• How can we help
people with learning
disabilities and their
family carers to look
after their weight?
• What do we need to
do to support people?
• How can we work
together to make a
difference?
•
West Midlands Strategic Health Authority
• Ranjit Senghera
Programme specialist
NHS Midlands and East is a cluster of SHAs comprising NHS East Midlands, NHS East of England and NHS West Midlands
Chair: Sarah Boulton
Chief Executive: Sir Neil McKay CB
Valuing People Now
vision
West Midlands Strategic Health Authority
• ‘All people have the
right to lead their lives
like any others, with
the same
opportunities and
responsibilities, with
the right support to
make possible and be
treated with the same
dignity and respect”
NHS Midlands and East is a cluster of SHAs comprising NHS East Midlands, NHS East of England and NHS West Midlands
Chair: Sarah Boulton
Chief Executive: Sir Neil McKay CB
Areas to cover?
West Midlands Strategic Health Authority
• Background to programme and
development of Charter and resources
• Strategic context of the Charter and
Framework for action
– Values of resources for commissioners and
providers
– What differences the resources can make?
– Ideas for Implementation
NHS Midlands and East is a cluster of SHAs comprising NHS East Midlands, NHS East of England and NHS West Midlands
Chair: Sarah Boulton
Chief Executive: Sir Neil McKay CB
Background and context
West Midlands Strategic Health Authority
• Charter has ‘Valuing people Now’ vision at
the heart and approach was innovative:
• strives to tackle health inequalities related
to weight management in people who
have learning disabilities and works on
ways to improve quality of life and
outcomes.
• why should we take this approach?
NHS Midlands and East is a cluster of SHAs comprising NHS East Midlands, NHS East of England and NHS West Midlands
Chair: Sarah Boulton
Chief Executive: Sir Neil McKay CB
Why we should care?
West Midlands Strategic Health Authority
• The Facts:
• One person in three (1 in 3) with a learning
disability who are obese (compared to one
in five (1 in 5) of the general population)
• This means 328,333 people with Learning
disabilities being obese in England.
• What else do we know?
NHS Midlands and East is a cluster of SHAs comprising NHS East Midlands, NHS East of England and NHS West Midlands
Chair: Sarah Boulton
Chief Executive: Sir Neil McKay CB
The real facts?
West Midlands Strategic Health Authority
• Women, people with Down’s syndrome, people of higher ability and
people living in less restrictive environments are at increased risk of
obesity .
• Less than 10% of adults with learning disabilities in supported
accommodation eat a balanced diet, with an insufficient intake of
fruit and vegetables.
• Carers generally have a poor knowledge about public health
recommendations on dietary intake.
• Over 80% of adults with learning disabilities engage in levels of
physical activity below the Department of Health’s minimum
recommended level, a much lower level of physical activity than the
general population (53%-64%),
• People with more severe learning disabilities and people living in
more restrictive environments are at increased risk of inactivity.
• The rate of Type 2 Diabetes in people with learning disabilities is
NHS Midlands
and East is a cluster
of SHAs comprising NHS East Midlands, NHS East of England and NHS West Midlands
double that
of general
population.
Chair: Sarah Boulton
Chief Executive: Sir Neil McKay CB
Where to start?
West Midlands Strategic Health Authority
• We know that better support and services could
be provided for these individual’s
• This charter sets out to raise the profile of the
needs of this population regarding
– weight management services,
– support commissioning and prioritisation and
– provide clear standards for service deliverers to
adhere to through contracting processes.
This approach will empower people with learning
disabilities, their carers and family members to make
healthy choices the norm no matter what their
circumstances.
NHS Midlands and East is a cluster of SHAs comprising NHS East Midlands, NHS East of England and NHS West Midlands
Chair: Sarah Boulton
Chief Executive: Sir Neil McKay CB
Aims of the Charter
West Midlands Strategic Health Authority
• The implementation of the charter will:
• Improve practice relating to the commissioning and
delivery of weight management and related services for
people with learning disabilities, their carers and families.
• Standardise the services offered to people with learning
disabilities, their carers and families regarding weight
management.
• Advise on the standards that are expected when
commissioning and delivering services to people with
learning disabilities to support them in maintaining a
healthy weight.
NHS Midlands and East is a cluster of SHAs comprising NHS East Midlands, NHS East of England and NHS West Midlands
Chair: Sarah Boulton
Chief Executive: Sir Neil McKay CB
The Charter aims to:
West Midlands Strategic Health Authority
• Promotes and supports the prioritisation of the needs of
people with Learning Disabilities regarding the
commissioning of specialist and community services to
aid weight management.
• Strengthens commissioning processes and advises on
the standards expected when delivering services.
• Aids the determining of strategic direction and the
requirements for contracting services that maximise
opportunities for people with learning disabilities, their
carers and families to be supported to maintain a healthy
weight.
NHS Midlands and East is a cluster of SHAs comprising NHS East Midlands, NHS East of England and NHS West Midlands
Chair: Sarah Boulton
Chief Executive: Sir Neil McKay CB
The Rights and Values of the
Charter
West Midlands Strategic Health Authority
•
•
•
•
•
•
•
People have the right to a healthy life and to be given the appropriate support
to achieve this.
