Improving the Health and Wellbeing of People with Learning Disabilities: An Evidence-Based Commissioning Guide for Clinical Commissioning Groups Dr Matt.

Improving the Health and Wellbeing of People with Learning Disabilities: An

Evidence-Based Commissioning Guide for Clinical Commissioning GroupsDr Matt Hoghton; RCGP Clinical Champion Learning

DisabilitiesSue Turner; Improving Health and Lives Learning

Disabilities Public Health ObservatoryDr Ian Hall; Faculty of Psychiatry of Intellectual Disability,

Royal College of Psychiatrists

Aim of guide

To bring information about people with learning disabilities and links to good practice guidance together in one document.

Structure of guidance

Primary care (general good practice)

Acute care

Specialist learning disability services

Wider health and wellbeing and public health issues

Cross cutting commissioning considerations

Mental health services (JCP writing)

Appendices - Commissioning cycle and Clinical lead Job Description.

Key Messages

Know about children and adults with learning disabilities and families locally. Find out what they need and want. Ensure the information is in the Joint Strategic Needs Assessment and use it to inform strategy.

Use what is out there (SAF, Partnership Boards, local expertise and good practice guidance).

Turn good practice into common practice.

Key messages

Commissioners remain accountable for the services they commission.

Work in partnership with The NHS Commissioning Board, Health and Wellbeing Boards, Local Authorities, public health and providers.

Commission to reduce health inequalities – and ensure commissioned services are underpinned by Valuing People principles (Rights, Independence, Control and Inclusion).

Better health for people with learning disabilities is everyone’s responsibility.

Primary care – good practice

CCGs should have a learning disability lead (job description appendix II)

Health checks promoted

Up to date registers

Flagging system

Reasonable adjustments

Data collection to inform service planning

Support for family carers

Support access to other primary care services

Specialist learning disability services can help.

Acute hospital services

The Monitor Compliance Framework

Patients with learning disabilities identified

Reasonable adjustments in place

Support for family carers

Training for staff

Representation of people and families

Regular audit of above

Learning disability liaison functions or equivalent

Acute hospital services

Death by indifference: 74 deaths and counting•Robust care pathways and use of a Patient Passport•Use of a pain identification tool and training•Full compliance with Mental Capacity Act•Board level ownership

Specialist learning disability services

Community learning disability teams

Various models but all teams should:•Enable access to other services•Provide direct assessment and support

Some areas also have intensive response teams.

Health facilitators/acute liaison nurses•Enable access – increasing evidence of effectiveness

Assessment and treatment services•Should only be used as part of an agreed care pathway with clear outcomes and discharge plan

Forensic services and the criminal justice system•Prevention, identification and support

Specialist learning disability services

Core service spec. for learning disability services being developed by NHS Commissioning Board, ADASS and other key partners - due March 2013

Quality of health principles to be embedded in NHS contracting

Wider health and wellbeing

• Partnership working with Health and Wellbeing Board and others to tackle social determinants of poorer health.

• SAF indicators• Data on access to disease prevention

and screening compared to general population collected, and support to access services provided.

• Well functioning partnership agreements between health and social care.

Where to find the guide

www.ihal.org.uk/publications

For

•Guide

•Easy read guide

•Presentation

•Easy read presentation

Reasonable adjustments reports

• Reasonable adjustments in cancer screening – August 2012

• Reasonable adjustments in Dentistry – October 2012.

• Reasonable adjustments to eye care services (with SeeAbiity). January 2013.

• Reasonable adjustments and diabetes – by end March

• Planned – Health checks, dementia, Mental Capacity Act…

Other IHaL work

• Health checks – evidence into practice update

• Hospital admissions that should not happen

• Joint conference with the Confidential Inquiry – 20th/21st March

• Health Equality Framework – putting it into practice – 18th April

Any questions?