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BASW England’s response to the Deaths from COVID19 (LeDeR programme)

Learning Disabilities Mortality Review (LeDeR) programme by University of Bristol raises serious questions about treatment of people with learning disabilities

BASW, the professional association for social work, acknowledges the importance of this review. There remains limited information about the deaths of people with learning disabilities and virtually no information about the deaths of autistic people linked to Covid-19.

This latest information raises serious questions over the way people with learning disabilities have been treated throughout the pandemic.

The Learning Disabilities Mortality Review (LeDeR) programme identified the following six broad conclusions:

1. Mobility impairments and/or mental health needs may be proxy indicators of people at risk of catching the virus, or may underpin prejudicial attitudes towards care, treatment and judgements about ceilings of care.

2. It would seem appropriate to consider people with learning disabilities and epilepsy as being at increased risk of death from the virus and pay attention to protecting them.

3. The key symptoms of COVID19 in the general population (fever, new continuous cough, loss of sense of smell or taste) may not be as apparent in people with learning disabilities.

4. The use of DNACPR decisions and the initiation of palliative/end of life care should be monitored to ensure that this population is not being disadvantaged.

5. Close attention needs to be paid to safe and appropriate hospital discharge planning. One in five of the completed reviews indicated that the person had previously been discharged from hospital, only to be readmitted again soon afterwards.

6. Additional resourcing for specialist learning disabilities staffing and expertise in primary and secondary care appears to be indicated from the findings of this small study.

Of the 50 people whose deaths were reviewed between 19.3.20-19.5.20, 88% of people died in hospital. 78% had a DNACPR in place, 20% of people had been discharged and then re-admitted to hospital. Concerns about adequate PPE and access to hospital care and treatment are also identified.

The very high percentage of people with a DNACPR in place is of particular concern.  It is not clear how, by whom or whether after effective decision-specific capacity assessments such orders were signed. 

This review adds to the evidence that people with learning disabilities, for a variety of reasons, have much poorer health outcomes than the population as a whole. As with other vulnerable and marginalised groups, people with a learning disability and autistic people are bearing a disproportionate weight of the impact of Covid – 19 including a greater risk of death.

Social work is a Human Rights Profession, as outlined in BASW's statement on Upholding Human Rights during Covid-19.

BASW is calling on LeDeR for further updates to understand the risk factors in terms of Covid-19 for people with learning disabilities and autistic people. To ensure this is possible, BASW calls on the Government to make extra resources available to LeDeR if these will be required to produce further interim reports.

Other factors of concern highlighted by this review and the recent survey undertaken by Mencap include the impact of the suspension, reduction or removal of social care support.  

BASW England will be consulting further with members to identify any concerns relating to care being cancelled or suspended during the pandemic. We will be exploring what is happening with reviews for people with learning disabilities and/or autism, families and carers.

To support this social workers are encouraged to share views and experiences through the BASW survey which contains a specific question about the use of the Care Act during covid-19

BASW are also in full support of the campaign by Mencap who are calling on the government to increase funding for social care.

Show your support by signing the petition.

BASW has developed the capabilities statement for social work with adults with learning disabilities and the accompanying implementation resources to support best practice with people and families.