learning disabilities as they grow older. Both aim to help staff and others to improve their understanding of how growing older may affect individuals, and ways of providing good support to people with learning disabilities so that they can:

Age well through staying healthy, keeping friendships and connections and adapting their lifestyle as necessary;

Cope with challenges and difficulties they may face, particularly as they become frailer and lose some independence.

Through knowledge content, exercises, key learning points and video clips of older people with learning disabilities talking about their experiences of growing older, the materials will help support staff to explore how planning for and providing good support can make a positive difference to individuals' lives in the key areas of:

Emotional well-being

staying healthy and accessing healthcare

Being active and involved

Home life

understanding growing older

Bereavement and dying

Throughout the learning process, the themes of person-centred planning, good communication, and building confidence and encouraging independence are central to the development of good support.
Download sample of Supporting People with ID to Have a Good Life as They Grow Older

Author

Christine has over 35 years' experience of working with people with learning disabilities and their families. During this time, she has worked in the not-for-profit sector as well as health and social care services with a focus on the development and management of services. Christine has also been involved in a number of research projects. Central to her work has been developing ideas alongside people with learning disabilities and their families, partnership working and person-centred approaches. She has been a member of the National Valuing Families Forum for over ten years.

She worked at the Foundation for People with Learning Disabilities for 10 years where her particular areas of interest were planning with families, improving the quality of support, older people with learning disabilities and the development of social and community networks.

Christine set up Together Matters as she believes that talking, planning and working together help people to find new approaches to overcome hurdles and can lead to people with learning disabilities getting good lives.

Audience

This study guide offers a wide range of good practice ideas for accessing opportunities so people can enjoy active and fulfilling lives while also being supported to be safe and well. The information will be useful for anyone providing support to people with learning disabilities as they get older, and also to those managing support services, commissioning support, and shaping and reviewing care and support plans. It will be a useful for personal assistants, support workers and senior workers in supported living, residential and respite care and day opportunity services.

This study guide may also help family carers think about what support they would like their relative to receive, whether they live in the family home or elsewhere, and to help them understand what good support should look like so they can check the quality of the support their relative is receiving.

This book could also be used by community and voluntary organisations looking to be more inclusive of older people with learning disabilities, and by support services for older people who want to improve their offer to older people with learning disabilities.

Details

ISBN: 9781912755516

Publication Date: November 2019

Only logged in customers who have purchased this product may leave a review.

You may also like...

Related products

# data[].attributes.attachment_link.title
Supporting People with Intellectual Disabilities to Have a Good Life as They Grow Older: A self study guide | Pavilion Publishing

# data[].attributes.attachment_link.description
Christine Towers Paperback A self-study guide £15.95 Supporting People with Intellectual Disabilities to Have a Good Life as They Grow Older is a new self-study guide designed to both support the delivery of training via the companion training pack , but can also be purchased separately to provide a self-study route.

# data[].attributes.body
PBS and support skills resources

# data[].attributes.attachment_link.description
Karen Dodd, Vicky Turk and Michelle Christmas This illustrated booklet describes the dementia process and helps people with a learning...

# data[].attributes.headline
Love Life Project Easy Read Guide to Words About Sex

# data[].attributes.subject
Love Life Project Easy Read Guide to Words About Sex

# data[].attributes.attachment_link.readable_text
This guide was produced by the LoveLife project, and made into easy read by Easy Read Wales. It is a list of hard words that have something to do with sex. Each word has been explained in easy read.

For more information about the LoveLife project click here.

# data[].attributes.attachment_link.title
LoveLife Project Easy Read Guide to Words About Sex

# data[].attributes.attachment_link.description
This guide was produced by the LoveLife project, and made into easy read by Easy Read Wales. It is a list of hard words that have something to do with sex. Each word has been explained in easy read. For more information about the LoveLife project click here.

# data[].attributes.body
Gov.uk, 10 February 2020

# data[].attributes.attachment_link.readable_text
Tell us whether you accept cookies

We use cookies to collect information about how you use GOV.UK. We use this information to make the website work as well as possible and improve government services.

This document gives an introduction to Universal Credit for people who are claiming it.

Documents

Details

This guide explains:

your responsibilities while claiming Universal Credit

sanctions you could face if you do not meet your responsibilities

how, when and where Universal Credit is paid

how you can be better off in work

help to become self-employed

help with childcare costs

help with housing costs

# data[].attributes.attachment_link.description
Tell us whether you accept cookies We use cookies to collect information about how you use GOV.UK. We use this information to make the website work as well as possible and improve government services. This document gives an introduction to Universal Credit for people who are claiming it.

# data[].attributes.body
Free resources to support those who work, disabled children and young people

# data[].attributes.attachment_link.readable_text
Disability Matters is a free online learning resource for the UK workforce.

It's an innovative suite of free resources to support those who work, volunteer or engage with disabled children and young people (from 0 to 25 years) and their families. It seeks to address the barriers that make society disabling. These challenges are faced by those with either physical and/or intellectual disabilities.

Developed by disabled young people, parent carers and other experts, Disability Matters arranges individual modules into helpful bite-sized learning packages so that the training offered matches the needs of specific individuals, groups, organisations and sectors. It offers practical advice about supporting disabled children, young people and their families to achieve the outcomes that matter to them.

It consists of:

Disability Matters: all Disability Matters e-learning sessions

Disability Matters Learning Packages: e-learning sessions that have been grouped together to meet particular learning needs.

What is this event about

We will have speakers, demonstrations of the revamped Disability Matters online resource, plus a live performance on the evening.

Audience

Disability Matters is for everyone who may work with, volunteers with, care for, commission or delivers services for disabled children, young people and their families.

Disability Matters has something for everyone.

For more information

Please contact the RCPCH Events team by email: events@rcpch.ac.uk or by telephone on 0207 092 6000

# data[].attributes.attachment_link.description
Disability Matters is a free online learning resource for the UK workforce. It's an innovative suite of free resources to support those who work, volunteer or engage with disabled children and young people (from 0 to 25 years) and their families. It seeks to address the barriers that make society disabling.

# data[].attributes.body
Alcohol, Abuse, Decisions, Diabetes, Belly Ache, Fire Safety + Others

# data[].attributes.body
Skills for Care

# data[].attributes.attachment_link.readable_text
People with a learning disability can be more likely to experience poor mental health. We've developed free resources to help adult social care staff talk to people about their everyday mental health, and enable them to get the support they need.
Background
It's estimated that around 40% of people with learning disabilities also have mental ill-health. This is more than double the number in the general population.

Often, people with a learning disability haven't had a chance to heal from negative life experiences which might include abuse, grief and/or trauma, and, as a result, live their everyday lives feeling scared, worried and/or anxious which has a negative impact on their everyday mental health.

They also don't always have access to the support they need to improve their mental health, and rarely have the opportunity to talk openly about their feelings.

We worked with people with a learning disability to develop practical resources for staff, so they can become more confident and knowledgeable to talk openly about mental health.
The resources
Click on the headings below to download the free resources to help.
Download the top tips poster Top tips Download the poster here Download the poster here
Download the journal here

# data[].attributes.attachment_link.description
People with a learning disability can be more likely to experience poor mental health. Skills for care has developed free resources to help adult social care staff talk to people about their everyday mental health, and enable them to get the support they need.

# data[].attributes.headline
Cervical screening for people with a learning disability

# data[].attributes.subject
Cervical screening for people with a learning disability

# data[].attributes.attachment_link.readable_text
Smear tests are happening and you may get a letter inviting you to go. We know you may find smear tests confusing or worrying, but you are not alone if you feel this way. If you want to ask questions about having a smear test at the moment, on read our information about what is happening. You may want a friend, carer, or learning disability nurse to read it with you. You can also call our free Helpline 0808 802 8000.

What is a smear test?

A smear test is a free health test. It is sometimes called cervical screening.

It makes sure your cervix is healthy.

Your cervix is inside your body at the top of your vagina. You cannot see it.

Video - What happens at a smear test?

This video is about smear tests. It tells you what happens at a smear test and why it is important. Women with a learning disability are in the video and helped us make it.

Who has a smear test?

All women between age 25 and 64 are asked if they want to have a smear test. In England, Wales and Northern Ireland you are invited:

every 3 years between age 25 and 49

every 5 years between age 50 and 64

In Scotland you are invited every 5 years between age 25 and 64.

Smear tests can help stop you getting cervical cancer. It is your choice whether to have a smear test. This information can help you decide.

Some carers, guardians, doctors or nurses don't think women with a learning disability need a smear test.

Sometimes carers and guardians do not know if you are having sex.

Some parents and carers are embarrassed to talk about it. They may not help women with learning disabilities to get a test.

It is important that women with a learning disability are given the option to go to a smear test because it saves 5,000 lives every year.

What happens during a smear test?

You get a letter from your doctor asking you to go for a smear test.

