Six lives: English Health Care Policy for people with intellectual disability (2013)

Six Lives
The English Government’s policy on health
care for people with a learning disability
(this is what we call intellectual disability in
Australia)

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National Council on Intellectual Disability Inc ncid.org.au
What Happened
2
Mencap – an advocacy organisation in 2007
wrote a report called ‘Death by Indifference’
which told the story of people who died in the
English health care system.
http://www.mencap.org.uk/campaigns/take-action/death-indifference
In 2009 the Health Ombudsman wrote another
report - ‘Six Lives”- about six people who died
because of mismanagement and maltreatment in
the English health care system.

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3
 The Six Lives report established policy and
practice improvements to ensure that people with
learning disabilities received good quality health
care services all over England.
 It was legislated and implemented in 2010.
 The 2013 report is telling us what progress has
been made in this policy area
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/212292/
Six_lives_2nd_Progress_Report_on_Healthcare_for_People_with_Learning_Disabilities_-
_full_report.pdf

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4
Things going well in health care mean
1. Reasonable adjustments being made based on
individual differences and need.
2. Staff having a positive attitude towards people with a
learning disability.
3. Involving people with a learning disability and their
families/carers in health care treatment and plans.
4. Employment of learning disability nurses.
5. People (staff) in hospitals do what the law says in the
Mental Capacity Act.
What they found

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5
They also found
Things not going well in health care mean
1. It takes too long to find out what is wrong with someone
and start treatment.
2. Annual health checks are not always done properly.
3. People with learning disabilities are not given information
in a way they can understand.
4. People who work in hospitals do not always realise when
someone is in pain.
5. People are not included in decisions about their care.

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6
Australian Context
Current research supports the English findings of
Six Lives. The Queensland Centre for Intellectual
and Developmental Disabilities (QCIDD) INC
undertakes a range of research in this area and
also have a You Tube channel with a range of
information available.
https://www.youtube.com/channel/UChCUpCHdvnHqAf8SBOuV_tA

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7
The Six Lives Plan (Rationale)
1. Getting information from the Learning Disabilities
Public Health Observatory. (Research)
2. Looking at the results of the Confidential Inquiry
which looked at why people with learning disabilities
died earlier than other people. (Analysis)
3. Annual health checks for people (Action)
4. Share good practice with everyone (Education)

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8
5. Educate staff in the health system how to work with
people with intellectual disabilities and their families.
(Mentoring)
6. Have people with intellectual disabilities on
partnerships boards. (Communication and
Education)
5. Put quality control monitoring mechanisms in the
system (Regulation and Legislation)
6. Regularly check the progress of the health care
system (Evaluation)

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9
Advocates have been calling for
better health care in Australia too
To our knowledge there has not been a report like
the Mencap 2007 report, which looks at the number
and cause of deaths of people with an intellectual
disability in the Australian health care system.
Q. Is it time for one? Do we know what is
happening? Would it affect policy change?

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10
The Australian Context
The Australian government in 2010 introduced the
National Disability Strategy 2010 - 2020 which has 6
key strategies.
Priority 6 deals with health and wellbeing and sets out
broad system and policy changes; none in detail or
legislated to date.
Some states have developed policy responses on the
health care of people with intellectual disability.

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11
Following England’s lead by
 Establishing yearly health checks for people that
are funded through Medicare.
 Individual health care plans with one
professional taking responsibility for actioning
the plan and placing relevant information on the
e-health system for future reference.
 Longer time given to appointments times for
people with intellectual disability.

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 Having people with an intellectual disability as
advisors on boards in the health system.
 Providing information in Easy English for people
and their families.
 Education and mentoring of health care workers
on ways to work effectively with people with
intellectual disabilities and their support networks.
 Involving the person and their support networks in
health care team.

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Calling for action
 The current research in this area established that
people with intellectual disabilities have poorer health
than other Australians and die 20 years earlier.
 Negative attitudes toward people with intellectual
disabilities continue to play a role in how the health care
system responds to them and there is a need for
intensive education of health care workers to change
this.
 Urgent action is require for equity to be achieved

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14
NCID advocates the health
sector learn from the Six
Lives policy and commitment
to change demonstrated by
the English Government in the
policy and follow their lead.

Six lives: English Health Care Policy for people with intellectual disability (2013)

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