{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T02:57:04Z","timestamp":1777431424360,"version":"3.51.4"},"reference-count":22,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T00:00:00Z","timestamp":1646870400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>People with a learning disability can experience significant problems in accessing healthcare and this may be partly reflected in worse health outcomes compared with the general population, including a shorter life expectancy. The Equality Act (2010) requires that organisations and individuals make changes to the way services are provided for all disabled people to mitigate, as far as possible, any disadvantage they may face in accessing these services. These changes are termed \u2018reasonable adjustments\u2019. This article describes the reasonable adjustments that can be made to facilitate the admission of an adult surgical patient with a learning disability, and therefore reduce health inequality. Each stage of a patient's journey through the hospital needs to be anticipated and planned for. Many of these changes are not only applicable to the wider care of people with a learning disability, but also to any person who lacks capacity and who is struggling to access healthcare. Key recommendations include the development of assessment tools, pathways and policies specific to the learning disabled patient; identification of key personnel including a learning disability lead, an acute liaison learning disability nurse, pre\u2010assessment and operating theatre personnel and ward learning disability champions; regular multidisciplinary team meetings for planning and best interest assessments; and establishing an electronic alert on the patient administration system to identify learning disabled patients. The anaesthetist, operating theatre and learning disability teams play a pivotal role in ensuring individualised admission plans are made for patients with a learning disability to reduce these healthcare inequalities and improve peri\u2010operative care.<\/jats:p>","DOI":"10.1111\/anae.15691","type":"journal-article","created":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T06:04:43Z","timestamp":1646892283000},"page":"674-683","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Peri\u2010operative care of elective adult surgical patients with a learning disability"],"prefix":"10.1111","volume":"77","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3396-6859","authenticated-orcid":false,"given":"T. A.","family":"King","sequence":"first","affiliation":[{"name":"Department of Anaesthetics East Sussex Healthcare NHS Trust Eastbourne  East Sussex UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6058-3303","authenticated-orcid":false,"given":"J.","family":"Duffy","sequence":"additional","affiliation":[{"name":"Department of Learning Disability East Sussex Healthcare NHS Trust Eastbourne  UK"},{"name":"Sussex Partnership NHS Foundation Trust  East and West Sussex UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,3,10]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"Mencap.Treat me right! Better healthcare for people with a learning disability.2004.https:\/\/www.mencap.org.uk\/sites\/default\/files\/2016\u201008\/treat_me_right.pdf(accessed 06\/10\/2021)."},{"key":"e_1_2_6_3_1","unstructured":"Mencap.Death by indifference report: following up thetreat me right!Report.2007.https:\/\/www.mencap.org.uk\/sites\/default\/files\/2016\u201006\/DBIreport.pdf(accessed 06\/10\/2021)."},{"key":"e_1_2_6_4_1","unstructured":"HeslopP BlairP FlemingP HoghtonM MarriotA RussL.Confidential Inquiry into premature deaths of people with learning disabilities (CIPOLD). Final Report.2013.https:\/\/www.bristol.ac.uk\/media\u2010library\/sites\/cipold\/migrated\/documents\/fullfinalreport.pdf(accessed 06\/10\/2021)."},{"key":"e_1_2_6_5_1","unstructured":"Department of Health and Social Care.Valuing people: a new strategy for learning disability for the 21st century.2001.https:\/\/www.gov.uk\/government\/publications\/valuing\u2010people\u2010a\u2010new\u2010strategy\u2010for\u2010learning\u2010disability\u2010for\u2010the\u201021st\u2010century(accessed 06\/10\/2021)."},{"key":"e_1_2_6_6_1","unstructured":"Mencap.What is a learning disability?https:\/\/www.mencap.org.uk\/learning\u2010disability\u2010explained\/what\u2010learning\u2010disability(accessed 06\/10\/2021)."},{"key":"e_1_2_6_7_1","unstructured":"National Institute for Health and Care Excellence.Challenging behaviour and learning disabilities: prevention and interventions for people with learning disabilities whose behaviour challenges.2015.https:\/\/www.nice.org.uk\/guidance\/ng11\/resources\/challenging\u2010behaviour\u2010and\u2010learning\u2010disabilities\u2010prevention\u2010and\u2010interventions\u2010for\u2010people\u2010with\u2010learning\u2010disabilities\u2010whose\u2010behaviour\u2010challenges\u20101837266392005(accessed 06\/10\/2021)."