A dedicated clinic has facilitated the immunisation of nearly 70 patients with learning disabilities and/or autism, and 42 carers in just one day.
Primary Care Wirral has supported Healthier South Wirral PCN (HSW) via specialist staff and by providing a mobile clinical unit for patients who preferred to have their vaccinations at outdoors.
The service has taken place at HSW’s Covid-19 vaccination centre at The Oval Leisure Centre, which has been adapted to this vulnerable cohort via a series of reasonable adjustments.
Given the success of the initial pilot on Wednesday 17th of February, this dedicated clinic for patients with learning disabilities and/or autism will be run again on Wednesday 24th.
New dedicated clinics will be organised based on results and overall vaccination uptake within this cohort.
Tailored experience for patients with learning disabilities and/or autism
Since the announcement of the NHS Covid-19 Vaccination Service, HSW Vaccination Team, HSW Learning Disability Team and PCW have been working in the design of a dedicated immunisation strategy that guarantees the early vaccination of patients with learning disabilities and/or autism.
“In the past, it has been notoriously difficult to encourage the uptake of vaccinations within this vulnerable cohort”, said Suzanne Thomas, HSW Learning Disability Care Coordinator.
“Some patients feel uncomfortable in an clinical environment, others have needle phobia and others feel stressed when they are taken outside of their normal routine and contact people they are not familiar with or do not have a relationship with.
“We knew from the very beginning that we needed needed a tailored approach starting from the moment patients and carers were first contacted.”
You really are a superstar! ???? pic.twitter.com/n9vfFupKJE
— Primary Care Wirral Federation (@PcwFed) February 19, 2021
To achieve the goal of quickly vaccinating as many patients as possible, whilst ensuring a comfortable experience, it was decided the most effective plan was to dedicate one day to hosting a clinic exclusively inviting patients with learning disabilities and/or autism.
Pre appointment contact with patients followed a more personalised approach, with longer telephone and face-to-face conversations with patients, carers and families to discuss and manage any concerns and fears they may have.
The Learning Disability Team also dedicated a substantial amount of time getting to know patients and building a friendly relationship to increase their trust before they came into The Oval.
On site, a series of adaptations and reasonable adjustments were implemented to make the vaccination experience as friendly, comfortable and positive as possible.
This solution allowed HSW to utilise the vaccination capacity and equipment at The Oval Leisure Centre in Bebington, without needing any structural modifications.
The dedicated clinic was also aimed at helping patients become more desensitised to stressful stimulus and it is expected improve their outlook on future vaccinations and clinical experiences.
The Oval Team prepared the dedicated vaccination clinic with several adaptations and reasonable adjustments regarding staff, patient numbers, layout and care, which included:
- Ensuring the LD Team was present to support both patients and staff who were unsure of any aspect of care provision for individuals with learning disabilities and/or autism (i.e. communication, recognising challenging behaviour, making quick and efficient changes).
- Increasing appointment time slots to allow the LD and vaccination teams to have longer conversations with patients to generate positive rapport, answer questions and reassure them over any concerns they had.
- Limiting the number of staff and having fewer people coming for their vaccination to reduce feelings of crowdedness, minimise noise and create a friendlier environment.
- Adapting the original set-up by reducing the number of vaccination stations and spacing them out more than normal to guarantee comfort and privacy.
- Changing displays and documents to easy-read formats to ensure patients were fully informed before granting consent.
- Providing an alternative for patients who preferred having their vaccine in an outdoor setting by giving them the option to attend a mobile clinical unit instead.
- Allowing a more flexible experience which included giving patients chocolate and sweets, letting them bring people or objects (i.e. a doll) to make them feel safe, allowing them to explore the facilities or receive the vaccine outside the vaccination station.
In addition, patients within the autism spectrum were informed about the importance of having regular NHS Health Checks and were offered one at The Oval if they wished to do so.
Carers were also offered a Covid-19 vaccine if they had not received one yet.
Patients and staff feedback
The majority of patients providing feedback after vaccinations were very satisfied with the experience and would recommend it to others, with the service being described as “very efficient, many thanks” and “a fantastic experience.”
Stephen Hyde and Clayton Thorpe who came together to get their Covid-19 vaccine at the mobile clinical unit highlighted how they felt very brave after receiving their vaccine despite being afraid of needles.
“I am afraid of needles and now I just had the vaccine. I feel brave to have it done. Thank you”, said Stephen.
Stephen and Clayton came to @south_wirral‘s dedicated #COVID19 vaccination clinic for patients with #LearningDisabilities and #autism. They felt more comfortable having their vaccine outdoors, so they received it in our mobile clinical unit instead.
You were very brave! ???? pic.twitter.com/Z0YdJ0vzPs
— Primary Care Wirral Federation (@PcwFed) February 18, 2021
Neeraj Rangan who attended the clinic with his mother Rama, also felt “brave now” after having his vaccine and had a health check after speaking to our LD Wellbeing Practitioner, Amy Eggeling.
As Neeraj’s main care, Rama was also offered a Covid-19 vaccine.
“I came here actually for my son, for him to get his vaccine and then being his primary carer, I was offered one as well, so I am really grateful for that. Thank you”, said Rama.
“I was scared before, I am brave now I had my vaccine.”
Today, Neeraj and his mum Rama have received their #CovidVaccine at The Oval’s dedicated #COVID19 vaccination clinic for patients with #LeaningDisability and #autism.@autism_together @AutismInit @WirralMencap @WiredCeo pic.twitter.com/RvlnSpajzW
— HealthierSouthWirral (@south_wirral) February 17, 2021
The service has received very positive feedback from the vaccination team as the new setting “reduced anxieties for the patients and carers,” said Rachel Stott, Project Leader and Practice Manager at Eastham Group Practice.
“Staff found the clinic to be a real success as they felt able to give adequate time to explain the procedure in a patient friendly way, which helped them build on the trust and good rapport they already had with patients.
“By having our Learning Disability Team on site, they were able to recognise challenging behaviours and make quick and efficient adaptations, whilst communicating with patients to allow the vaccination to be completed safely”.
Support for PCNs during Covid-19
PCW has been involved in system planning and operational management of Covid-19 related services and has successfully helped local GP networks implement out-of-practice Covid-19 Additional Capacity Hubs and community testing centres.
Since 2020, HSW have expanded their support services for patients with learning disabilities, with the objective of improving health choices, overall wellbeing and helping them become more independent.
PCW has supported HSW through the recruitment, training and management of new ARRS roles specifically adapted to patients with learning disabilities and/or autism.
The current team includes a Learning Disability Care Coordinator and a Learning Disability Wellbeing Practitioner (Social Prescribing Link Worker) and it has recently been expanded with the incorporation of a new Learning Disability Trainee Nurse Associate.
This is a recruitment solution open to all local PCNs which includes other PCN roles such as Wellbeing Practitioners (Social Prescribing Link Workers), Health Coaches and Cancer Care Coordinators.
For more information on this service or other PCN support programmes, please contact PCW Health & Wellbeing Operations Manager, Lucy Holmes, on firstname.lastname@example.org.