Hospital Staff's Experiences of Acute Learning Disability Liaison Services in Hospital Care: Organisational Conditions, Barriers and Enablers of Success Identified From a National Service Evaluation in Wales

ABSTRACT Background People with learning disabilities experience persistent health inequalities, particularly in acute hospital settings. Acute Learning Disability Liaison Services (ALDLS), typically delivered by Learning Disability Liaison Nurses (LDLNs), have been established to support equitable, safe, and person‐centred care. However, their effectiveness depends on how services are implemented within local healthcare systems. This study explores how ALDLS are configured, accessed, and integrated in practice across Welsh Health Boards. Methods A qualitative service evaluation was conducted across seven Health Boards in Wales. Semi‐structured interviews ( n = 23) and one focus group ( n = 3) were undertaken with hospital staff who worked with or referred patients with learning disabilities to ALDLS Teams in secondary care hospital‐based settings across Wales. Data were analysed using a framework approach informed by the Medical Research Council (MRC) Process Evaluation Framework, focusing on context, implementation, and mechanisms of impact. Results Implementation of ALDLS varied across Health Boards and was strongly influenced by organisational context. Key determinants of effective implementation included service visibility, workforce capacity, and integration within routine care pathways. Barriers included limited staffing, inconsistent referral processes, and fragmented communication systems, often resulting in reactive rather than proactive service use. Enablers included leadership endorsement, relationship‐based working, consistent service presence, and training that supported staff confidence and engagement. Conclusions ALDLS are a critical component of acute care for people with a learning disability, but their effectiveness depends on organisational integration and sufficient resourcing. Strengthening workforce capacity, improving visibility, and embedding services within routine clinical pathways are essential for consistent and sustainable implementation.