In this section you will find guidance around DST-PH rating and clinical recommendations

 

The DST-PH is divided into two parts with the first part providing factors that impact on physical health outcomes which is scored and the second part looking at underlying health conditions which may impact on the overall health of an individual. The second part is not scored but instead uses a checklist to support clinical decision making.

  • Part 1: Nine areas that could impact physical health outcomes for an individual, such as, degree of learning disability, if a person presents as a challenge to accurate clinical assessment, has an unstable or untreated mental health condition or if their posture / mobility is impacting on their overall health.
  • Part 2: Eleven items that help identify underlying health conditions, for example, the presence of epilepsy, a neurological condition, or respiratory difficulties / conditions.

Once completed a final score will be given.  This then corresponds to a RED / AMBER / YELLOW score each having additional actions to take as part of the clinical intervention. Intervention guidance can be found further down this page.

There are also links to further reading relating to the development of the DST-PH and additional information relating to ways you can support to reduce health inequalities through reasonable adjustments.

Once all questions are answered in part 1 the following section (Below) will be automatically populated with the resulting vulnerability (RAY) rating and Total numerical score:

 

Yellow: 0-6

Amber: 7- 14

Red: 15+

Total Score

 

Vulnerability Rating

 

 

For all levels of response, basic interventions should be completed with additional actions required as the vulnerability rating increases including:

  • Ensure and record that the individual is on the GP register as having a learning disability.  (Click for more information)
  • Ensure and record that the individual has had an Annual Health Check in the past 12 months or is booked in for one within 12 months.  (Click for more information)
  • Ensure and record if the individual has a Health Action Plan which has been completed by the GP or by the care team / family with the GP’s input.  (Click for more information)
  • Ensure the individual has an up to date and accurate hospital passport.  (Click for more information)
  • Ensure and record the use of Person-centred thinking tools such as one-page profiles / good day - bad day / what is working – what is not working.  (Click for more information)
  • Making reasonable adjustments, such as alterations to buildings and changes to policies, procedures and staff training, to ensure that services work equally well for people with learning disabilities (Click here for a guide and here for a reasonable adjustment checklist)
  • Improving communication to ensure that everyone is receiving good quality healthcare. This could include a flag placed on GP record to indicate what support the person needs and would like, easy read information for investigations, medical procedures, treatments and immunisations and providing priority and longer appointments. Click here for NHS England's Accessible Information Standard

Further support and guidance can be provided by the local specialist learning disability team

For all levels of response, basic interventions should be completed with additional actions required as the vulnerability rating increases including:

  • Ensure and record that the individual is on the GP register as having a learning disability.  (Click for more information)
  • Ensure and record that the individual has had an Annual Health Check in the past 12 months or is booked in for one within 12 months.  (Click for more information)
  • Ensure and record if the individual has a Health Action Plan which has been completed by the GP or by the care team / family with the GP’s input.  (Click for more information)
  • Ensure the individual has an up to date and accurate hospital passport.  (Click for more information)
  • Ensure and record the use of Person-centred thinking tools such as one-page profiles / good day - bad day / what is working – what is not working.  (Click for more information)
  • Making reasonable adjustments, such as alterations to buildings and changes to policies, procedures and staff training, to ensure that services work equally well for people with learning disabilities (Click here for a guide and here for a reasonable adjustment checklist)
  • Improving communication to ensure that everyone is receiving good quality healthcare. This could include a flag placed on GP record to indicate what support the person needs and would like, easy read information for investigations, medical procedures, treatments and immunisations and providing priority and longer appointments. Click here for NHS England's Accessible Information Standard

Further support and guidance can be provided by the local specialist learning disability team

 

Amber specific interventions

A rating of amber indicates that the person requires specialist intervention surrounding their physical health. The people rated in this category are at high risk of physical health decline and avoidable mortality without appropriate actions and direct interventions being put in place.

This needs to include a multi-disciplinary approach involving a range of professional, family and carers. 

Action Needed

  • A referral to be made to local Specialist Community Learning Disability Team.
  • Consider health coordination in discussion with Community Learning Disability Team - In general this should be member of the community learning disability team but in few cases this might be practice nurse of Specialist Learning Disability Health Facilitator.

For all levels of response, basic interventions should be completed with additional actions required as the vulnerability rating increases including:

  • Ensure and record that the individual is on the GP register as having a learning disability.  (Click for more information)
  • Ensure and record that the individual has had an Annual Health Check in the past 12 months or is booked in for one within 12 months.  (Click for more information)
  • Ensure and record if the individual has a Health Action Plan which has been completed by the GP or by the care team / family with the GP’s input.  (Click for more information)
  • Ensure the individual has an up to date and accurate hospital passport.  (Click for more information)
  • Ensure and record the use of Person-centred thinking tools such as one-page profiles / good day - bad day / what is working – what is not working.  (Click for more information)
  • Making reasonable adjustments, such as alterations to buildings and changes to policies, procedures and staff training, to ensure that services work equally well for people with learning disabilities (Click here for a guide and here for a reasonable adjustment checklist)
  • Improving communication to ensure that everyone is receiving good quality healthcare. This could include a flag placed on GP record to indicate what support the person needs and would like, easy read information for investigations, medical procedures, treatments and immunisations and providing priority and longer appointments. Click here for NHS England's Accessible Information Standard

Further support and guidance can be provided by the local specialist learning disability team

 

Red specific interventions

This rating indicates that the person requires urgent specialist intervention surrounding their physical health. The people rated in this category are at a significant risk of physical health decline and premature mortality without appropriate actions and direct interventions being put in place.

Immediate Action Is Needed

An urgent referral to be made to local Specialist Community Learning Disability Team.

Learning Disability Professional to liaise with Primary Care to ensure:

  • Agreement for individual to have named Primary Care professional to coordination healthcare (this could be in collaboration with LD Health facilitator)
  • An urgent multi agency healthcare review to be arranged to ensure delivery of a robust and high level of integrated care.
  • Clear and robust treatment and Health Action plan to be developed to address health needs.