Access to Secondary Healthcare for People with Intellectual Disabilities: The Role of Community Learning Disability Nurses in Wales

People with intellectual disabilities experience many health disparities including difficulties with accessing healthcare, and a lack of appropriate and timely healthcare. Nurses are well placed to address such disparities, and, in the UK, this is a key focus of the role of specialist community learning (intellectual) disabilities nurses (CLDNs). However, research relating to this aspect of their role is limited.

This qualitative research study therefore aimed to explore the role of the CLDN in supporting access to secondary healthcare. Semi-structured interviews using critical incident technique were conducted with 14 CLDNs. These were subsequently transcribed and analysed using thematic analysis. Four major themes emerged: proactive/ preparatory work, therapeutic relationships, coordination and influencing healthcare outcomes. Within each of these themes there was evidence of CLDNs identifying and removing/ reducing barriers to effective and timely healthcare.

It is concluded that CLDNs use a range of strategies to promote access to healthcare for those they support and that their focus is on identification and removal of barriers to healthcare. Through this focus on barriers to healthcare they are thus promoting health within a social model of disability. Whilst specialist CLDNs do not exist in other countries it is argued that the strategies they employ could be utilised by non-specialist nurses working both within the UK and elsewhere to enhance access and reduce health disparities.