Following a project funded by Health Education England which took place between 2022 and 2023, VODG alongside the National Development Team for Inclusion (NDTi) Learning Disability England (LDE) and Skills for Care have published this summary report on the essential role of the health and care workforce in reducing the reliance on psychotropic medication.
It is estimated that on an average day in England between 30,000 and 35,000 people with a learning disability, autism or both are taking prescribed psychotropic medication without appropriate clinical justification (NHSE, 2015) . This is medication which results in alterations to perception, mood or consciousness. Long-term use of these medicines puts people at unnecessary risk of a wide range of side effects including weight gain, organ failure and even premature death.
The 2020 Learning Disabilities Mortality Review (LeDeR) report identified that almost a quarter of all people who have died were on an antipsychotic medication, of which 8% were taking two or more of these drugs. This is contra to advice from NICE.
Key findings in the report include:
- To date, information about STOMP-STAMP has not reached those who need it.
- There are many misconceptions in the health and social care workforce about STOMP-STAMP
- Many of the non-prescribing health professionals, social professionals and family carers didn’t know that STOMP-STAMP applied to them or that they could use it.
- Where training about STOMP-STAMP had been undertaken, professionals reported having the skills, knowledge, and confidence to use STOMP-STAMP in their roles.
- There is a need for a designated role within the health and social care workforce, which includes Learning Disability Nurses, to Champion STOMP-STAMP, advocate for individual needs and act as conduit between them, prescribing and non-prescribing professionals.
Recommendations from our research include:
- STOMP-STAMP training should be mandated for all tiers health and social care staff working directly with people with a learning disability, autism, or both.
- It is recommended that the MindEd STOMP - STAMP modules already available are reviewed and embedded within the learning disability and autism training all regulated service providers must ensure their staff receive (Health and Care Act, 2022).
- The MindEd STOMP-STAMP modules for family carers should be broadened and widely promoted to encourage their use within this population.
- To review and revive the national campaign to raise awareness of STOMP - STAMP to all workforce groups, including family carers, with links to a repository of resources and information.
- Learning disability nurses and pharmacists should be utilised for their clinical knowledge and unique position to Champion STOMP-STAMP and act as conduits between individuals, their families, health, and social care professionals.
- Personalised, structured medication reviews, including STOMP - STAMP, as part of Annual Health Checks.
- More work needs to be done to understand what good looks like in the provision of safe, timely alternative support for individuals to whom STOMP-STAMP applies.
We are hopeful that STOMP - STAMP becoming part of the wider NHS Long Term plan will improve its utilisation by the health and social care workforce and lead to an overall reduction in the use of psychotropic medications for people with a learning disability, autism, or both. However, from the findings in this research it is clear that a multi-pronged approach is needed to achieve this outcome.