You need to call your doctors to book a time and day to go. Book a time and day when you are not having your period.

A nurse usually does the smear test. If you want to make sure a female nurse does it, tell them.

If you want a friend to stay with you, tell them.

You will go into a private room. The nurse will ask about your health.

The nurse will then ask you to take your knickers (underwear) off.

The nurse will ask you to lie down on a bed. You will have a paper sheet over you. This is the time to try to relax.

The nurse will ask you to open your legs. This is so they can put a new, clean plastic or metal speculum inside your vagina. A speculum is a cylinder with a round end that gently opens your vagina. The speculum may feel uncomfortable. If it hurts, tell the nurse to stop.

A small, soft brush is put inside the speculum. It takes a sample of cells from your cervix. This should not hurt.

The speculum is taken out and the test is over. You can leave. The whole visit to the doctor takes 15 minutes at the most.

The sample of cells is tested. You will get a letter with your results in a few weeks. You can talk about your results with your carer, guardian, or learning disability nurse.

Read our EasyRead booklet

If you found this information helpful, you may like our EasyRead booklet. We made it with women with a learning disability. It is about smear tests and it explains:

what smear tests are

why they are important

what cervical cancer is.

Download our EasyRead booklet >
How we can help

Lots of people find smear tests confusing and worrying, so you are not alone if you feel this way. If you want to ask questions about having a smear test, you may want to speak to you carer, guardian or learning disability nurse. Or you can call our Helpline on 0808 802 8000.

Images on this page

Artwork includes material from the Inspired EasyRead Collection and cannot be used anywhere else without written permission from Inspired Services. Visit www.inspired.pics
How we research and write our information >

# data[].attributes.attachment_link.title
Smear tests for people with a learning disability

# data[].attributes.attachment_link.description
A smear test is a free health test. It is sometimes called cervical screening. Some carers, guardians, doctors or nurses don't think women with a learning disability need a smear test. But all woman and people with a cervix aged 25 to 64 are entitled to one.

# data[].attributes.headline
Health matters: physical activity - prevention and management of long-term conditions 

# data[].attributes.subject
Health matters: physical activity - prevention and management of long-term conditions 

# data[].attributes.body
Public Health England 23 January 2020

# data[].attributes.attachment_link.readable_text
Summary

This edition of Health Matters focuses on the benefit of physical activity for the prevention and management of long-term conditions in adults.

The government's prevention green paper highlights that becoming more active is good for our mental and physical health, and reduces our risk of developing a number of health conditions. It also sets out the ambition of getting everybody active in the 2020s, including those of us who are already living with a health condition.

One in 3 adults in England live with a long-term health condition and they are twice as likely to be amongst the least physically active. However, evidence shows that regular physical activity can help prevent or manage many common conditions such as type 2 diabetes, cardiovascular disease and some cancers. It also helps keep symptoms under control, prevent additional conditions from developing, and reduce inequalities.

Health benefits of physical activity

In the new UK Chief Medical Officers' (CMOs) physical activity guidelines launched in September 2019, the CMOs reiterated a clear message about physical activity:

"If physical activity were a drug, we would refer to it as a miracle cure, due to the great many illnesses it can prevent and help treat."

Regular physical activity provides a range of physical and mental health, and social benefits, many of which are increasing issues for individuals, communities and society. These include:

reducing the risk of many long-term conditions

helping manage existing conditions

ensuring good musculoskeletal health

developing and maintaining physical and mental function and independence

supporting social inclusion

helping maintain a healthy weight

reducing inequalities for people with long-term conditions

Physical activity guidelines for adults

The updated UK CMOs ' physical activity guidelines refreshed the 2011 guidelines across all age groups. It also draws on new evidence to develop additional guidance on being active during pregnancy and after giving birth, and for disabled adults.

The guidelines state that for good physical and mental health, adults should aim to be physically active every day. Any activity is better than none, and more is better still.
Christopher Whitty - Chief Medical Officer full interview
There are 3 elements of the physical activity guidelines:

1. strengthening activity

2. cardiovascular activity

3. sedentary time

Strengthening activity

Muscle strength, bone health and the ability to balance underpin physical function. Each attribute contributes independently to overall health and functional ability, and in combination they provide lifelong benefits.

There is a challenge faced in physical activity promotion with unequal emphasis on the aerobic, rather than the strength components, of the CMOs ' physical activity guidelines for adults.

Considered the 'forgotten guidelines', the CMOs ' strengthening activity guidelines state that: adults should do activities to develop or maintain strength in the major muscle groups. Muscle strengthening activities should be done at least 2 days a week, but any strengthening activity is better than none.

The guidelines also highlight the additional benefit of balance and flexibility exercises for older adults. Exercises that improve leg strength, balance and coordination can help people maintain and improve muscle strength and avoid falls as they age. Improving flexibility can improve posture, reduce aches and pains, lower risk of injury, and help with continuing to carry out everyday tasks.

Evidence suggests that muscle strength, bone strength and balance ability increase in childhood and peak in early adulthood, eventually followed by a decline.

Therefore, muscle and bone strengthening and balance activities ( MBSBA) are important across the lifecourse for different reasons:

Cardiovascular activity

For cardiovascular activity, the guidelines state that: each week, adults should accumulate:

at least 150 minutes of moderate intensity activity (such as brisk walking or cycling), or

75 minutes of vigorous intensity activity (such as running), or

even shorter durations of very vigorous intensity activity (such as sprinting or stair climbing), or

a combination of moderate, vigorous and very vigorous intensity activity

Sedentary time

For sedentary time, the guidelines state that: adults should aim to minimise the amount of time spent being sedentary, and when physically possible should break up long periods of inactivity with at least light physical activity.

There have been notable developments in the evidence base for the health effects of sedentary time in adults, with research suggesting sitting time is associated with increased all-cause and cardiovascular mortality, and cancer risk and post-treatment outcomes (including quality of life and prognosis).

Adults with long-term conditions

In England, 15 million people are living with one or more long-term health conditions. One in 3 of the working age population have at least one long term condition and 1 in 7 have more than one.

Since the 2011 physical activity guidelines were published, the evidence to support the health benefits of regular physical activity for all groups has become increasingly compelling.

The 2019 guidelines utilised the latest evidence from systematic reviews, meta-analyses, and pooled analyses comprising hundreds of epidemiological studies with several million study participants comparing active and low activity people. Figures for different health risks cannot be compared as they come from different studies.
Dr. Zoe Williams - NHS GP and PHE Physical Activity Clinical Champion Full Interview
Regular physical activity is associated with a reduced risk of a range of diseases including some cancers and dementia. There is also evidence that it can help to prevent some and manage many common chronic conditions and diseases, many of which are on the rise and affecting people at an earlier age, such as:

some cancers

obesity

type 2 diabetes

cardiovascular diseases (CVD) including coronary heart disease and stroke

hypertension

osteoarthritis and lower back pain

mental health conditions including depression and anxiety

dementia

chronic obstructive pulmonary disease (COPD) and asthma

musculoskeletal (MSK) conditions

Physical activity is as good or better than treatment with drugs for many conditions, such as type 2 diabetes and lower back pain, and has a much lower risk of any harm.

Physical activity can also benefit those who have MSK conditions. However, many people with MSK conditions often mistakenly believe that physical activity will make their conditions worse. The more conditions you have, the more you need to improve the core aspects of fitness:

You can read more about this in this previous edition of Health Matters on productive healthy ageing and MSK conditions and healthy ageing consensus statement developed by PHE and the Centre for Better Ageing.

The role of physical activity for preventing and managing illness is included within many National Institute for Health and Care Excellence (NICE) guidelines, and the promotion of physical activity helps to support their implementation.

Adults with disabilities

PHE commissioned an evidence review for the UK CMOs' guidelines, specifically focusing on the scientific evidence of the health benefits of physical activity for disabled adults. Evidence shows a relationship between engaging in physical activity and positive health outcomes for disabled adults.

It concluded that for substantial health gains, disabled adults should:

Little evidence was found to show that physical activity is unsafe for disabled adults when it is performed at an appropriate level for their current level of activity and health conditions.

Individuals with uncontrolled symptoms for cardiac, metabolic, renal and some musculoskeletal conditions should seek advice before greatly increasing physical activity.

Physical activity during pregnancy and postpartum

The benefits of physical activity during pregnancy include:

reduction in hypertensive disorders

improved cardiorespiratory fitness

lower gestational weight gain

reduction in risk of gestational diabetes

The benefits of physical activity in the postpartum period (up to one year) include:

reduction in depression

improved emotional wellbeing

improved physical conditioning

reduction in postpartum weight gain and a faster return to pre-pregnancy weight

Physical activity can safely be recommended to women during and after pregnancy and has not been found to have any negative impacts on breastfeeding postpartum.

