Gathering information

When you are gathering information talk directly to the person, and bring the carer into the conversation with the person's permission when clarification is necessary. Find out why the person has attended today and what their goals for the consultation are.

Explore the person's understanding, concerns, ideas and expectations of the consultation and their medicines. Note the language that the person is using, so that you can reflect this back in your responses to them, both in terms of words and complexity.

As the consultation progresses there may be times when you need to rephrase questions to make them clearer. Think about how you introduce and use a pause.

Physical examination

If a physical examination is required as part of the consultation, then explain and demonstrate what you are going to do first, to reduce the person's anxiety. Be aware that some people with a learning disability may be hypersensitive to pain.

Explanation and planning

Agree an action plan, taking into account a holistic approach and any goals that the person has. Shared decision-making will involve explaining the risks and benefits of treatment in a way that is meaningful to the patient. It might be appropriate to use decision aids.

Prioritise the information that you give. It is better to limit the amount of information given in one session and be successful than to overwhelm the patient. Be prepared to explain something several times and do this without being condescending or patronising.

Keep your explanations clear and concise, using only one or two information words per sentence. Use simple language and avoid using jargon or abstract words. For example €Take the tablets twice a day€ can be confusing. It would be better to say €Take one tablet with your breakfast and one tablet with your dinner€. The General Medical Council has a guide to help you to avoid jargon.

Chunking information is important. For example, give all of the information about blood pressure medicines together, and then give all of the information about diabetes.

Give information at a level appropriate to the person's understanding. You should tailor this to the individual, and the extent to which you need to do this will vary according to their learning disability and personal preferences. Check the person's understanding, using open questions, for example €what do you think I mean by€¦?€ Be aware of the person agreeing or acting as if they are in agreement, without fully understanding what you have said.

Give appropriate written information about what has been discussed for the person to take away with them. It might be appropriate to offer the person an easy read leaflet containing pictures, however not every person with a learning disability will want this so offer them a choice.

Closing the session

Summarise the key actions and if possible ask the person to tell you what they will do after the consultation. It might be appropriate to write this down using simple language, and it can be helpful to use pictures even if your drawing is not very good.

Provide a safety net, i.e. discuss what the person can do if things don't go to plan. If you can, give the person an open offer to return. For example you might say, €If your medicines change or you have any questions about your medicines please come and see me €“ we can go through any of this information again€