New treatment on the menu for patients – supporting patients with learning disabilities in theatre at North Manchester General Hospital

learning disabilities theatres
New treatment on the menu for patients – supporting patients with learning disabilities in theatre at North Manchester General Hospital
25 August 2016

THEATRE staff at North Manchester General Hospital are serving up a different kind of facility for patients with learning disabilities – a café style setting within a working operating theatre.

To improve the service for patients with learning disabilities, who have to undergo elective surgical procedures, the theatre team looked to see how they could try and alleviate the anxiety which coming into hospital causes the patients.

Theatre team manager Julie Barber came up with an innovative approach in that the anaesthetic room within the operating theatre is now disguised as a café, with medical equipment covered up and the room instead decorated with familiar objects that would be found in a café.

The patient’s time in hospital corridors and waiting rooms is kept to a minimum as they enter the hospital with their regular carer via the nearest entrance to the theatre department. They are then taken to the anaesthetic room where they are encouraged to sit in the ‘café’ whilst sedation and eventually general anaesthetic is administered.

The primary procedure is then carried out, but in addition, a dental and podiatrist check-up is also performed with any follow-up treatment that is needed, to prevent the patient having to come back into hospital for another general anaesthetic in the near future.

Julie Barber said: “This patient journey was developed out of recognising the different needs of each patient with learning disabilities. Each patient is treated as an individual and we always involve the patient’s family or carers and try to find something to connect to the patient with, particularly if they have limited verbal communication. Our aim is to try to prevent the person becoming distressed at all if possible.

“Patient K was our first patient for the café style anaesthetic room. After he had a bad experience in hospital, his family could not even drive past a hospital without K becoming uncontrollably upset. When he came back to North Manchester General Hospital for further treatment, he came in very pleased to see us and promptly sat down cross-legged on the trolley covered in his blanket, without demonstrating any distress and pointed to the empty carton of orange juice.

“The next thing K knew, he was waking up, with orange juice waiting for when he was ready. What he did not realise was that we had put him to sleep, taken all the blood samples his GP had requested, received two dental fillings and had his teeth scaled and polished. As requested we also arranged for a podiatrist to cut his finger and toe nails and remove his hard skin.”

Dr Elzy Kuruvilla, consultant anaesthetist at The Pennine Acute Hospitals NHS Trust, which runs North Manchester General Hospital, said: “When Julie presented the idea of a café setting within the anaesthetic room, I thought it was a superb one to reduce anxiety and challenging behaviour caused by extreme anxiety of the patients. Some patients with special needs had to be cancelled previously as when they arrived in theatre they were too frightened to undergo the procedure.

“The café style setting in the anaesthetic room reduced this and now five patients have very willingly walked into the room accompanied by their carers.”

Ruth Bell, learning disability liaison nurse at Pennine Acute Hospitals NHS Trust, said: “The theatre staff at North Manchester General Hospital have embraced person centred planning and multi-agency working, bringing together all parties and showing that, by working in this way, even the most complex situations can be navigated to produce a successful and positive outcome for the person themselves and everyone who supports them too.”

Pictured: kneeling, Julie Barber, theatre team manager; front row – Pamela Bird, theatre scrub nurse; Dr Elzy Kuruvilla, consultant anaesthetist; back row – Dr Ejaz Qureshi, SAS anaesthetic doctor; Simon Carter, carer’s lead; Prakash Bonomaully, anaesthetic nurse; Ruth Bell, learning disability liaison nurse and porter Philip Kennedy.