Wider role and benefits of physical activity

In addition to supporting good physical and mental health and functioning, regular physical activity also contributes to a range of wider social, environmental and economic benefits for individuals, communities and wider society. Addressing physical activity can also benefit a broad range of wider priorities at a local level, such as reducing air pollution and increasing social cohesion.

Wider benefits come primarily from physical activities undertaken in a community setting such as walking, cycling, active recreation, sport and play. They include:

improved learning and attainment

increasing productivity in the workplace

managing stress

self-efficacy

improved sleep

the development of social skills

better social interaction

The relevance and importance of these benefits vary according to life stage and other factors.

Social prescribing enables individuals presenting through primary health care to be signposted and connected to local organisations, groups and activities. There are social prescribing schemes that focus on physical activity and staff with knowledge of the resources available in the local community match individuals to opportunities and support them to engage in activities. In some social prescribing schemes, health trainers and health champions signpost and support clients to become involved in community activities.

Social and community development

Sport England's Sport Outcomes Evidence Review sets out how sport and physical activity can contribute to the government's Sporting Future strategy outcomes. One of the outcomes is social and community development, which is described as being about "helping to build stronger communities by bringing people together, often from different backgrounds, to make them feel better about where they live, improve community links and cohesion, and build social capital."

The evidence review found that sport and physical activity can lead to social and community development through:

It is of increasing importance to take a whole systems approach to addressing public health challenges, including physical inactivity and obesity. Local government plays an important leadership role in bringing together statutory, voluntary and private sectors and engaging their populations to build confident and connected communities as part of efforts to improve health and reduce health inequalities.

Community-centred approaches seek to mobilise the assets within communities, increase people's control over their health and promote equity. There is a diverse range of practice, evidence-based approaches that can be used by local leaders, commissioners and service providers to work with communities.

PHE has developed a guide that outlines evidence-based community-centred approaches to health and wellbeing and this previous edition of Health Matters details a whole systems approach to obesity and PHE 's professional guide to support local approaches to promoting a healthy weight.

Wider economic benefits

In terms of wider economic benefits, physical activity can lead to cost savings for the health and social care system. This is because in some cases, long term conditions can lead to greater dependency on home, residential and ultimately nursing care. However, physical activity supports greater independence and reduced requirement of support, including these statutory services, therefore leading to financial cost savings.

The benefits of active travel

PHE conducted an evidence review - intended for health and social care policy makers, decision makers and commissioners - which looks at the impact of walking and/or cycling on different health outcomes. The review found that walking and cycling benefit health in a number of ways, including:

Active travel also reduces road congestion and air pollution, which provides both environmental benefits and greater health benefits for the general population.

PHE has an active travel briefing for local authorities - including transport planners and public health practitioners - which sets out a range of actions from overall policy to practical implementation.

The scale of physical inactivity

In England:

1 in 3 (34%) men are not active enough for good health

almost 1 in 2 (42%) women are not active enough for good health

1 in 5 (21%) men are classed as physically inactive

1 in 4 (25%) women are classed as physically inactive

44% of disabled adults are physically inactive

only 34% of men and 24% of women undertake muscle-strengthening activities at least twice a week

'Not active enough for good health' means not achieving the CMOs ' guideline of 150 minutes of moderate intensity physical activity per week.

'Physically inactive' is defined as doing less than 30 minutes of moderate intensity physical activity per week.

Insufficient physical activity is associated with:

This is not a new issue. Over the last few decades, trends such as increased car ownership and use, reduced manual element of jobs, and increased home-based entertainment has designed physical activity out of people's lives. This has made us the first generation that needs to make a proactive choice to be physically active.

According to the World Health Organisation ( WHO), physical inactivity is in the top 5 non-communicable disease ( NCD) risk factors for mortality in high income countries. The WHO Global Non-Communicable Disease Action Plan 2013 to 2020 sets targets for improvements in the prevalence of NCD risk factors, including physical inactivity. The Richmond Group of Charities commissioned the BHF Centre on Population Approaches for Non-Communicable Disease Prevention to run a research project, which translates these WHO targets into a UK health context.

This was conducted in a 2-stage process: a modelling project to estimate the NCD burden in England between 2010 and 2025 if the WHO 25 by 25 targets are met, and a policy review of the potential prevention-based population-level interventions that are available, including those for reducing physical inactivity.

Read the UK PROMISE study to find out more about the potential of these interventions.

Physical activity and health inequalities

There are inequalities in physical activity across socioeconomic status and the protected characteristics, including:

These compound or exacerbate other inequalities and lead to physical inactivity being more prevalent in certain groups.

Data on local inequalities in physical activity are available from the PHE physical activity data tool.

Inactive people from economically disadvantaged backgrounds are also more likely to undertake unhealthy behaviours such as smoking, alcohol consumption, and have a poor diet.

A rapid review of the evidence base on physical activity for general health benefits for disabled adults found that no evidence exists that suggests appropriate physical activity is a risk. It also found analogous health benefits for disabled people of engaging in physical activity as for the rest of the adult population.

The UK CMOs ' guidelines say that for both adults with and without disabilities, the risk of adverse events from physical activity is relatively low and the health benefits accrued outweigh the risks.

For people with mental health conditions, inequalities in physical activity is associated with inequalities in physical health. Amongst people with severe mental disorders, there is a high prevalence of low physical activity and 12 hours on average is spent on sedentary activities everyday. This can, in part, lead to crucial physical health disparities and premature mortality, reducing their life span by 10 to 20 years.

The World Health Organisation ( WHO) has guidelines that provide evidence-based recommendations to practitioners on how to recognise and manage physical health conditions in adults with severe mental disorders.

Everybody active, every day

Everybody active, every day is the national physical activity framework co-produced with over 1,000 local and national stakeholders, for national and local action to address the physical inactivity epidemic. It is based on international evidence of 'what works' to increase population activity.

The framework sets out that if we want everyone to be active every day, physical activity needs to be made easy, fun and affordable. Physcial activity and active recreation must be available to all, in every community across England.

Creating this vision requires actions across 4 domains at both a national and local level:

1. Active society: creating a social movement

2. Moving professionals: activating networks of expertise

3. Active environments: creating the right spaces

4. Moving at scale: interventions that make us active

These 4 domains of action are supported by the WHO Global Action Plan on Physical Activity 2018 to 2030.

Everybody active, every day: 2 years on reviewed the progress of these 4 domains of action 2 years on from the framework's implementation. This ICF report published in 2018 also review the implementation of the framework at a national and local level. A '5 years on' review will be published in early 2020.

The barriers to physical activity for those with long-term conditions

Insight work has found that 61% of people with long-term conditions and 68% of people with multimorbidities are not content with their physical activity levels and wish to be more active.

The Richmond Group of Charities' Sport and Physical Activity project identified a need for insight into physical activity and long-term conditions. It commissioned research with individuals with long-term conditions and people close to these individuals, to understand the barriers that prevent those with long-term conditions from engaging in physical activity, as well as other factors.

The research found that people with long-term conditions experience both internal and external barriers to exercise. Internal barriers come from within those with long-term conditions themselves, and external barriers are factors external to those with long-term conditions, which make it harder for them to exercise. The latter are often practical or logistical.

Internal barriers are perceived to be greater than external barriers and include:

pain before, during or after physical activity

feeling tired before, during or after physical activity

breathlessness before, during or after physical activity

lack of motivation

not knowing what types of activity are right for them or their condition

fear of hurting themselves

feeling embarrassed

feeling unsafe in public spaces

Within this, there is agreement that barriers arising from the symptoms of long-term conditions are greatest, such as pain, feeling tired and breathlessness.

Both exercise and physical activity are seen as "not for people like me" amongst inactive participants with multiple long-term conditions. However, the research found that the majority of people with a long-term health condition want to be active.

Almost all qualitative participants from this research found it much easier to cite barriers to physical activity than benefits. The benefits cited most commonly were psychological, including increased self-esteem and confidence, and improved mood and motivation. Social benefits are also important for many, such as getting out of the house and seeing people, which was seen to support the psychological benefits.

Physical activity resources, programmes and campaigns for the public

OneYou resources: Active 10 and Couch to 5K

PHE and the NHS' OneYou resource exists to help the public make small changes that fit their life, so that they feel better and healthier everyday. As part of OneYou, Active 10 and Couch to 5K are resources that support the important physical activity message that 'some is good, more is better' and that you can start small and build your activity up. A rapid evidence review found that a reduced level of health benefits can be achieved through activity at less than the optimum 150 minutes, with some benefits shown even at levels of 10 minutes or more of at least moderate intensity activity per day.

Active 10 is a free walking tracker app that can be used to monitor brisk walking, set daily goals, and find out how to increase physical activity. It has been downloaded over 800,000 times and since its launch it has remained popular with a rating of 4.3 and 3.3 out of 5 on the iOS and Google Play App stores, respectively.

