Stories of Change
This page offers some stories describing what mental health services have done to take forward the Green Light agenda. The aim is to illustrate some of the actions that can be taken to support individuals and to change systems so that mental health services respond in a respectful and effective way to people with learning disabilities, autistic people and autistic people with learning disabilities.
Coventry and Warwickshire Partnership NHS Trust
The Trust has appointed a learning disability acute liaison nurse for mental health. A priority at the start of the work is to offer practical expertise, help and training to mental health teams so that individuals in their care receive effective support. It is hoped that this will build an appetite for changes in structures and systems. More here.
Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust
When the NHS Learning Disability Improvement Standards were published they were adopted in place of the Green Light Toolkit. Now the Trust is considering reintroducing the Green Light Toolkit.
Derbyshire Healthcare Foundation Trust
A Learning Disability psychosis NICE action plan was formulated to bring together and implement the recommendations from relevant NICE publications. The action plan included:
- A checklist for clinical staff to help adherence to NICE guidance
- Development of a mental wellness course
- Development of a range of Easy Read resources – assessment tools (GAD7, PHQ9, Glasgow Anxiety Scale and the Glasgow Depression Scale), Contact Card and a Stay Well Plan for Recovery.
- The Trust joined POMH-UK to enable all nurses to gain access to their Ready Reckoner on psychoactive drug dosages.
- Development of an Easy Read set of sort-cards to assist individuals to identify their psychotic symptoms, narrate their lived experience, and to formulate their own relapse signature.
A conference was planned to launch all these developments, with the agenda including lived experience stories, how to adopt a formulation approach, and trauma related illness. However, due to Covid the conference has been postponed.
Kent and Medway NHS and Social Care Partnership Trust
A Transforming Neurodiversity Support Programme Board has been established in which 95% of the membership are autistic people. They meet every six weeks and have worked on three issues so far – (i) physical health checks; (ii) specialist services and (iii) a Green Light survey. More here.
Lancashire & South Cumbria NHS Foundation Trust
An Associate Psychological Practitioner in the Specialist Community Learning Disability Team for Adults has created an occasional newsletter for mental health teams to draw attention to the potential for reasonable adjustments.
Leeds & York Partnership NHS Trust
The Electronic Patient Record was interrogated to yield a count of the number of people with learning disabilities and autistic people who were in touch with mental health services. More here.
Lincolnshire Partnership NHS Foundation Trust
The Lincolnshire Autism Partnership Board devised an Autism Inclusion Mark which set a performance threshold and now grants the award to organisations that meet this standard. Experts by Experience are funded and trained to carry out site assessments and decide on eligibility for the Autism Inclusion Mark. Resources include an overview, guidance, self-assessment form and feedback form for the external review. Commissioners adopted the Autism Inclusion Mark as a requirement for fully funding services and around 30 teams completed the process, with some reporting that meeting these obligations helped them achieve other requirements too.
Norfolk and Suffolk NHS Foundation Trust
The Trust carried out an annual Green Light survey and collated the responses to show year-on-year change. This has spurred the large group of around 300 Green Light champions to implement reasonable adjustments, like these on communication. More here.
Northamptonshire Healthcare NHS Foundation Trust
A regular manager’s meeting addresses eligibility and transfer issues so that people receive a timely service rather than referrals bouncing between teams. More here.
Nottinghamshire Healthcare NHS Foundation Trust
In December 2021, a three-year pilot project was launched within the Trust, funded by Nottinghamshire Learning Disability and Autism Care Partnership. It focuses on supporting Community Adult Mental Health teams across the Trust to support autistic adults who need to access their services but do not have learning disabilities. This has incorporated baseline evaluations, workforce development and clinical input as well as wider Trust developments.
The project is being run by two Speech & Language Therapists who have significant experience of supporting autistic adults and children in various settings. Speech and Language Therapy is the only significant healthcare profession that has not previously been represented within the Community Adult Mental Health pathways. Providing access through the project will enhance care as Speech and Language Therapists have expertise in understanding and supporting communication, interaction and information processing. Their role in providing consultation support to mental health colleagues will be rooted in the evidence base for delivery of successful health outcomes.
Links are being made with autistic adults who use services, their families and carers, community support and advocacy services as well as autistic staff within community Adult Mental Health services in the Trust to glean their views, insight and guidance. These data will be analysed using both quantitative and qualitative approaches.
The project will report at regular intervals over its three-year life and is considering how the Green Light Toolkit can be incorporated into the project to support the work that is being undertaken.
Sheffield Health and Social Care NHS Foundation Trust
South London and Maudsley NHS Trust
South London and Maudsley NHS Trust is committed to undertaking annual Green Light Toolkit surveys. It also has a clear commitment to support the STOMP campaign to reduce the over-use of psychotropic medication with autistic people and people with learning disabilities. The Consultant Nurse visits team meetings to go through the Green Light survey with them, teasing out a local action plan for the team and noticing common themes that need a Trust wide solution. Themes that have required a Trust wide response have included improving access to specialist support and increasing availability of accessible information. A weekly Consultant Nurse-led learning disability and autism staff surgery has been established; and a resource page set up on the intranet, working with the Trust patient information officer to improve availability of Easy read resources for staff and the public. The Nurse Consultant collaborates with Matrons, RNLDs and learning disability champions working across adult mental health services to promote the use of the Green Light Toolkit and to facilitate audit discussions. The next stage is to support these networks in the roll out of local action plans arising from the Green Light Toolkit discussions.
South West London and St George’s Mental Health Trust
The Trust used the Green Light Toolkit for a time but then moved on to the Improvement Standards published by NHS England and NHS Improvement as they wanted to benchmark with other Trusts. They have adopted the ‘Ask, Listen, Do’ cycle for learning from complaints and staff are engaged in regular training in supporting autistic people and people with learning disabilities.
South West Yorkshire Partnership NHS Foundation Trust
There is some reluctance to appoint champions in parts of the Trust, as other staff can shunt their responsibility on to the champion rather than positively acquire skills by learning from the champion. Instead, the Trust aims to promote a view that all mental health staff should be able to support autistic people and people with learning disabilities.