All people with a learning disability, their families and carers have an equal right to
support and advice that will enable them to make healthy lifestyle choices and
maintain a healthy weight.
This support should be person centred with services that are developed to take
into account individuals communication needs.
Services should be individually tailored, flexible, responsive to changes in
individual circumstances and delivered in the most appropriate local situation.
Services should be delivered by individuals with the right values, attitudes,
training and experience.
People have the right to environments that enable individuals, their families
and carers to make healthy choices regarding lifestyle.
Services should be developed on the principles of positive behavioural support
and other evidence based approaches that will respond to all the needs of the
individual.
All services and professionals delivering services should put valuing the lives
of people with a learning disability at the heart of their work and provide a high
standard of care and support regarding weight management.
NHS Midlands and East is a cluster of SHAs comprising NHS East Midlands, NHS East of England and NHS West Midlands
Chair: Sarah Boulton
Chief Executive: Sir Neil McKay CB
Who charter aimed
at?
West Midlands Strategic Health Authority
• Support organisations to meet legislative
frameworks of the Equalities Act 2010
– Disability discrimination Act
– Disability Equality Duty – all public bodies to
make reasonable adjustments to meet needs
• Public Health, NHS and Social care
Commissioners and strategists
• Front line health services
• Service deliverers (service managers)
NHS Midlands and East is a cluster of SHAs comprising NHS East Midlands, NHS East of England and NHS West Midlands
Chair: Sarah Boulton
Chief Executive: Sir Neil McKay CB
Charter allows you to..
West Midlands Strategic Health Authority
• Work done for you:
– Commissioners and contracts statements
– CQC mapping against meeting CQC essential
standards for quality and safety
NHS Midlands and East is a cluster of SHAs comprising NHS East Midlands, NHS East of England and NHS West Midlands
Chair: Sarah Boulton
Chief Executive: Sir Neil McKay CB
West Midlands Strategic Health Authority
Learning Disabilities and Obesity
WEST MIDLANDS
FRAMEWORK FOR ACTION
NHS Midlands and East is a cluster of SHAs comprising NHS East Midlands, NHS East of England and NHS West Midlands
Chair: Sarah Boulton
Chief Executive: Sir Neil McKay CB
Framework for Action
West Midlands Strategic Health Authority
• Framework is:
• A partnership approach of DH West
Midlands and its partners in 2009/10 to
develop a focus on the needs of people
with learning disabilities regarding:
– maintaining a healthy weight,
– participating in physical activities and
– making healthy food choices
NHS Midlands and East is a cluster of SHAs comprising NHS East Midlands, NHS East of England and NHS West Midlands
Chair: Sarah Boulton
Chief Executive: Sir Neil McKay CB
Framework s focus:
West Midlands Strategic Health Authority
• The initial stages of this focus included:
• Gaining an understanding of the agendas, policies and
challenges effecting people with learning disabilities
• Developing an understanding of the relationship between
obesity and learning disabilities
• Understanding the challenges of maintaining a healthy
weight for people with learning disabilities
• Developing knowledge of the programmes of work
happening already to tackle obesity within this specific
group in the community
NHS Midlands and East is a cluster of SHAs comprising NHS East Midlands, NHS East of England and NHS West Midlands
Chair: Sarah Boulton
Chief Executive: Sir Neil McKay CB
Partnerships are important –
regional seminar
West Midlands Strategic Health Authority
• DH West Midlands Public health and
social care teams
• West Midlands public health observatory
• NHS West Midlands SHA and Pan-WM
• Specialists practitioners in LD, physical
sport, transport, dance, healthy eating,
obesity, commissioners
• People with learning disabilities and their
carers
NHS Midlands and East is a cluster of SHAs comprising NHS East Midlands, NHS East of England and NHS West Midlands
Chair: Sarah Boulton
Chief Executive: Sir Neil McKay CB
WM Framework for
Action
West Midlands Strategic Health Authority
• Seminar identified:
• Strategic hooks and leavers to support
work
• Identified areas of work in the region and
identified good practice
• Looked at challenges facing people with
Learning disabilities and their carers in
accessing and participating in physical
activities, healthy eating
NHS Midlands and East is a cluster of SHAs comprising NHS East Midlands, NHS East of England and NHS West Midlands
Chair: Sarah Boulton
Chief Executive: Sir Neil McKay CB
Context of framework
West Midlands Strategic Health Authority
• Facts on Learning disabilities and Obesity
• Numbers are scarce as recording is low, yet people with
Learning disabilities is 2% of population
• Sports and recreational activities – access is low,
therefore take up is low
• Diet and nutrition – people with LD have access to
limited range of foods, people in traditional long stay
units and nutritional problems
• People with Prader-Willis – syndrome where people with
a LD have an insatiable appetite and eat excessively
even when full, often leading to chronic obesity.