Brisk walking is a moderate intensity physical activity and evidence-based intervention for promoting physical activity. For currently inactive individuals, evidence shows the following health benefits could be achieved from 10 minutes of brisk walking per day for 7 days:

increased physical fitness

greater ease of performance of everyday physical activities

improved mood

improved quality of life

increased body leanness and healthier weight

15% reduction in risk of early death

The Couch to 5K app guides people through a 9-week programme by encouraging them to run 3 times a week. The app was designed to support people who have never run before, regardless of age.

It helps people to increase the distance they run incrementally, so that by the time they arrive at week 9 they are encouraged to run for half an hour, which is approximately 5K. Over 3 million people have downloaded the app, and its rating on the app store continues to stay high at 4.5 out of 5.

NHS Health Check

The NHS Health Check is a health check-up for adults aged 40 to 74 in England, which plays an important role in the prevention and early detection of CVD. According to the WHO, CVD is the leading cause of death globally, but an estimated 50% to 80% are preventable as they are caused by modifiable risk factors. One of these risk factors is low physical activity (less than 150 minutes of moderate intensity physical activity).

Everyone having an NHS Health Check should receive tailored lifestyle advice and access to local services, including physical activity services and the NHS Diabetes Prevention Programme ( NHS DPP).

NHS Diabetes Prevention Programme

Type 2 diabetes is a major cause of premature mortality, with around 22,000 people with diabetes dying early each year in England. Being overweight and obesity, driven by the obesogenic environment and physical inactivity, are significant risk factors in the development of type 2 diabetes.

The NHS DPP is a joint commitment from PHE, NHS England and Diabetes UK. The programme provides evidence-based behavioural interventions at scale for individuals identified - for some through the NHS Health Check - as being at high risk of developing type 2 diabetes.

One of the 3 core goals that underpins the NHS DPP behavioural intervention is achievement of the CMOs ' physical activity recommendations. This may be through recommending the use of apps such as Active 10 and Couch to 5K to start adding small amounts of physical activity into your life.

We Are Undefeatable campaign

The We Are Undefeatable campaign - led by a collaboration of 15 leading health and social care charities and supported by PHE and Sport England - is designed to inspire and motivate people living with long-term conditions to get active in a way that's right for them.

It is designed with the perspective and lived experience of people with health conditions, and provides an opportunity to stimulate positive discussion and action, and identify and address barriers to engaging this audience.

The main audience for the campaign is:

The campaign drives sustainable attitude and behaviour changes, therefore addressing some of the factors that people with long-term conditions identify as barriers to physical activity.

Physical activity initiatives and training for healthcare professionals

More than 1 in 10 people visit their GP every 2 weeks and there are 1.2 million health-related visits to a community pharmacy every year. In most cases, those who are regularly engaging with healthcare professionals have, or are at risk of, developing health conditions and are more likely to be inactive. In addition, 1 in 4 people would be more active if advised by a healthcare professional, so healthcare professionals play a unique role in supporting people to be more physically active.

However, a 2017 survey of 1,000 GPs found that:

80% of GPs in England are unfamiliar with the national physical activity guidelines

less than half (44%) are confident in raising physical activity with patients

over half (55%) had done no specific training on physical activity

A 2017 survey of 552 physiotherapists found that:

This is, in part, due to a system issue around providing adequate training for healthcare professionals on the guidelines and physical activity for people newly diagnosed with a long-term condition or in treatment.

Healthcare professionals may also feel that they cannot speak to patients about physical activity when they are seeing them about certain symptoms they are experiencing due to their long-term condition, such as fatigue and pain. They may also face time difficulties with regards to fitting a conversation about physical activity into a 10-minute appointment.

Moving Healthcare Professionals Programme

The Moving Healthcare Professionals Programme ( MHPP) is a national partnership programme led by Sport England and PHE. It is a whole-system educational approach to embed prevention and physical activity promotion into clinical practice, helping to address the barrier of healthcare professionals not speaking to their patients about the benefits of physical activity due to either lack of knowledge, skills or confidence.

The programme provides peer-led training and is developing practical resources to support healthcare professionals implement the NICE guidance on physical activity, and guidance for treatment of a breadth of conditions that recommend physical activity.

There are multiple strands to the programme:

training existing healthcare professionals

development of resources, such as Moving Medicine (outlined below)

upskilling the next generation

testing innovative ideas

Further information on each of these strands can be found on Sport England's website.

Upskilling NHS workforces through the MHPP provides the opportunity to:

address a recognised knowledge and skills gap across healthcare professionals and their capability to implement physical activity guidelines

provide the workforce with access to evidence-based training and resources proven to increase their knowledge and confidence, and support their practice

improve management of patients with over 30 long-term conditions that physical activity is known to improve

help reduce service demand and costs to the NHS

Recognised by the WHO as good practice, a second, 3-year programme was launched in the government's prevention green paper. It will continue to provide free, evidence-based training and resources to healthcare professionals across their careers.

Moving Medicine

Moving Medicine is an initiative led by the Faculty of Sport and Exercise Medicine UK, in partnership with PHE and Sport England. It is a digital toolkit for clinicians and allied health professionals that is part of the Moving Healthcare Professionals programme, and has been developed in collaboration with experts, professional bodies and charities representing patients and healthcare professionals in each disease area.

The toolkit provides accessible, evidence-based and condition-specific information to help give advice on physical activity at all stages of a patient's treatment pathway for 10 common conditions:

The toolkit provides what is needed for a 1 minute, 5 minute and longer conversation, complete with step-by-step guides, behavioural change insights, and all the evidence to back it up. This helps to alleviate the barrier of time constraints that healthcare professionals face when speaking to their patients, allowing them to incorporate physical activity into their conversation.

Through the work of the Moving Healthcare Professionals programme and others, we are seeing changes in the awareness and knowledge of healthcare professionals. We are seeing them becoming empowered to embed physical activity into the care of disabled people and people with long-term health conditions, to improve their health and quality of life.

Physical Activity Clinical Champions training

PHE and Sport England's Physical Activity Clinical Champions training involves a national network of 50 healthcare professionals providing a free, peer-to-peer, standardised training package to over 22,000 other healthcare professionals. Clinical champions are paid on a sessional basis to provide the training, which PHE has peer-reviewed, sponsored and updated to match the new CMO guidelines.

An independent evaluation has showed that this training:

E-learning courses

There are several other digital resources that PHE, in collaboration with partners, has developed to support healthcare professionals in championing the benefits of physical activity with their patients.

PHE, Health Education England and Sport England have developed a physical activity and health e-learning course, which is hosted on the e-Learning for Healthcare hub. The course will familiarise the learner with:

the UK CMOs' physical activity guidelines

the underpinning evidence base

how to incorporate the guidelines into their daily clinical care

PHE's All Our Health e-learning session on physical activity gives health and care professionals an overview of the topic and provides evidence, data and resources to help professionals in embedding physical activity into daily life. This supports system-wide priorities on prevention, including those within the NHS Long Term Plan and prevention green paper.

Royal College of General Practitioners 3-year priority

PHE is working with the Royal College of General Practitioners ( RCGP) on their 3-year priority on physical activity. This includes their Physical Activity and Lifestyle Toolkit and Active Practice Charter, both developed in partnership with Sport England. The toolkit can be downloaded to help healthcare professionals embed physical activity within the conversations they're having with patients. The charter inspires and celebrates GP practices that are taking steps to increase activity in their patients and staff, and aims to support around 8,000 GP practices in the UK.

More resources and condition-specific resources for healthcare professionals can be found on the RCGP website.

The RCGP and parkrun UK also launched the parkrun practice initiative in June 2018, which asks GPs to affiliate themselves with their local parkrun and become parkrun practices. Involvement in this initiative will help practices:

More than 16% of GP practices in the UK have registered to become a parkrun practice to date.

Call to action

The role for healthcare professionals

As discussed above, healthcare professionals play a unique role in supporting people living with, or at risk of developing, long-term health conditions to get more physically active.

With this in mind, healthcare professionals should:

They can have an impact on the individual level by:

providing high-quality brief interventions for physical activity behaviour changes

being familiar with the important messages

being familiar with local physical activity options

becoming a physical activity role model

Caroline Abrahams - Charity Director at Age UK Full Interview
Healthcare professionals also play an important role in using the NHS Health Check as an opportunity to assess physical activity levels using the general practice physical activity questionnaire ( GPPAQ). They can subsequently provide brief advice or behaviour change support.

Social prescribing is another important area that GPs and other healthcare professionals should focus on, referring people to 'activities' or services in their community instead of offering only medical solutions.

The NHS Long Term Plan sets out that through social prescribing, the range of support available to people will widen, diversify and become accessible across the country. Over 1,000 social prescribing link workers will be in place by 2020 to 2021, so that over 900,000 people can benefit from social prescribing by 2023 to 2024. This is reiterated in the prevention green paper.

