Background: In 2008 NHS Lothian implemented a COPD tele-monitoring service incorporating a touch-screen computer for daily recording of symptoms and weekly oximetry and spirometry measurement. Data were transmitted by secure broadband link to a call centre where trained workers monitored data and contacted clinicians according to an agreed algorithm.

BACKGROUND To comply with an action plan patients need to recall information accurately. Little is known about how well patients recall consultations, particularly telephone consultations increasingly used to triage acute problems. PURPOSE OF STUDY This was an exploratory study to measure how accurately patients recall the content of face-to-face and telephone consultations and what factors may be associated with accurate recall. STUDY DESIGN In Scotland in 2008, the advice (diagnoses; management plan(s); and safety-netting arrangements) given in audio recorded face-to-face and telephone consultations was compared with the advice recalled by patients at interview approximately 13 days later. Patients also performed a memory test. Interactions were sought between accurate recall, consultation type, and factors postulated to influence recall. RESULTS Ten general practitioners (GPs) and 175 patients participated; 144 (82%) patients were interviewed. Patients recalled most important components of telephone and face-to-face consultations equally accurately or with only minor errors. Overall, patients presenting multiple problems (p<0.001), with brain injury (p<0.01) or low memory score (p<0.01) had reduced recall. GPs rarely used strategies to improve recall; however, these were not associated with improved recall. CONCLUSIONS Contrary to previous hospital based research, patients tended to remember important components of both face-to-face and telephone consultations-perhaps reflecting the familiar, less anxiety provoking environment of primary care. The unsuccessful use of strategies to improve recall may reflect selective use in cognitively impaired patients. Clinicians should compensate for situations where recall is poorer such as patients presenting multiple problems or with brain injury. Patients might be advised to restrict the number of problems they present in any one consultation.

Accessible summary  There is little information about pregnancy for people with learning disabilities. This means it is hard to make good choices.  The pregnancy support pack has easy to read information about pregnancy and birth.  Women with a learning disability told us the pack helped them to understand information their midwife gave them.  Midwives told us the pack helped them to work better with women with a learning disability. SummaryThe literature agrees that an increasing number of people who have a learning disability have children. This group of parents are expected to fit into existing health services and are disadvantaged when presented with complex information regarding pregnancy and birth. There is a dearth of information in relation to accessible information on antenatal care and consent to medical procedures for parents with learning disabilities, despite this being a recommendation by best practice guidelines on working with parents who have a learning disability (SCLD, 2009; Department of Health and the Department of Education and Skills (DoH DfES) 2007; Department of Health 2009). This project aims to redress this balance by developing accessible resources for a typical pregnancy. Thematic analysis is used to evaluate the accessibility and acceptability of the resources from a professional and service user perspective, and identified themes are discussed. Results suggest that adapted resources are helpful in supporting parents with learning disabilities to access essential information about their pregnancy and to make informed decisions about their care. They support the interaction between parents and maternity services, resulting in a more effective and efficient care process. Implications for further research and developments are discussed.

The present study examined relationships between assault levels and sickness levels in staff working in a specialist challenging behaviour unit. The staff group experienced an average of 279.7 total assaults and an average of 422.5 hours sickness occurred each month. No significant relationships were found between total assaults and sickness levels, short-or long-term. Implications of these findings are discussed in relation to the available literature. Methodological difficulties are also discussed.

This paper examines the usefulness of using the philosophy of normalisation and, in particular, O'Brien's (1992) Five Accomplishments as a basis for evaluating client satisfaction with a community-based health service learning disabilities team. It is based on a survey of a group of people with mild learning disabilities, using the Five Accomplishments as a framework for a semi-structured interview. Areas of client satisfaction and dissatisfaction are discussed in the context of the use of a value-based means of obtaining feedback from clients. Limitations of interviewing techniques and specifically those used in this study are reviewed.