As a group, we researched into Learning Disabilities with the focus being on diagnostic over shadowing, but as a group we also investigated the role of liaison nurses, how paramedics and other health care professionals can work with the patient’s best interests and with statistics from Mencap. Personally, I investigated into the role of liaison nurses and how their role within hospital settings can improve the quality of care provided to patients living with learning disabilities. I then furthered my research into diagnostic overshadowing to patients living with learning disabilities to add to the group poster that we displayed during our group presentation. Using Rolfe et al’s Framework for Reflective Learning (Freshwater, 2016) which is based on Driscoll’s Cycle by Borton (Clark, et al., 2009) I will be reflecting on how my research of liaison nurses and diagnostic shadowing relates to person-centred care and its application to people with learning disabilities. My research into the role of the liaison nurse allowed me to find how they adapt each care plan to each patient making changes that suit that individual. Person centred care is when patients positively participate in their medical treatment in with close links to the health care professionals. Liaison nurses liase with patients living with learning disabilities and their families and careers so that they can work closely with practitioners so that there is more understanding of their specific needs and how reasonable adjustments can be made, such as physical adaptations including wheelchair access, and communication adaptations, for example, providing more time in appointments so that there is a better understanding between patients and health care practitioners and so that there is more time to explain concepts in a way that is easy to understand and digest, ensuring they receive the best care possible. As a paramedic this is something we would need to do without the advanced planning that liaison nurses can do beforehand. People with learning disabilities tend to find it harder to learn new things, communicate, read, write or manage personal care. (Unknown, 2018). From this, it could be assumed that having to call an ambulance would be extremely overwhelming for someone who has a learning disability, as it can be for someone who also does not have a learning disability. Paramedics must be able to evaluate and adapt in a very short space of time, so that patients are always treated equally but diversely as well. It is important that everyone we treat has equal access to the services provided. This is particularly important for patients in need who, because of a disability, are unable to take adequate care of themselves and keep themselves from harm. (Betts, 2018).A large-scale study was done by Allerton and Emmerson (Eric Emerson, 2012) into the access to good quality healthcare for British adults with chronic health conditions in which 309 people in the sample had a learning disability. 40% of the people with a learning disability reported a difficulty using the health services compare to only 18% of people who did not have a learning disability. This study goes to show that even with the use of Liaison Nurses, there is a problem with equality with in the health care system. I investigated a specific case study on a man named Nigel, and how because of his communication skills, he was ignored by healthcare practitioners thereby meaning that he had cancer that went undetected and then spread which could have been stopped. During my research I found that the spread of funds to expand resources such as Liaison Nurses was not equal across the country therefore showing a consistent line in which patients with Learning Disabilities essentially suffered due to the funding. This causes problems for individual who go to use the health care service where there are insufficient funds, meaning due to the lack of resources they receive poorer care than they possibly would in different regions. In Nigel’s case where he did not have a liaison nurses working closely with him. It was each health care practitioner’s responsibility, that worked with him, that he was a victim of diagnostic overshadowing and not enough time was taken to listen to him and find the cause of his symptoms. So now, as a student Paramedic and in the future as a qualified Paramedic, it is my responsibility to listen to each patient in a way that I can understand what they mean even if it isn’t being explained in the most conventional way, so that I can work out what to do from there and how would be bet to treat them.Liaison nurses must always look at patients with the psychosocial approach. This means looking at individuals in the context of the combined influence that psychological factors have, and the surrounding social environment has on their physical and mental wellness and their ability to function. (Institute of Medicine , 2015) Liaison nurses look at the psychological and social sides of the patient before clinicians and practitioners can look at the biological side. This ensures that the patient is seen holistically instead of just the issue that the patient is in hospital for in the first place. How people react to the same situation differs massively due to factors including gender, age and personality. Roger B. Fillingim has researched into how people react to pain differently and is specifically interest in gender, race, age and genetic factors and has found that there is a substantial sex differences in clinical and experimental pain responses, and some evidence suggests that pain treatment differs due to genetic abnormalities. (Fillingim, 2009). Learning disabilities can stem from a variety of things such as single genes and chromosomal abnormalities. Someone with a learning disability may react very differently, to someone who does not have a learning disability, to pain or a situation due to their communication and understanding of new situations. Hence the use of the liaison nurse is important so that the patient can be understood in how they are reacting to a situation or a pain and can be treated effectively.The role of the liaison nurse enables patients to be treated holistically and equally regardless of having a learning disability which may affect understanding and communication. Research into and around the role of liaison nurses has enabled me to broaden my knowledge on patients with learning disabilities and how reasonable adjustments may need to be made as a Paramedic on the spot and how to adapt my method of communication for a person-centred care approach that provides respectful and responsive to, the preferences, needs and values of people.