The role for local authorities

Local authorities are the main investors in physical activity in local areas, and should adopt a whole systems approach to ensure that physical activity is embedded across their relevant functions.

A local whole systems approach enables local stakeholders, including communities, to come together, share an understanding of the reality of the challenge, consider how the local system is operating and where there are the greatest opportunities for change. Stakeholders agree actions and decide as a network how to work together in an integrated way to bring about sustainable, long term systems change.

However, leading on taking a whole systems approach to physical activity is just one part of local authorities' role, as they also have a wider role to play in:

Building on this work, PHE is working with Sport England to support their Local Delivery Pilots.

Local authorities should work with multiple organisations and groups, for example:

The role for NHS organisations

NHS organisations have an important role to play in the management and prevention of long-term conditions in adults through physical activity. Their role involves:

identifying a senior lead for physical activity in line with NICE guidance

sharing and encouraging training leads to include Clinical Champions training sessions within the staff training sessions

promoting the use of the e-learning and Moving Medicine resources

creating a culture that promotes physical activity, including supporting national and local campaigns such as One You, We Are Undefeatable and parkrun practices

creating links with local physical activity providers (for example, local Active Partnership, Walking for Health)

# data[].attributes.attachment_link.title
Health matters: physical activity - prevention and management of long-term conditions

# data[].attributes.attachment_link.description
This edition of Health Matters focuses on the benefit of physical activity for the prevention and management of long-term conditions in adults. The government's prevention green paper highlights that becoming more active is good for our mental and physical health, and reduces our risk of developing a number of health conditions.

# data[].attributes.headline
About Down's Syndrome : Let’s Talk about Relationships and Sex training resource

# data[].attributes.subject
About Down's Syndrome : Let’s Talk about Relationships and Sex training resource

# data[].attributes.body
Down's Syndrome Association

# data[].attributes.attachment_link.title
Let's Talk about Relationships and Sex training resource

# data[].attributes.attachment_link.description
Whilst most people with Down's syndrome will have had access to some form of relationship and sex education (RSE) at school, the timescales of these do not usually allow for the repetition, reinforcement and depth of teaching needed for people to fully understand some of the complex issues...

# data[].attributes.headline
Beyond Words Easy Read Free download booklets 

# data[].attributes.subject
Beyond Words Easy Read Free download booklets 

# data[].attributes.body
Cancer screening, medical conditions, and Criminal Justice information

# data[].attributes.attachment_link.description
Publisher of books, the BW Story App and provider of training. Beyond Words create resources for people with learning disabilities and supporters, family and professionals.

# data[].attributes.body
We are making Brighton and Hove even friendlier by creating opportunities to talk to new people

# data[].attributes.attachment_link.readable_text
We are making Brighton and Hove even friendlier by creating opportunities to talk to new people. So far over forty fantastic cafes including some incredible independents alongside some great chains have signed up to our movement. Not only that, we have been working with Brighton Buses who have put a Table Talk table on all 30 of their all singing, all dancing electric buses.

The idea is simple: cafes have a table, marked with a TABLE TALK BRIGHTON stand, where you can sit if you are happy to talk to other customers. It's for everyone - come on your own, with friends, with children or carers.

Together, we are helping to make Brighton and Hove the UK's first Talking City.

Enjoy sharing a Table Talk table - make a difference to yourself and others.

Take time to talk - even a few words can make a difference to your day.

Let's connect our community!

Maybe you'd like to meet and talk with more people?

Or take a break from your phone or laptop?

We know your confidence will grow each time you talk to a new person, so before you know it, it will become the norm!

# data[].attributes.attachment_link.title
Table Talk Brighton - Where Everyone is Welcome

# data[].attributes.attachment_link.description
We are making Brighton and Hove even friendlier by creating opportunities to talk to new people. So far over forty fantastic cafes including some incredible independents alongside some great chains have signed up to our movement. Not only that, we have been working with Brighton Buses who have put a Table Talk table on all 30 of their all singing, all dancing electric buses.

# data[].attributes.headline
Protecting adults at risk Keeping Safe Easy Read Guides

# data[].attributes.subject
Protecting adults at risk Keeping Safe Easy Read Guides

# data[].attributes.body
North Yorkshire Safeguarding Adults Board

# data[].attributes.attachment_link.readable_text
Protecting adults at risk
Keeping Safe Easy Read Guides
It is important that everyone has the information they need to be safe and feel safe. It is also a legal requirement under the Accessible Information Standard that people with a disability have information they can understand.

That is why the Safeguarding Adults Board worked with the North Yorkshire Learning Disability Partnership Board and Inclusion North to write some easy read books about 'Keeping Safe'.

Self-advocates with a learning disability helped us think about the important issues people need to know to stay safe. Working with Inclusion North and KeyRing, self-advocates decided on the best words and images to help people understand what to do.

Together we have made three Keeping Safe books:

The books are full of useful information for anyone interested in learning more about keeping safe and the work of the North Yorkshire Safeguarding Adults Board. All the books are available for free. Print out a copy for yourself or to read with someone you know.

To download an Easy Read flyer about the books to share with people or put on your workplace wall, click here

Thank you to everyone who helped us make this book, especially self-advocates from the North Yorkshire Learning Disability Partnership Board, Rebecca Cole from Inclusion North and KeyRing Support Services.

# data[].attributes.attachment_link.description
Keeping Safe Easy Read Guides It is important that everyone has the information they need to be safe and feel safe. It is also a legal requirement under the Accessible Information Standard that people with a disability have information they can understand.

# data[].attributes.headline
POSITIVE BEHAVIOURAL SUPPORT AN INFORMATION PACK FOR FAMILY CARERS

# data[].attributes.subject
POSITIVE BEHAVIOURAL SUPPORT AN INFORMATION PACK FOR FAMILY CARERS

# data[].attributes.body
PBS Academy & CBF, 2019

# data[].attributes.body
Mindfulness for life, Mindfulness people with learning disability and or autism.

# data[].attributes.attachment_link.readable_text
Mindfulness for Life is a programme designed to bring mindfulness to people with learning disability and or autism. This programme has been developed by Skills for People in partnership with people who have living experience of learning disability and/or autism and experts in mindfulness.

What is Mindfulness?

Noticing what is happening right now

Paying attention

Being aware of what's going on inside and around us

Trying not to live in our heads

Not judging ourselves and other unkindly

Why Mindfulness?

Mindfulness is known to help people cope with anxiety, stress, unhappiness or exhaustion.

Often we do not notice the good things that happen in our lives that can make us feel happy, Mindfulness can help change that!

Our Mindfulness for Life programme includes a course for people with learning disabilities or autism to learn how to use mindfulness.

We also support a weekly practice group which helps people to keep going strong with mindfulness.

The impact on people's lives has gone way beyond what we had hoped. Our practice group members are now champions for the benefits that mindfulness can bring to us all.

Working with Your Voice Counts, Sunderland People First, Cumbria Independent Advocacy and many other local organisations, we have rolled out our programme across the NE and Cumbria to bring Mindfulness for Life to more people.

People who have attended our courses can now access at our Mindfulness for Life Hub and resources, to support them to keep practising mindfulness in their daily lives.

Who to Contact

To find out more, contact Kathy Steele and Gail Wright:

Tel: 0191 281 8737 0r email: information@skillsforpeople.org.uk

Thank you to our supporters

# data[].attributes.attachment_link.description
Mindfulness for Life is a programme designed to bring mindfulness to people with learning disability and or autism. This programme has been developed by Skills for People in partnership with people who have living experience of learning disability and/or autism and experts in mindfulness.

# data[].attributes.headline
Getting extra support from your energy supplier

# data[].attributes.subject
Getting extra support from your energy supplier

# data[].attributes.body
Citizens Advice

# data[].attributes.attachment_link.readable_text
If you find it hard to deal with your energy supply you could get extra help from your energy companies - for example, large print bills or more support during a power cut.

To get extra help, you can apply to be added to your electricity network priority services register. Your electricity network is the company that manages your electricity cables.

Your electricity network will give your details to your energy supplier so they can add you to their priority services register as well.

Check if you're eligible

You'll normally be able to get priority services if your energy companies class you as 'vulnerable'.

You could be classed as vulnerable if you:

are disabled or have a long-term health condition

are recovering from an injury

have mental health problems

don't speak or read English well

have children under 5 or are pregnant

have reached your State Pension age

If your situation isn't listed, you might still be able to sign up for priority services for other reasons - for example, if you're recently bereaved or you've returned to living independently after some time in residential care.

After you've applied

Your energy companies might contact you to ask extra questions about what help you need.

It's worth calling them if you don't hear anything within 2 weeks - you can find their phone numbers on their websites.

Ask them:

if you're on their priority services register

what support they can offer you - give as much detail as you can about your needs

If you move home

Your new home might be covered by a different electricity network. This means you'll need to apply for priority services again.

