Oliver McGowan Mandatory Training on Learning Disability and Autism

Patient safety and consent issues have dominated the news in recent years. Whilst not all of the incidents have been directly relevant to orthopaedics, some of the lessons learned and measures introduced will protect orthopaedic patients, surgeons and the wider multidisciplinary team.   

The Government has recently published a code of practice that sets out the expectations of registered health and care providers to meet the new requirement for training and lets people with a learning disability and autistic people and their families know what to expect from their service providers. The code emphasises the importance of person-centred care which is crucial to identify and support a person’s needs sooner, ultimately improving outcomes and tackling health inequalities. An impact assessment has also been  published which sets out the rationale, costs and expected benefits of this policy in more detail. This is in response to the case of Oliver McGowan, an autistic teenager with a mild learning disability who died in 2016 after having a severe reaction to medication which he and his family had asked for him not to receive.

In 2022, 42% of deaths of people with a learning disability were rated as avoidable in comparison to 22% for the general population. Oliver died because clinicians did not understand learning disability, autism and how this affects a person. They did not understand how to make reasonable adjustments for Oliver or read his hospital passport which would have told them exactly how to do this. Clinicians did not follow the relevant laws: the Human Rights Act 1998, the Autism Act 2009, the Equality Act 2010, the Mental Health Act 1983 and the Mental Capacity Act 2005. They were misunderstanding Oliver’s autism which resulted in diagnostic overshadowing. They were not familiar with STOMP (stopping over medication of people with a learning disability, autism or both with psychotropic medicines) or Ask Listen Do. These are all core ingredients that are at the heart of The Oliver McGowan Mandatory Training. Each person working for a provider registered with the Care Quality Commission (CQC)  who carries out regulated activities must have the necessary skills and knowledge to interact with and support people with a learning disability and autistic people, even if their role does not ordinarily include caring for people with a learning disability and autistic people.

Section 181 of the Health and Care Act 2022 (the 2022 Act) introduces a requirement into the Health and Social Care Act 2008 (the 2008 Act) and regulation 18 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (the 2014 Regulations) that, from 1st July 2022, service providers registered with CQC must ensure their staff receive training on learning disability and autism appropriate to their role. It applies to all registered providers of all health and adult social care in England.