The role of the paid companion in remote consultations for patients with learning disabilities

Primary care consultations are a gateway for people with learning disabilities to interact with health services and can play a part in reducing the health inequalities they face. When people with learning disabilities visit their GP, they are often accompanied by a paid ‘companion’ who supports them, such as a social care staff team member or a personal assistant. It can be hard for companions to know exactly what their role should be in these encounters - and the situation can also be difficult for healthcare professionals, who may be unsure how to balance their interactions between the person with learning disabilities and the companion. This situation is further complicated when the consultation is conducted remotely (i.e, by video link or phone) where key interactional resources (e.g, eye gaze, body posture, facial expressions) may be disrupted. The need for research on this topic has become urgent due to rapid and widespread adoption of ‘remote’ healthcare consultations. We will work with people with learning disabilities, social care staff and healthcare professionals to record and analyse communication in remote healthcare consultations involving a person with learning disabilities being supported by a paid companion. Five focus groups (two with people with learning disabilities, two with social care staff, one with representatives from social care provider organisations) will also be conducted to explore experiences of the role of the companion, and suggestions for supporting the role. The research findings will be used to develop guidance on how the role of the companion can best support positive healthcare outcomes for people with learning disabilities in remote consultations.