# data[].attributes.attachment_link.title
Getting extra support from your energy supplier

# data[].attributes.attachment_link.description
If you find it hard to deal with your energy supply you could get extra help from your energy companies - for example, large print bills or more support during a power cut. To get extra help, you can apply to be added to your electricity network priority services register.

# data[].attributes.body
You could get £140 off your electricity bill for winter 2019 to 2020 under the Warm Home Discount Scheme.

# data[].attributes.attachment_link.readable_text
Skip to main content

Cookies on GOV.UK

We use some essential cookies to make this website work.

We'd like to set additional cookies to understand how you use GOV.UK, remember your settings and improve government services.

We also use cookies set by other sites to help us deliver content from their services.

You have accepted additional cookies. You can change your cookie settings at any time.

You have rejected additional cookies. You can change your cookie settings at any time.

Accept additional cookies Reject additional cookies View cookies

You could get £150 off your electricity bill for winter 2023 to 2024 under the Warm Home Discount Scheme.

The money is not paid to you - it's a one-off discount applied to your electricity bill between early October 2023 and 31 March 2024.

You'll usually get the discount automatically if you're eligible. You only need to apply if you're on a low income in Scotland - contact your energy supplier to apply.

If you might be eligible, you'll get a letter by early January 2024.

If you do not get a letter and you think you're eligible, you must contact the Warm Home Discount Scheme before 29 February 2024.

You may be able to get the discount on your gas bill instead if your supplier provides you with both gas and electricity and you're eligible. Contact your supplier to find out.

The discount will not affect your Cold Weather Payment or Winter Fuel Payment.

Eligibility

There are different ways to qualify for the Warm Home Discount Scheme depending on where you live.

If you live in England and Wales

You qualify if you either:

If you live in Scotland

You qualify if you either:

Pre-pay or pay-as-you-go meters

You can still qualify for the discount if you use a pre-pay or pay-as-you-go electricity meter.

Your electricity supplier can tell you how you'll get the discount if you're eligible, for example a voucher you can use to top up your meter.

Park (mobile) homes

You apply a different way if you live in a park home.

Apply for the Park Homes Warm Home Discount.

# data[].attributes.attachment_link.description
The Warm Home Discount Scheme could take £150 off your winter electricity bill - eligibility, how to get your discount, deadlines.

# data[].attributes.body
Easy read recipes For people with learning disabilities, Mencap

# data[].attributes.body
Downs Syndrome Association easy read leaflet

# data[].attributes.headline
Keep Yourself Healthy, Eating Well and Staying Fit 

# data[].attributes.subject
Keep Yourself Healthy, Eating Well and Staying Fit 

# data[].attributes.body
NHS Scotland easy read Leaflet

# data[].attributes.body
Mencap easy read leaflet

# data[].attributes.headline
Flu vaccination: easy read flu resources

# data[].attributes.subject
Flu vaccination: easy read flu resources

# data[].attributes.body
Gov.uk easy read leaflet

# data[].attributes.body
Paradigm

# data[].attributes.attachment_link.readable_text
THE REACH STANDARDS PRACTICAL GUIDE 2019

The REACH standards are a set of voluntary standards recommended by CQC (in 'Registering the Right Support' 2017) that introduce the fundamental principles of Support for LIVING.

They remain the only nationally recognised standards underpinning 'supported living'. The 9 standards are:

More information very soon! Please check back here later.

'The Reach Standards are an essential tool in helping providers to meet their responsibilities to support people to live an ordinary life. That is why we recommend that providers consider how The Reach Standards are met when developing and providing services for people with a learning disability and/or autism.'

Deborah Ivanova. Deputy Chief Inspector (London and South), Adult Social Care. Care Quality Commission

To talk this through contact hello@paradigm-uk.org or call 020 8870 8643.

# data[].attributes.attachment_link.description
The REACH standards are a set of voluntary standards recommended by CQC (in 'Registering the Right Support' 2017) that introduce the fundamental principles of Support for LIVING. They remain the only nationally recognised standards underpinning 'supported living'. The 9 standards are: More information very soon! Please check back here later.

# data[].attributes.body
Easyread Leaflet, MacIntyre 2019

# data[].attributes.headline
Learning disabilities: making reasonable adjustments in hospital

# data[].attributes.subject
Learning disabilities: making reasonable adjustments in hospital

# data[].attributes.body
Nursing Times [online] October 2019

# data[].attributes.body
Open Future Learning, Video and training

# data[].attributes.body
NHS tool for making feedback, concerns and complaints about education, health and social care

# data[].attributes.attachment_link.readable_text
Improving experiences and outcomes for children and adults who are autistic or have a learning disability, their families and carers
Ask Listen Do resources are designed to:

support organisations to listen, learn from and improve the experiences of children and adults who are autistic or have a learning disability, their families and carers

make it easier for people, families and paid carers to give feedback, raise concerns and complain.

What people told us

Ask Listen Do came from the poor experiences people reported when giving feedback, raising concerns and making complaints. We ran a survey in which nearly 1,300 people took part. Some of the main results from this survey were:

Nine out of 10 people said they had wanted to raise a concern or make a complaint at some time.

Two out of three people said they sometimes or never knew how to do this.

Seven out of 10people said that they did not feel that their complaint(s) had changed the way the organisation supports people as a result.

We also carried out events across England where we asked people for their ideas about what needs to change and advice they could share with others.

Find out more about what people said about feedback, concerns and complaints. See the principles of Ask Listen Do below.

Why it matters

The NHS constitution and values are grounded in equality and human rights laws which say everyone has the right to good quality services, person-centred care and support. Children and adults who have a learning disability or are autistic often have more health inequalities than other groups, which are unfair, sometimes life-shortening, differences that could be avoided.

History shows that people with a learning disability and autistic people can be at increased risk of harm through institutional abuse or neglect, giving organisations an absolute duty to encourage the reporting of, and response to, concerns.

Ask Listen Do means doing things differently so people who have a learning disability or are autistic get their right to high quality, safe care and equal access to services. This is about ensuring people, their families and staff are truly listened to and have their concerns acted on.

As well as being embedded in policies from the NHS England Learning Disability and Autism programme, Ask Listen Do is part of the NHS Standard Contract 2023/24.

This is a service development improvement plan (SDIP) for all providers who offer services to people with a learning disability, autism or both (including children and young people) to set out how the provider will use the Ask Listen Do resources and embed the practice into how the provider supports people with a learning disability, autism, or both, and their families and carers, to provide feedback on services and to raise a concern or complaint.

Ask Listen Do resources for people and families

Ask Listen Do resources for organisations

To raise a concern or complain:

Always raise any concerns first with the people providing the care, such as the manager of the service, and/or the Patient Advice and Liaison Service (PALS) for hospital care. Services want to improve and should make everyone feel it's OK to raise a concern. Do say if you think somebody is not safe.

Or you can speak to the commissioner or case manager who organised the NHS care being provided. NHS England or your local integrated care board (ICB) (see below) should be able to help if you are unsure who the commissioner is. If you or someone you know is unhappy with the way your concern is handled, you can complain.

Integrated care boards commission primary care services including GPs, dentists, opticians or pharmacists.

NHS England commission prison, military and some other specialised health services.

Find out about concerns and complaints to NHS England or contact your ICB for concerns or complaints about primary care, secondary care, such as hospital care, mental health services, out-of-hours services, NHS 111 and community services like district nursing. Every ICB will have its own complaints procedure, which is often displayed on its website.

Find your local ICB.

The NHS website has more advice about how to complain and who to contact. The Ask Listen Do booklets also help with each stage from feedback, to concern or complaint.

Finding an advocate

If someone needs help to complain, they can ask for an advocate. An NHS complaints advocate is independent of the NHS and may help with writing a letter, going to a meeting, or explaining what options are available. This service is free to anyone making a complaint about their NHS treatment or care. It should also cover NHS funded care in independent hospitals or services (you may already have an advocate in a mental health hospital).

Local Healthwatch can help you find independent NHS complaints advocacy services in your area. Or contact social services at your local council and ask about advocacy services.

Find your local social services.

If you have a concern about the care of a person with a learning disability or autism that no one else can answer, please email: england.asklistendo@nhs.net

Ask Listen Do principles

The organisation asks people about their experiences and makes it easy for people to do this by making the reasonable adjustments needed.

The organisation really listens to what has been said and is not defensive.

The organisation does something positive about it in good time and tells the person what they are doing to put it right, in a clear way that is right for the person.

The organisation makes sure that the person, their family and advocate know how to give feedback, raise a concern and make a complaint.

The organisation and staff have the skills to listen and understand what it feels like for the person.

The organisation learns from the feedback, concern or complaint and changes things so the service can improve.

And that people feel able to speak up when they have feedback, a concern or complaint.

The organisation improves its services by working with the people that use them, listening to and learning from people's experiences.

Everyone knows when a concern or complaint is a safeguarding or a criminal issue, and what must happen.

