#TeamNorthMid blogs

Welcome to #ThisIsMe, our blog series focusing on the incredible diversity of our North Mid family. Dr Charly Annesley , is a Consultant Physician and Geriatrician and the Trusts’ Physician Lead for Adult Learning Disability and Autism - the first and only one of its kind in the NHS.

If you wish to share your own story and experiences about diversity, please contact our communications team at northmid.comms@nhs.net.

Feel free to leave any comments for her at the end of this page.          

My role at North Mid                                                                                           

My name is Dr Charly Annesley and I have worked as a Consultant Physician and Geriatrician here at North Mid since 2019. In this time, I have set up the role of Learning Disability Physician - the first and only one of its kind in the NHS.

I review adults with a learning (intellectual) disability and/or autism who are admitted to North Mid, and focus on providing holistic, patient-centred care whilst optimising their physical health. My aim is to tackle the significant health inequalities faced by people with a learning disability, which leads to premature morbidity and mortality, as evidenced by the Learning Disabilities Mortality Review Programme (“LeDeR”).

Can you tell us a bit more about how you started in the NHS?

I started working for the NHS as a healthcare assistant in 2004, prior to starting as a junior doctor at North Mid in 2009. Since then, I have worked at a variety of different London hospitals, as well as doing a year of Emergency Medicine in South Africa in 2011. Despite all the challenges we face in UK healthcare, I am really proud to work for the NHS.

Disability support at North Mid

The 2019 LeDeR report revealed that men die on average 22 years younger, and women on average 27 years younger than those without a learning disability. There are many barriers to good care faced by people with a learning disability. For example:

1. Diagnostic overshadowing, i.e. attributing a person’s symptoms as being due to their learning disability and failing to diagnose a separate medical problem
2. Atypical presentations – people with a learning disability are less likely to present in a ‘textbook’ fashion. E.g. appendicitis could present with a change in behavior, rather than right sided abdominal pain.
3. Behaviour that challenges – this normally reflects an unmet need, e.g. fear, pain, hunger, and once the trigger is identified and addressed, behavior can improve.
4. Mental capacity assessment – people may refuse treatment because they are scared or in pain. All healthcare staff need to be able to assess mental capacity. If a person lacks capacity, then we must proceed to a best interest decision meeting.
5. Lack of reasonable adjustments – we are required by law to provide reasonable adjustments in hospital to facilitate the care and management of our patients with disabilities, be they physical or mental.  

I work closely with Lucy Palmer, our hospital Learning Disability Nurse Specialist. We have set up close links with the Community Learning Disability Teams for both Enfield and Haringey, in order to highlight patients most at risk. We recently won a national award for Outstanding Care at the End of Life for a Person with a Learning Disability (Linda McEnhill award, 2021). The judges stated that this was one of the best examples of care they had seen in the 20 years of doing the awards.

In addition to my clinical work, I have been working with the Royal College of Physicians (RCP) and Health Education England (HEE) for the past two years in order to develop post graduate training in this area of medicine. We (RCP and HEE) will be launching a medical credential in Learning Disability Medicine next year, with the aim of training senior clinicians to adopt the role of Learning Disability Physician up and down the country. It’s great to see North Mid as a pioneer in this area of healthcare, and I am proud to be part of a trust that is striving for excellent care for disabled people.

Currently I am only funded for inpatient liaison work, but I hope to expand the service to include an outpatient clinic. I would also love to help support patients with multiple physical health problems – particularly those whose needs may not be fully met in the traditional model of single-organ outpatient clinics. In addition to this, I am also working on a new model for transition of care for young people with a learning disability who are leaving paediatric services.

I’m happy to discuss cases or referrals from anyone, and can be contacted via switchboard or email charlotteannesley@nhs.net 

What does diversity mean to you?

I am passionate about diversity. Let’s face it - life would be so boring if we were all the same. It is important that we all embrace diversity as it allows us to celebrate individuality. I’m really keen to tackle discrimination (conscious or unconscious) in the workplace – be it to patients, relatives/carers or staff. Our diversity is our strength and we should celebrate that.

Have you experienced any challenges whilst at North Mid?

I think the main challenge most of us face at North Mid is the volume of workload. I have so many ideas of how I want to improve services and care, but it often feels like there aren’t enough hours in the day! Sometimes I get a bit of grief about looking ‘too young’ to be a consultant or even a doctor, and on occasion this has led to my specialist advice being taken less seriously.

I’m really keen to avoid prejudice in the workplace, especially on occasions where it can compromise patient care. I try to be a role model for other female or young-looking doctors and other members of staff – it’s our performance rather than our looks that counts, after all.