NHS Midlands and East is a cluster of SHAs comprising NHS East Midlands, NHS East of England and NHS West Midlands
Chair: Sarah Boulton
Chief Executive: Sir Neil McKay CB
Strategic Policy context
West Midlands Strategic Health Authority
• Valuing People Now – Making it happen for everyone outlined:
– Rights, Independent Living, Control and Inclusion
• The NHS White Paper, Equity and excellence: Liberating the NHS
(2010)Healthy Lives, Healthy People: Our strategy for public health
in England (2010)
– Greater control to people over their health and care
– Greater accountability for patient outcomes for both the NHS and
Social care
– Health and care professionals being encouraged and supported
to work more effectively across boundaries to achieve improved
outcomes.
• Social Care White Paper 'A vision for adult social care: Capable
communities and active citizens'
• Public Health White Paper; Healthy Lives, Healthy People (2010)
NHS Midlands and East is a cluster of SHAs comprising NHS East Midlands, NHS East of England and NHS West Midlands
Chair: Sarah Boulton
Chief Executive: Sir Neil McKay CB
Policy context
West Midlands Strategic Health Authority
• No Health Without Mental Health Strategy (2011)
• The Quality, Innovation, Productivity and Prevention
(QIPP) programme
• Forthcoming Green Paper on Special Educational Needs
and Disability
• Healthy Lives, Healthy People: A call to action on obesity
in England
• The 2011 update for the UK Physical Activity Guidelines
• NHS Operating Framework 2012/13
NHS Midlands and East is a cluster of SHAs comprising NHS East Midlands, NHS East of England and NHS West Midlands
Chair: Sarah Boulton
Chief Executive: Sir Neil McKay CB
Coalition commitment
West Midlands Strategic Health Authority
• The Coalition Government have stated their commitment
to fulfil the priorities laid out by the previous Government
in the Valuing People Now strategy, reiterating a
pledge for equity, excellence and personalised
services for all people with learning disabilities. The
vision stated in Valuing People Now is reinforced in the
valuing People Now Summary Report as;
• “All people have the right to lead their lives like any
others, with the same opportunities and responsibilities,
with the right
• support to make this possible and be treated with the
same dignity and respect”
NHS Midlands and East is a cluster of SHAs comprising NHS East Midlands, NHS East of England and NHS West Midlands
Chair: Sarah Boulton
Chief Executive: Sir Neil McKay CB
Policy context
West Midlands Strategic Health Authority
• The Obesity and Physical Activity papers are due to be published in
spring 2011. The document also makes links to the Local Transport
White Paper and the Natural Environment White Papers that are
due out imminently.
• The new Public Health Service will focus on key outcomes
developed into a framework that will include 5 domains:
• Health protection
• Tackling wider determinants
• Health improvement – promoting the adoption of health lifestyles
• Preventing ill health
• Healthy life expectancy
NHS Midlands and East is a cluster of SHAs comprising NHS East Midlands, NHS East of England and NHS West Midlands
Chair: Sarah Boulton
Chief Executive: Sir Neil McKay CB
Mapping to Outcomes
West Midlands Strategic Health Authority
•
•
•
•
•
Measuring outcomes is key
Framework for action maps outcomes to:
The Public Health Outcomes Framework
NHS Outcomes Framework
Social care Outcomes Framework
NHS Midlands and East is a cluster of SHAs comprising NHS East Midlands, NHS East of England and NHS West Midlands
Chair: Sarah Boulton
Chief Executive: Sir Neil McKay CB
Value of Charter and
resources
West Midlands Strategic Health Authority
• Commissioners and strategists
• Service Providers and Practitioners
• Organisations – Advocacy, Health-watch,
LINKS
• Individual and family carers
• Health and Well Being Boards
• Learning Disability Partnership Boards
• Clinical Commissioning Groups (CCGs)
NHS Midlands and East is a cluster of SHAs comprising NHS East Midlands, NHS East of England and NHS West Midlands
Chair: Sarah Boulton
Chief Executive: Sir Neil McKay CB
Differences resources
can make?
West Midlands Strategic Health Authority
• Turn evidence into action
• Examples from Telford and Coventry
• Examples of how the Charter and the
Framework for action can work to make a
difference to the lives of people with
learning disabilities and their carers
NHS Midlands and East is a cluster of SHAs comprising NHS East Midlands, NHS East of England and NHS West Midlands
Chair: Sarah Boulton
Chief Executive: Sir Neil McKay CB
Ideas for action: Process for
organisations and partners
West Midlands Strategic Health Authority
Charter and resources
Monitoring
implementation,
evaluation and identify
outcomes for user.
Deliver of service –
person centred approach
Follow commissioners
checklist via service
specifications and
contracts
Sign up and embed
principles of charter
Inform contractors to
sign up via
commissioning/delivery
Inform staff to sign up
and embed principles
with commissioning and
delivery
NHS Midlands and East is a cluster of SHAs comprising NHS East Midlands, NHS East of England and NHS West Midlands
Chair: Sarah Boulton
Chief Executive: Sir Neil McKay CB
Thanks....
West Midlands Strategic Health Authority
NHS Midlands and East is a cluster of SHAs comprising NHS East Midlands, NHS East of England and NHS West Midlands
Chair: Sarah Boulton
Chief Executive: Sir Neil McKay CB