A qualitative study investigating how paid carers experience a virtual clinic set up to monitor and coordinate the health needs of people with learning disabilities in residential care settings

Background: Influenced by the information and technology transformation of the National Health Service (NHS) and the recommendations set out in the Confidential Inquiry into Premature Deaths of People with Learning Disabilities, a nurse led virtual clinic was set up, implemented, and evaluated over an eighteen-month period between 2017-2019. The virtual clinic was a pilot study based in a clinical setting within an NHS acute hospital trust in the geographical area of Essex in England. The overarching objective behind the pilot study was to compliment face-to-face medical consultations and address the problem of premature and avoidable deaths by regularly monitoring and coordinating the care and support needs of adults with a learning disability who were living with two or more long term health conditions. Purpose: The aims and focus of this research study was to explore the unique experiences of formal carers who had engaged in the virtual clinic whilst working in a residential care setting and caring for adults with learning disabilities. Methods: Fifteen participants engaged in this qualitative study which uses a phenomenological approach to research. Semi-structured interviews were conducted on an individual basis. Once transcribed an inductive reflexive thematic analysis approach was then used to code and identify the patterns, categories, and subsequent themes. Findings: “Empowerment and values” were the two key themes identified in the study as determined by the researcher. A willingness to work both remotely and collaboratively was reflected in the participants level of engagement. The use of technology to remotely monitor and coordinate care for adults with learning disabilities was broadly welcomed as it supplemented formal carers traditional caregiving role with the additional availability and access to health information, resources, education, and ongoing external support. Mixed views were expressed by participants as they highlighted both the advantages and disadvantages of the remote service. There are implications for future development in promoting the use of technology in health and social care service delivery and provision for adults with learning disabilities and their formal carers based on the findings of this study. Further development and provision of remote health monitoring and care coordination implemented as a reasonable adjustment and managed by specialist learning disability nurses has the potential to improve patient safety and health outcomes in an under-served population. Further additional mixed methods research and longitudinal prospective studies are recommended in this area.