Vulnerable Adults Mortality Panel Report

Date: Thursday, 15th Jul 2021 | Category: General

This is the Fourth Annual Report collating learning from the mortality reviews of those living with a learning disability using the learning disability death review (LeDeR) framework. Activity this year has been sustained and enhanced, using reviewers forced to work at home due to the pandemic. 41 notifications have been received and 61 case reviews have been completed, resulting an improvement in timeliness of review completion. 97% of reviews notified to Oxfordsh ire in 2020 21 were completed within the 6 monthly target set by NHS England.

The average number of notifications of deaths per month in 2019 20 was less than 4 and this has remained consistent in 2020 21. This represents a variance to the nationally reported data that has suggested an increase in deaths among the learning disability community. Locally the data h as been cross referenced to ensure no individual was missed from the review process.

Hospital admissions in 2020 21 have been a challenge for all. During the pandemic it was necessary to ensure that there were adjustments made to support those living with a learning disability requiring hospital care. The rapid reviews undertaken led to changed visiting arrangements for those requiring additional support, changes to communications with care providers and families and the development of COVID 19 passports.

Key areas identified as requiring further improvement are:

1. Annual Health Checks (AHCs) and Health Action Plans (HAPs) / Education and Health Care Plans (EHCPs) need to be more closely aligned and linked so they inform each other, both being valued by all.
2. Transition from child to adult services needs to start with earlier discussions across teams and service, including primary care . This needs to include hearing the voice of the individual, their views and choices more consistently, whilst not excluding families.
3. Anticipatory care plans, and preparing for lifestyle changes needs to be more proactively supported across the system, including end of life choices, best interest decisions, advocacy and family roles.

The full report can be accessed here: Vulnerable Adults Mortality Group Annual Report 2020-21. An easy read version will be published shortly.

The following two national reports may also be of interest:

• This annual report from the University of Bristol provides information about the deaths of people with a learning disability aged four years and over notified to the programme: NHS England » University of Bristol LeDeR annual report 2020
• This Action from learning report identifies some of the work across the NHS in the past year to address the findings from LeDeR reviews, improve care and prevent premature mortality. NHS England » LeDeR Action from Learning report 2020/21