Platform 6: Improving Safety and Quality of Care
Solomon's care provided numerous opportunities for Alex to consider the factors that influence safety and quality of care for people with PMLD. By exploring national guidance, reviewing care documentation and discussing practice with members of the multidisciplinary team, he recognised the importance of risk management, evidence-based practice and continuous improvement in reducing avoidable harm.
Alex learned that people with PMLD are at increased risk of health inequalities, avoidable illness and premature mortality. He explored how learning disability nurses contribute to improving care quality through advocacy, early intervention, reasonable adjustments and the implementation of evidence-based practice (LeDeR, 2025; NHS England, 2018; Mansell, 2010).
Demonstrating Platform 6 Proficiencies
Proficiency 6.1: Understand the principles of quality improvement and patient safety
What Alex did
Alex explored the factors that contribute to poorer health outcomes for people with learning disabilities, including barriers to accessing healthcare, diagnostic overshadowing and health inequalities. He reviewed national reports and guidance that have informed improvements in services for people with learning disabilities (LeDeR, 2025; NHS England, 2018).
What this demonstrated
The importance of quality improvement and patient safety in reducing health inequalities and improving outcomes.
Proficiency 6.2: Recognise and respond to risk in order to improve safety
What Alex did
Alex identified the risks associated with Solomon's complex health needs, including aspiration, respiratory infection, epilepsy-related complications, postural deterioration and nutritional concerns. He observed how these risks were assessed, documented and managed through person-centred care planning (Crawford, 2009; Codling and MacDonald, 2009; Public Health England, 2018).
What this demonstrated
The need for ongoing risk assessments and the importance of preventative approaches in maintaining safety.
Proficiency 6.3: Use evidence and data to improve safety and quality of care
What Alex did
Alex reviewed care plans, risk assessments, health action plans and monitoring documentation to understand how information was used to identify risks, evaluate outcomes and support decision-making. He recognised the importance of evidence-informed practice in reducing avoidable harm (NMC, 2018b).
What this demonstrated
How evidence and assessment data contribute to safer and more effective care.
Proficiency 6.4: Recognise and challenge poor practice and discriminatory care
What Alex did
Alex explored the concept of diagnostic overshadowing and discussed how assumptions about a person's learning disability can result in physical health needs being overlooked. He reflected on the importance of advocacy and challenging inequalities that may affect access to healthcare (LeDeR, 2025; NHS England, 2018; Mansell, 2010).
What this demonstrated
An understanding of the nurse's role in promoting equitable care and challenging practices that may compromise safety or quality.
Proficiency 6.5: Participate in systems and processes that promote safety
What Alex did
Alex observed how risk assessments, care plans, communication passports and health action plans were used to support safe and consistent care. He discussed the importance of accurate documentation, effective communication and multidisciplinary review in maintaining patient safety.
What this demonstrated
How systems and processes contribute to safe care delivery.
Proficiency 6.6: Recognise, report and respond appropriately to incidents, concerns and near misses
What Alex did
Alex discussed how incidents relating to PEG feeding, medication administration, seizures, aspiration risk or changes in health status would be reported, documented and escalated in accordance with local policies and professional standards. He explored the importance of learning from incidents to improve future care (NMC, 2018a).
What this demonstrated
An awareness of incident reporting, organisational learning and the promotion of safer practice.
Proficiency 6.7: Apply infection prevention and control principles
What Alex did
Alex observed infection prevention and control measures associated with PEG care, stoma site monitoring and the management of respiratory infections. He discussed how infection prevention strategies help reduce avoidable complications and improve health outcomes (Bischoff et al., 2020; Malhi and Thompson, 2014).
What this demonstrated
The value of infection prevention and its contribution to safe, effective care.
Proficiency 6.8: Contribute to improving the quality of care through reflection and learning
What Alex did
Alex reflected on the lessons learned from national reports, multidisciplinary discussions and his experiences within the placement. He considered how learning disability nurses contribute to improving services and reducing inequalities experienced by people with learning disabilities (LeDeR, 2025).
What this demonstrated
The need for reflective practice and continuous quality improvement as integral components of professional nursing practice.
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