Related information and resources

The Care Quality Commission cannot help with individual concerns or complaints, but they welcome people's feedback to help them see how well a service is doing. Visit Declare Your Care to leave good or bad feedback about a service.

If someone's care is unsafe, it might be a safeguarding concern. The NHS Safeguarding app is a resource for healthcare professionals, carers and citizens. It provides information, guidance and help with reporting a safeguarding concern. It can be accessed via Apple iOS, Google Playor by visiting your device's appropriate app store and searching for 'NHS Safeguarding'.

NHS England has published a co-production resource toolkit to support involving people and families in service design.

Disability Matters is a free e-learning resource for the UK workforce.

Keeping in Touch with Home is a resource about keeping children with a learning disability in residential settings and their families in touch.

The NHS Patient Safety Strategy sets out how the NHS will support staff and providers to share safety insight and empower patients and staff to be part of improving safety.

NHS England has published guidance for NHS workers on freedom to speak up to build a more open culture, learning and improvement, safer care and treatment and improved patient experience.

See the NHS Long Term Plan for wider NHS work to address health inequalities.

Blogs

# data[].attributes.attachment_link.title
Ask Listen Do - feedback, concerns and complaints

# data[].attributes.attachment_link.description
Improving experiences and outcomes for children and adults who are autistic or have a learning disability, their families and carers Ask Listen Do resources are designed to: support organisations to listen, learn from and improve the experiences of children and adults who are autistic or have a learning disability, their families and carers make it easier for people, families and paid carers to give feedback, raise concerns and complain.

# data[].attributes.body
Remap custom-makes equipment to help disabled people live more independent lives service

# data[].attributes.attachment_link.title
Remap - custom made equipment for disabled people

# data[].attributes.attachment_link.description
Remap is a UK charity with skilled volunteers who custom make equipment for disabled people, helping them achieve independence and a better quality of life.

# data[].attributes.body
App and factsheets on healthy living for people with Down's syndrome

# data[].attributes.attachment_link.readable_text
Being healthy and active is important for everyone, but it is especially important for people with Down's syndrome who can be more susceptible to weight-related conditions such as Type 2 diabetes and obesity. Research has found that of those involved in DSActive sessions, 27% have lost weight, 68% have improved their fitness, 71% have grown in confidence, 78% have improved their physical ability and 91% have improved their social skills.

Being active is an important part of being healthy, but what you eat is just as important. The DSActive team have been working with a leading nutritionist to develop new resources to help support people with Down's syndrome to make good choices about their nutrition.

Below are two factsheets, one for parents and carers, and one for people with Down's syndrome. The first one gives information on why eating a healthy diet is important, as well as offering practical tips on how to help improve someone's diet. The second provides information on food in an accessible format for people with Down's syndrome. They can be downloaded by clicking on the images below:

The DSActive team are working with an app development company to produce a unique app specifically for people with Down's syndrome. The app is possible thanks to a grant from the Department for Digital, Culture, Media and Sport, with the grant being managed by Citizens Online.

The app will be specifically designed to suit the needs of people with Down's syndrome and the main aim is to allow improvement in the digital skills of its users. The app will also support the users to make positive choices about their nutrition and lifestyle, it will include a food tracker, an activity tracker and information and resources on making positive nutrition and lifestyle choices.

We've grown our team with a new Project Delivery Officer Guy who's got years of experience of leading and managing digital projects. Guy has recruited a team of wonderfully helpful people with Down's syndrome who form our App testing group. Thanks to Will, Pippa, Dan, Becksy and Anna for all your continued help.

The DSActive team have also had a wonderfully positive response from our members with over two hundred people offering help and completing our carer survey.

We have designed the App around the needs of its users, please watch highlights of our early research interviews (video). We are now busy working through design sprints and prototype testing. Keep an eye on our social media for updates on progress.

Download for FREE from the App Store or Google Play today:

# data[].attributes.attachment_link.description
Being healthy and active is important for everyone, but it is especially important for people with Down's syndrome who can be more susceptible to weight-related conditions such as Type 2 diabetes and obesity.

# data[].attributes.body
Choice Support, 2019

# data[].attributes.attachment_link.readable_text
Join the network

Fill out our short form
Click here
Supported Loving is a human rights-based campaign, with associated network meetings, hosted by Choice Support. The network includes people with learning disabilities and/or autism, family members, and professionals from varied disciplines and sectors including social care, the NHS, sexual health professionals, trainers and educators, academics, students and psychologists. The Supported Loving toolkit has been created in the true collaborative spirit that embodies the network. 'Members' volunteered to write a section, using their expertise to help guide others. We hope you find the toolkit useful. Authors' details are included if you want further advice.

Disclaimer
The organisations and services listed in the Supported Loving toolkit are included to assist you and are provided in good faith. Their inclusion in the Supported Loving toolkit does not imply that Supported Loving nor Choice Support endorses or supports them, nor does the absence of any other organisations or services, who are not included, imply that Supported Loving and Choice Support does not support them. Supported Loving and Choice Support cannot be held responsible for any damage or loss caused by any inaccuracy in the Supported Loving toolkit, or on linked sites/pages. Supported Loving and Choice Support cannot control and is not responsible for the privacy practices of any site to which a link is provided. It is recommended that you read the privacy policy of any site you visit, particularly if you are asked to give personal data. Every care is taken to ensure that the information listed in the Supported Loving toolkit is accurate. If you discover any information which you believe to be inaccurate, please let us know.

# data[].attributes.attachment_link.description
Join the network Fill out our short form Click here Supported Loving is a human rights-based campaign, with associated network meetings, hosted by Choice Support. The network includes people with learning disabilities and/or autism, family members, and professionals from varied disciplines and sectors including social care, the NHS, sexual health professionals, trainers and educators, academics, students and psychologists.

# data[].attributes.body
Self Advocacy Federation YouTube Video, 2018

# data[].attributes.body
Easy Read health information

# data[].attributes.attachment_link.readable_text
Our easy read newsletters tell you about what we are doing to make the NHS better for people with a learning disability, autism or both.

If you want us to post you a paper copy just let us know on engage@nhs.net

Easy Read Newsletter: Issue 10

In this issue you can find out about:

Looking after your teeth

Mindfulness - learning to settle your mind and relax

Reducing restrictive practices

Stopping people dying too soon

Social prescribing - getting help through other things rather than medicines and treatment

We would like to know what you think! You can give us feedback on the newsletter at engage@nhs.net
Read the Learning Disability newsletter Issue 10
Easy Read Newsletter: Issue 9

In this issue you can find out about:

The NHS Long Term Plan

Looking after your eyes

Summary Care Records

Learning from people's deaths

Getting medication right for children and young people

Personalised care

Getting support in the criminal justice system

NHS 11 helpline

We would like to know what you think! You can give us feedback on the newsletter at engage@nhs.net
Read the Learning Disability newsletter Issue 9
Easy Read Newsletter: Winter 2018-19

In this edition you can find out about:

Sepsis - when your body react badly to infection

Care and treatment reviews and getting ready to leave secure hospitals

Ask Listen Do, helping services to be better at listening to people

Protecting yourself from flu

Learning from deaths of people with a learning disability

We would welcome feedback on the newsletter at engage@nhs.net
Read the Winter 2018-19 Learning Disability newsletter
Easy Read Newsletter: Summer 2018

In this edition you can find out about:

Supporting young people who have problems with mental health or behaviour that challenges

Stopping over medication of people with a learning disability autism or both

Ask Listen Do, helping services to be better at listening to people

Sharing your information so that different parts of the NHS know how you like to be treated

A thank you from Ray James, the Director of Learning Disabilities at NHS England

We would welcome feedback on the newsletter at engage@nhs.net
Read the Summer 2018 Learning Disability newsletter
Easy Read Newsletter: Summer 2017

In this edition you can find out about:

Jean O'Hara who is our new national clinical director for learning disability

Care, education and treatment reviews for children and young people

How we are helping people who find it hard to swallow (sometimes called dysphagia)

What happened at our complaints, comments and feedback event

How we are helping organisations who plan services for people with a learning disability, autism or both

Our work to make sure we are learning from the deaths of people with a learning disability

Read the Summer 2017 Learning Disability newsletter
Easy Read Newsletter: Spring 2017

In this edition you can find out about:

Our new NHS England learning disability and autism advisory group

How we are making it easier to complain about NHS services

The updated care and treatment review policy

How we are helping people get the right care when they have diabetes

Our new quality checking tools

Two new videos about NHS 111 and how you can get involved in our work

Read the Spring 2017 Learning Disability newsletter
Easy Read Newsletter: Autumn 2016

In this edition you can find out about:

What Simon Stevens, Chief Executive of NHS England thinks about our learning disability programme

Our cancer and breast screening programmes

How a personal health budget can help you

Transforming Care Partnerships

Read the Autumn 2016 Learning Disability newsletter
Easy Read Newsletter: Summer 2016

In this edition you can find out about:

Medicines for people with a learning disability, autism or both

How annual health checks

Our NHS England learning disability and autism advisory group

Our transforming care programme

Read the Summer 2016 Learning Disability newsletter

# data[].attributes.attachment_link.description
Our easy read newsletters tell you about what we are doing to make the NHS better for people with a learning disability, autism or both.