},{"key":"e_1_2_6_8_1","unstructured":"MansellJ.Raising our sights: services for adults with profound intellectual and multiple disabilities.2010.https:\/\/kar.kent.ac.uk\/24356\/1\/DH_2010_Raising_our_sights.pdf(accessed 06\/10\/2021)."},{"key":"e_1_2_6_9_1","unstructured":"GOV.UKEquality Act 2010: guidance.2013.https:\/\/www.gov.uk\/guidance\/equality\u2010act\u20102010\u2010guidance(accessed 06\/10\/2021)."},{"key":"e_1_2_6_10_1","unstructured":"GOV.UKReasonable adjustments: a legal duty.2020.https:\/\/www.gov.uk\/government\/publications\/reasonable\u2010adjustments\u2010a\u2010legal\u2010duty\/reasonable\u2010adjustments\u2010a\u2010legal\u2010duty(accessed 06\/10\/2021)."},{"key":"e_1_2_6_11_1","unstructured":"University of Bristol Norah Fry Centre for Disability Studies.The Learning Disability Mortality Review (LeDeR) Programme. Annual Report 2018.2019.http:\/\/www.bristol.ac.uk\/media\u2010library\/sites\/sps\/leder\/LeDeR_Annual_Report_2018%20published%20May%202019.pdf(accessed 06\/10\/2021)."},{"key":"e_1_2_6_12_1","unstructured":"NHS England and NHS Improvement.Learning Disability Mortality Review (LeDeR) Programme: action from learning.2019.https:\/\/www.england.nhs.uk\/wp\u2010content\/uploads\/2019\/05\/action\u2010from\u2010learning.pdf(accessed 06\/10\/2021)."},{"key":"e_1_2_6_13_1","volume-title":"Report of the independent inquiry into access to healthcare for people with learning disabilities","author":"Michael J.","year":"2008"},{"key":"e_1_2_6_14_1","unstructured":"NHS Digital.Reasonable adjustment flag.2021.https:\/\/digital.nhs.uk\/services\/reasonable\u2010adjustment\u2010flag(accessed 17\/01\/2022)."},{"key":"e_1_2_6_15_1","unstructured":"GOV.UK.The Mental Capacity Act 2005.https:\/\/www.legislation.gov.uk\/ukpga\/2005\/9\/contents(accessed 06\/10\/2021)."},{"key":"e_1_2_6_16_1","unstructured":"Office of the Public Guardian.Making decisions about your health welfare or finances. Who decides when you can't? The Mental Capacity Act.2009.https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/365631\/making_decisions\u2010opg601.pdf(accessed 06\/10\/2021)."},{"key":"e_1_2_6_17_1","unstructured":"Mencap.Health guides. Hospital passports.https:\/\/www.mencap.org.uk\/advice\u2010and\u2010support\/health\/health\u2010guides(accessed 06\/10\/2021)."},{"key":"e_1_2_6_18_1","unstructured":"NHS ImprovementThe learning disability improvement standards for NHS trusts. 2018.https:\/\/www.england.nhs.uk\/wp\u2010content\/uploads\/2020\/08\/v1.17_Improvement_Standards_added_note.pdf(accessed 15\/01\/2022)."},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468-3156.2003.00226.x"},{"key":"e_1_2_6_20_1","unstructured":"Department for Education and Department of Health and Social Care.Reducing the need for restraint and restrictive intervention.2019.https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/812435\/reducing\u2010the\u2010need\u2010for\u2010restraint\u2010and\u2010restrictive\u2010intervention.pdf(accessed 06\/10\/2021)."},{"key":"e_1_2_6_21_1","unstructured":"Royal College of Psychiatrists.Restrictive interventions in in\u2010patient intellectual disability services: how to record monitor and regulate. College report CR220.2018.https:\/\/www.rcpsych.ac.uk\/docs\/default\u2010source\/improving\u2010care\/better\u2010mh\u2010policy\/college\u2010reports\/college\u2010report\u2010cr220.pdf?sfvrsn=c74ad0e4_2(accessed 06\/10\/2021)."},{"key":"e_1_2_6_22_1","first-page":"380","article-title":"The influence of clonidine on oral ketamine\u2010midazolam premedication in intellectually disabled patients indicated for dental procedures: double\u2010blind comparison of two sedation regimes","volume":"33","author":"Horacek J","year":"2012","journal-title":"Neuroendocrinology Letters"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199808000-00052"}],"container-title":["Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/anae.15691","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/anae.15691","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/anae.15691","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T16:28:55Z","timestamp":1761668935000},"score":1,"resource":{"primary":{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/10.1111\/anae.15691"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,10]]},"references-count":22,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2022,6]]}},"alternative-id":["10.1111\/anae.15691"],"URL":"https:\/\/doi.org\/10.1111\/anae.15691","archive":["Portico"],"relation":{},"ISSN":["0003-2409","1365-2044"],"issn-type":[{"value":"0003-2409","type":"print"},{"value":"1365-2044","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,10]]},"assertion":[{"value":"2021-11-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-01-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-03-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}