Improving the Health and Wellbeing of
People with Learning Disabilities: An
Evidence-Based Commissioning Guide
for Clinical Commissioning Groups
Dr Matt Hoghton; RCGP Clinical Champion Learning
Disabilities
Sue Turner; Improving Health and Lives Learning
Disabilities Public Health Observatory
Dr 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?