Access to Secondary Healthcare for People with Intellectual Disabilities: The Role of Community Learning Disability Nurses in Wales

Abstract

People with intellectual disabilities experience many health disparities including difficulties with access to healthcare, and a lack of appropriate and timely healthcare. Nurses are well placed to address such disparities. In the UK, this is a key focus of the role of specialist community learning (intellectual) disabilities nurses (CLDNs), as explained in our background section. Research relating to this aspect of their role is limited. This qualitative research study explored the role of the CLDN to support access to secondary healthcare. This article reviews our study methods, which included semi-structured interviews (n = 14) conducted with CLDNs using critical incident technique. These were subsequently transcribed and critical incidents (n = 74) analysed using thematic analysis. We describe in our findings four emerging themes: Proactive/Preparatory Work; Therapeutic Relationships; Coordination; and Influencing Healthcare Outcomes. Within each theme and several subthemes there is evidence of CLDNs identifying and removing or reducing barriers to effective and timely healthcare. The discussion section asserts that CLDNs use a range of strategies to support access to healthcare and with a focus on barriers, they promote health within a social model of disability. We conclude that, whilst specialist CLDNs do not exist in many other countries, the strategies they employ could be utilised by non-specialist nurses working both within the UK and elsewhere to enhance access and reduce health disparities for people with intellectual disabilities.