Improving access to Hackney Integrated Learning Disability Service

Aims Improving access to Hackney Integrated Learning Disability Service (ILDS) using quality improvement (QI) methodology by reducing the time taken to complete eligibility assessment by 50% by April 2021, while improving service user and staff experience. Background Referrals to ILDS require assessment of eligibility. It was noted that there was significant waiting time between referral and eligibility assessment, exacerbated by the COVID-19 pandemic. Quality Network for Community Learning Disability Services guidelines suggest waiting times for those accessing adult learning disability (LD) community services be locally agreed, although there is limited literature on this topic. Methods All staff members across the multidisciplinary team were invited to participate in the QI project. We defined outcome measures as days from referral to allocation of eligibility assessment to staff member and to completion of eligibility assessment, comparing referrals received before and after start of the project. The key change ideas tested using Plan-Do-Study-Act cycles were: (1) eligibility screening checklist, (2) eligibility assessments drop-in sessions for staff, (3) formal training for ILDS staff, (4) eligibility screening allocation system, (5) template letters for eligibility decisions, (6) new ILDS referral form, (7) workshops for local general practitioners. Results Time taken to eligibility assessment allocation decreased from median of 184 (mean=183.5 +/- 109.8) to 13 days (mean=19.9 +/- 26.4) (93% reduction). Time to completion of eligibility assessment decreased from a median of 271 (mean=296.0 +/- 133.8) to 63 days (mean=75.7 +/- 34.8) (77% reduction). We received positive feedback from staff and service users regarding the new eligibility process. Conclusions We report waiting times for accessing our community adult LD services and effective strategies for reducing this. We recommend similar services use a QI methodology to reduce waiting times and improve the experience of staff and service users.