On Tuesday 19^th November @WeLDNurses hosted a chat on the factors affecting readmission for a person with learning disabilities and autism onto a mental health unit using #WeLDNs.

We were joined by a range of healthcare professionals and student nurses who had a variety of experiences and knowledge. 

To help us understand admission statistics @chrishattoncedr compiled a graph using data from the Assuring Transformation dataset.  It showed that between Oct 18 to Sept 19 there was 2,250 admissions into AT, out of them 90 were readmitted in 30 days and 155 were readmitted within a year of leaving an inpatient unit. It is important to note however that data on readmission is limited and doesn’t highlight specific circumstances.

During the chat there was discussion on the Green light framework used in the north east that is a self-audit tool with the aim to improving the mental health support services for people with learning disability. Participants were able to educate and advise each other on various frameworks used across the rest of the UK.

Recurring themes emerging throughout the chat included readmission being due to the individual feeling safer within an inpatient unit, breakdown within placements, issues with funding and the role of the nurse.

These themes led to further discussion around the need for correct, personalised support to ensure these individuals feel safe in community, therefore potentially reducing the need for readmission. “Right place for the right person” was a phrase that cropped up surrounding breakdown of placements. Similarly, it is important to build a stable and supportive care plan ready for the individual when they are discharged into the community. This care plan should follow holistic principles and cover everything from communication needs to implementing positive behaviour support. Nurses should be establishing effective transition ensuring that new staff are educated on the individual and able to recognise possible relapse indicators so the correct support and intervention can be put in place in a timely fashion to reduce the chance of unnecessary readmission.

There were other issues highlighted that could have an impact on appropriate placements for an individual with learning disabilities. These could be funding, the reduction of budgets and management. It was also highlighted that whilst some may argue that a bespoke placement may be more expensive compared to other placements, in the long run it could be more cost effective due to the correct support being in place leading to reduction in unnecessary readmissions to mental health units. 

This chat created important discussion around such a vital topic, one that will be ongoing and evolve over time. Participants shared key messages and themes that they would take away from the chat into their practice.

A big thank you to our student intern @LiamFreeman1991 for championing this topic and helping to curate the chat. 

Florence Dowling