North Staffordshire Combined Healthcare Trust: Medication reduction in a Learning Disability inpatient service
People with learning disabilities often end up on anti-psychotic and anti-depressant medicines in an attempt to control their behaviour. This prescribing is not always based on clinical indications and can sometimes continue for years.
The trust decided to address this issue in its assessment and treatment unit through a positive behaviour support framework. The pathway through the unit has been redesigned to aim for a three month stay. The trust was a key player in developing a West Midlands mind workforce development framework to equip staff with the skills to deliver person centred care, with the primary outcome of improving quality of life.
Inpatients have a comprehensive functional assessment and discharge planning then focuses on teaching new skills, providing enabling environments and reducing restrictions – including medication. Service users were involved in shaping information to meet their needs.
Of 10 discharges in 2016-17, medication was reduced or stopped for five patients, and four who were not on medication at the time of admission remained medication-free. Direct cost savings were £4,000 a year but reducing the length of admissions by over 70 per cent to 71 days has resulted in savings of £85,314 per admission, There is a continued focus on medication reduction post-discharge.
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