Role of Learning Disabilities Nursing
in Clinical Commissioning Groups
Dr Ben Thomas
Director of Mental Health &
Learning Disability Nursing
Government, national policy
and learning disabilities
•
•
•
•
•
•
Norman Lamb MP –MS (CS)
Local Government HWB
Adult Social care
Safeguarding
Mental health
Physical & learning
disabilities
• Third sector
• Prison Health Services
National nursing leadership
Jane Cummings
Chief Nursing Officer
NHS Commissioning Board
Viv Bennett
Director of Nursing and Government
Principal Advisor on Public Health
Nursing
Department of Health
NHS Outcomes
Leadership
Implementation &
delivery
Public health
Adult social care
The Commissioning model
Why is it important to involve nurses
throughout the commissioning cycle?
•
•
•
•
•
•
•
•
•
•
•
Improve the health of people with learning disabilities
Improve services for people with learning disabilities
Listening, consulting and engaging
Look for opportunities and create solutions
Strong, effective clinical leadership
Monitor and improve patient care
Navigate their way through NHS and social care systems
Suitable measures to use in CQUINS
Contribution to clinical outcomes
Co-ordinating care
Make things happen !!!
How and why to involve learning
disability nurses on the board
Our Vision - developing the culture of compassionate care
Compassion
Care is
our
business
Our values and behaviours are at
the heart of the vision and all we do
Care
Delivering high
quality care is what
we do. People
receiving care expect
it to be right for them
consistently
throughout every
stage of their life.
Compassion Competence
Compassion is how
care is given, through
relationships based
on empathy,
kindness, respect
and dignity.
Competence means
we have the
knowledge and skills
to do the job and the
capability to deliver
the highest standards
of care based on
research and
evidence.
Our values and behaviours are at
the heart of the vision and all we do
Communication
Courage
Commitment
Good communication
involves better
listening and shared
decision making - ‘no
decision about me
without me’.
Courage enables us
to do the right thing
for the people we
care for, be bold
when we have good
ideas, and to speak
up when things are
wrong.
Commitment will
make our vision for
the person receiving
care, our professions
and our teams
happen. We commit
to take action to
achieve this.
Six Areas for Action
Helping people to stay
independent,
maximising
well-being and
improving
health outcomes
•Deliver evidence-based care
& extend evidence through
research
•Explicitly demonstrate our
impact on outcomes
•Make ‘every contact count’ to
promote health and wellbeing
•Support people to remain
independent
•Maximise the contribution to
specialist community public
health nursing
Working
with people
Measure
to provide
a positive
Impact
experience of care
•Design our services so
people, and their carers and
family are active participants
in their care
•Prioritise patients and the
people who receive care in
every decision we make
•Collect, listen to and act on
feedback and complaints
•Promote personal
responsibility for health and
wellbeing
Delivering high
quality care
and measuring
impact
• Follow evidence-based best
practice to deliver high quality
outcomes to those that use
health and care services
•Measure what we do and our
contribution to quality
• Be transparent and publish
the outcomes
• Promote careers in research
to strengthen the focus on
evidence based practice
Leadership at every level
Six Areas for Action
Building and
et Staffing
strengthening
Right
leadership
Ensuring
we have
Measure
the right
staff, with
Impact
the right skills in the
right place
Supporting positive
staff experience
•Ensure all registered nurses
& midwives understand their
leadership role with the wider
care-giving team
• Free our leaders to have
time to lead e.g. supervisory
status, better use of
technology
• Empower nurses, midwives
& registered managers to
make local changes to
improve care.
•Use evidence based staffing
levels
•Create worthwhile &
rewarding jobs
• Create equality of
opportunity
• Support each other & new
entrants to the professions
• Be professionally
accountable
• Embrace new technology
• Be productive and efficient
• Commit to and support life
long learning for the whole
care-giving team
• Recruit staff with the right
culture & values
Leadership at every level
Jane Cummings, CNO
6 Cs of Nursing
NHS Change Model
Making sense of it all to bring
Competency
Communication
Leading
change
a shared purpose to the vision
NHS OUTCOMES FRAMEWORK
2012/13
Domain 1
Preventing
people from
dying
prematurely
Domain 2
Domain 3
Enhancing
quality of life
for people
with longterm
conditions
Helping
people
recover from
episodes of ill
health or
injury
Domain 4
Domain 5
Ensuring
that people
have a
positive
experience
of care
Care in a safe
environment
and protecting
them from
avoidable
harm
Learning Disabilities Nursing
• 1995 – 12,504 in NHS
• 2011 – 5,189 in NHS
• 54% reduction (1,000 per
year)
• Increasing vacancy factor
1,7% in 2009)
• 600 student commissions
per year
• 4/500 register with NMC
Learning Disabilities Nursing Review
• Strengthening
capability
• Strengthening the
quality
• Strengthening the
profession
• Strengthening capacity
Recommendations:
• Ensure the knowledge and skills of
learning disabilities nurses are
provided to the right people, in the
right places at the right time
• Knowledge and expertise available
across the lifespan
• Work collaboratively with general
health services including health
improvement, prevention and public
health approaches
• Specialist services employ sufficient
numbers of learning disabilities nurses
Maximising the learning disabilities
nursing input into commissioning
• Assess and monitor the quality of
services
• Ensure the needs of people with
learning disabilities are considered in
all commissioning plans
• Raise awareness of social factors
• Joined up person centred services
• Effective commissioning, QIPP
• Strong clinical leadership
• Improve access to services
• Challenge discriminatory attitudes
• Implement reasonable adjustments
• Accessible information
Determinants of Health (In)equalities
as outcome measures
Determinant 1
Determinant 2
Determinant 3
Determinant 4
Determinant 5
Social factors
Genetic &
biological
conditions
Personal health
risks &
behaviours
Communication
difficulties
&
reduced health
literacy
Access to
healthcare
provision
e.g. poverty, poor
housing,
unemployment,
social isolation
e.g. self-harm,
poor diet, lack of
exercise
Summary
•
•
•
•
•
•
•
•
Safe, high quality local care
More responsive
More person centred
Reduction in variation
Increased range and choice
Improved health outcomes and satisfaction
More preventative care
More complex, long term care in the
community
• More joined up care
• More cost effective care
Thank You
Contact details:
Dr Ben Thomas
ben.thomas@dh.gsi.gov.uk