# data[].attributes.body
Training resource. NCVO

# data[].attributes.attachment_link.description
Keeping people safe is important. All organisations need to do safeguarding well. Everyone needs to be involved. These resources will help you make plans and carry them out.

# data[].attributes.body
Training resource. Skills for Care. 2019

# data[].attributes.attachment_link.readable_text
Browser does not support script.

Browser does not support script.

Browser does not support script.

Browser does not support script.

Browser does not support script.

This framework sets out some good practice guidelines about what adult social care employers and their staff need to know and do to work effectively with people's families, friends and carers.
Who is the framework for and how can you use it?
It's useful for adult social care managers or those in learning and development roles, such as human resources, trainers and learning providers, in any type of social care setting, including residential care, supported living, domiciliary care and/or voluntary organisations.

You can use the guidelines in the framework as a measure of good practice. For example, you can use the framework as a checklist to help you to review and assess how your service and staff work with families, friends and carers now, and identify what you can improve.

The framework can also give you an idea about what learning and development around 'working with families' might look like, to help you to design or commission training.

It might also be useful for adult social care staff, to show them some of the ways that they can work well with families, and people who need care and support and families, to help them to understand what they can expect from the services and staff that support them.

Please note that not all the points in the framework will be relevant for all settings. You can adapt and build on the framework, and tailor it to your service, the people you support and their families, friends and carers.
Note about terminology
For ease, we've used the terms 'families' and 'family members' throughout the framework. This includes reference to people's partners and wider connections, including friends, distant relatives and carers, and shouldn't be read as people who are only formally related by birth or marriage.
Note about legislation
The framework adopts a person-centred approach. The Mental Capacity Act 2005 states that we should assume that people have the mental capacity to make their own decisions.

If someone has the mental capacity to make a decision, when it needs to be made, their choice should take precedence over anyone else's. This means that sometimes, in practice, you might need to help people to explain the decision that they've made to family members who disagree with it or do things that family members disagree with.

This framework explains some of the ways that you can manage these situations, to ensure that the individual is always at the heart of any decisions around working with families, friends and carers.

Where a person lacks the mental capacity to make a decision, you need to work in line with relevant legislation and guidance, including the Mental Capacity Act (2005) Deprivation of Liberty Safeguards (currently under review) and the Human Rights Act.

What you need to do when your service first starts working with an individual and their family

Get off to a good start by making early contact with family members, where appropriate.

Check if individuals and family members have previously said how and when they'd like to be involved, for example, in conversations with a social worker or care manager. Respect that decision and use it to start conversations, rather than repeating information.

Offer to visit or meet with family members to understand their needs, worries and issues.

Involve family members throughout the process when their relative starts to use your service. Be mindful that there may be occasions when this isn't possible, or you're asked not to.

Respect family member's knowledge of their relative, and their history. Use this information to plan effective care and support.

Agree how and when family members would prefer you to communicate with them, for example email, phone, face to face or text messaging.

Agree the frequency for communicating with family members, and under what circumstances you would otherwise contact them.

Help family members to understand the role of your service by sharing information about your service and staff with them.

Your organisational values, policies and procedures, and how they support you to work with families

Ensure that your workplace values, policies and procedures enable staff to work well with families.

Role model dignity, respect, empathy and compassion in all interactions with families.

If policies and procedures don't support a partnership approach with families, ensure staff know who to talk to about changing this.

The unique dynamics of different families and family relationships

Identify the significant people in an individual's life, and what skills and experience they can bring. Don't make assumptions about this.

Communicate with the individual and their family to find out about them.

Find out if, and how, an individual's family is involved in their care and support.

Understand and respect that individuals have different perceptions of the role of family members.

Recognise that individuals within a family will have different levels of involvement and different preferences for how this happens, and that there may be smaller family groups within a wider family.

Understand how people who need care and support want to engage with their family, and the support they need to do this

Where possible, ask the individual if, and how, they would like their family to be involved in their care and support.

Establish what areas of their life the individual would like their family to be involved in, for example:

updates about their health and wellbeing

updates about social and everyday activities

communication and decision making

healthcare appointments

planning care and support

regular visits.

Establish if there are any times or situations that the individual does not want shared with their family or particular family members.

Prepare for the individual to want different family members involved in different ways, and discuss with them how this will work in practice.

Consider how these decisions can be made if the individual doesn't have the capacity to consent.

Document this in their care plan and review it regularly.

Ensure that all staff are aware of this information.

Understand how families want to be involved in their relative's care and support, and the support they need to do this

Ask family members about what aspects of their relative's life they are already involved in, and what they'd like to be involved in.

If family members are involved in an individual's care and support, plan ways to manage any risks associated with sharing it.

Offer support to families to identify any support they need, and signpost them to accessible information and independent advice.

Identify if family members need any learning and development, to enable them to support their relative in the agreed ways (for example, new ways of understanding and communicating with their relative).

Explore if and how family members can get involved in wider aspects of your service, such as activity planning.

Review this information regularly.

When and how to provide information to families

Find an appropriate and agreed balance between the individual's right to privacy, and their choice to share information with family members.

Agree with the individual what information you will share with their family members and help them to communicate this to those family members.

Respect the rights of the individual in regards to information that they do not want to share with family members

Fully understand the Mental Capacity Act 2005 and best interests decisions as they relate to individuals and their family members.

Discuss with the individual about occasions when you might have to share personal information with a family member.

Interact with family members in a way that respects their individual experience, culture and expertise.

Explore and address your own unconscious bias when work with and support families.

Adapt your attitude and behaviours, as needed, to support families.

How to address concerns, dilemmas and conflicts that may arise when working with families

Ensure that everyone puts the individual at the focus of any conversation.

Listen carefully to individuals and family member's concerns, grievances and complaints. Ensure that they feel heard and decide, together, what actions will be taken.

Understand that what one family member sees and identifies as 'normal' may not be the same for others.

Be open to explaining how and why you're providing care and support in the way that you are, and invite family members to suggest ways that they do it.

If needed, explain the importance of choice, involvement and mental capacity assessment of the individual, to their families - they might need learning and development to aid this understanding.

Be confident in your own skills and knowledge about how and when to challenge decisions.

How to involve families when planning for the future

Understand the wishes of individuals and their family members, to plan for the future, including their needs and aspirations.

Follow your organisations policies and procedures for documenting future planning.

The organisational and legal requirements for recording information

Understand and comply with your organisation's policies and procedures around recording and sharing information, including General Data Protection Regulations (GDPR) and confidentiality policy.

Discuss confidentiality and privacy with individuals and their family members from the start.

The agreed process for reviewing how you work with families

Get feedback from families about how staff work with them and express your workplace values. Use this to shape, change and improve the quality of support.

Offer family members suggestions or comments in a way that preserves your relationship with the family.

How people who need care and support want to maintain family relationships, and how staff can support this

Review if and how people who need care and support want to maintain their family relationship(s).

Support the individual to be engaged with family members to the level and in the way that they wish to do so. If needed, suggest a range of options for them to manage relationships with different family members and support and respect their decisions.

Offer the individual support to identify and develop opportunities to engage with their family members.

Support individuals to set goals around family involvement, and document these in their care plan.

Ensure that any decisions are made in the best interest of the individual, which may not necessarily be in the best interest of the family.

Ensure that families understand the Mental Capacity Act 2005 and best interests decisions. If needed, provide training, or there are lots of online videos that explain the Act.

Ensure that staff know how to guide families with the Mental Capacity Act 2005, and provide training if needed.

Support the individual and their family members to spend time together in a way that benefits them and be aware of activities that an individual enjoys doing with their family members. Create and maintain opportunities for them to continue, and make sure that your support doesn't get in the way of these activities.

Browser does not support script.

Browser does not support script.

Browser does not support script.

Browser does not support script.

Browser does not support script.

Browser does not support script.

Browser does not support script.

# data[].attributes.attachment_link.description
The families of people who need care and support play a vital role in adult social care services. However, lots of employers have a culture that sees families as a problem and difficult to work with. This guide explains what skills and knowledge adult social care staff need to do this.

# data[].attributes.body
Information leaflet. Brook.

# data[].attributes.body
Information Leaflet. Lancaster University. 2019

# data[].attributes.headline
Promoting access to cancer screenings for people with a learning disability

# data[].attributes.subject
Promoting access to cancer screenings for people with a learning disability

# data[].attributes.body
Information Leaflet by County Durham Learning Disability Health Facilitation Team 2019