Grace under pressure

Physios working with people with a learning disability typically work in community teams, but Sammy Gibson, 25, believes she is the first physio in the country to work within an acute liaison team. The young pioneer, who grew up in Whitby,

North Yorkshire, had an early interest in learning disabilities (LD) as a schoolgirl when volunteering as a sports leader with children with additional needs with local charity InterActive.

‘I have always loved working with children and young adults with varying additional needs and supporting them to join in and have fun,’ she says.

Her first contact with a physio was a private MSK for her own injuries. She became fascinated by problem-solving and how the human body works (and often doesn’t work).

This prompted her to complete a BSc in physiotherapy at Leeds Beckett University, graduating in 2017. 

‘As a student I completed a rotation with a Leeds-based learning disabilities team, and then as a band 5 I opted to commute to Barnsley, so I could rotate and have the opportunity to work in the amazing community learning disability team there,’ she says. ‘I learnt more about the needs of adults with learning disabilities and how these are being met in the community by the fantastic teams and their approaches to healthcare.’

After 18 months she began work at Leeds Teaching Hospitals NHS Trust to expand her knowledge of acute physiotherapy.

‘In all the areas I have worked in, I have always come across patients with learning disabilities, and autistic people, and I saw that they are at high risk of struggling in the hospital settings. 

‘It made me realise that we have community learning disability teams that have a multi-disciplinary team approach, who are there to support adults with LD throughout all aspects of health care. However, in hospitals, there are commonly only specialist learning disabilities nurses.’

A new dimension to patient care

Gibson believed that there was an important role that physios could play in acute settings in large trusts, such as Leeds. She applied for a six-month non-physio secondment, just after the first wave of the pandemic as clinical liaison to the LD team as the team was increasing capacity to meet patient need.

‘I was working alongside a LD nurse and our team leader (who is a speech and language therapist by background),’ Gibson says. ‘I was supporting patients through all things non-physiotherapy related for most of the time. However, when patients did have physiotherapy needs, I would go to see them and help the physios on the ward to engage the patients in ways that make reasonable adjustments in a holistic way.

‘My team found my physiotherapy knowledge really beneficial as it brought another dimension to the patients’ care.’

It was after this secondment that Leeds Teaching Hospitals NHS Trust was awarded money from the NHS England and Improvement Exemplar programme for a six-month Acute Liaison Physio Pilot, which the trust has funded for a further six months. Gibson is now in this band 6 physio liaison role within the acute learning disabilities and autism team.

It’s exciting as I am creating the job, the role and the responsibilities, using my experience, and belief that we can help people with LD and autistic people receive the care they need in an acute setting if we can share the knowledge of what to do.

Tackling health inequalities

Health inequalities are frequently reported for this patient population, for example, via the Learning Disability Mortality Review Programme (LeDeR). ‘We know patients with a LD are dying of preventable causes more frequently than the rest of the population, often those that physiotherapy can have a huge impact on – for example, hospital acquired pneumonia,’ says Gibson. 

‘If physios can identify patients more at risk of this earlier, we can put preventable measures in place to reduce the risk of this chest deterioration. We believe that a learning disabilities and autism multi-disciplinary team is the best way to reduce the number of preventable deaths.

‘Supporting staff working in hospitals to help increase their confidence in assessing and treating patients with LD and or autism is key. It can be so difficult to understand why a person may be overwhelmed by a hospital admission and how to support them so they can receive treatment. It can save lives.

‘I’ve already learnt so much from everybody around me, but mostly from the patients themselves.

‘We are gathering data to show the benefits of having a physiotherapist sitting within the acute learning disabilities and autism team. I already know how important this work is – referrals to our team are up 500 per cent since I started.’ 

Gibson advises other physios working in hospitals who have patients with a learning disability to contact acute liaison LD nurses for support and the local community LD team physios, because the patient may be known to them. 

A model for all hospitals

Julian Hartley, chief executive of Leeds Teaching Hospitals NHS Trust says: ‘We believe this is the first acute liaison physiotherapy role in the country. We are pleased to see the benefits that this role is having and we have received positive feedback from patients, their families and staff within the trust.’

Head of physiotherapy at the trust, Becky Goodwin Vickers, says: ‘We noticed that people with a learning disability are dying because some staff in hospital don’t always have the skills or time to understand or engage with them, because patients with learning disabilities are relatively rare in the acute setting.

‘Sammy is passionate about finding methods to help people with learning disabilities and the team, she is supportive and kind and has an amazing capacity to connect with people. I hope that we can extend this role from 12 months as the hospital trust benefits so much, and that other large trusts will consider an acute MDT.’