Good Health Recommended Actions: Valuing People Now (2009)
Background information:
Better health for people with learning disabilities is a key priority. There is clear evidence that most people with learning disabilities
have poorer health than the rest of the population and are more likely to die at a younger age. Their access to the NHS is often
poor and characterised by problems that undermine personalisation, dignity and safety. The final report of the NHS next Stage
Review9 sets out the vision for the NHS that it will ‘deliver high quality care for all users of services in all aspects’. Key issues for the
NHS are to achieve full inclusion of people with learning disabilities in mainstream work to reduce health inequalities and to ensure
high-quality specialist health services where these are needed.
The report of the Independent Inquiry into access to healthcare for people with learning disabilities, Healthcare for All, was
published in July 2008 and made 10 key recommendations for improvement. This strategy sets out a programme of work to
address Healthcare for All recommendations. People with learning disabilities are entitled to be treated with the same dignity and
respect as any other member of the community. Neglect or abuse of disabled people is absolutely unacceptable and the
Government is determined that lessons are learnt and that action is taken to improve healthcare for people with learning disabilities.
Better health
Overall policy objective: all people with learning disabilities get the healthcare and the support they need to live healthy lives.
‘Everyone can expect to live healthy lives with the appropriate support from a personalised and fair National Health Service, that
ensures the most effective treatments within a safe system.’ high Quality Care for all (2008)
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References: Valuing People Now: a new three-year strategy for people with learning disabilities
‘Making it happen for everyone’ Jan 2009.
Johanna Lee Clinical Lead Nurse LD NHS Knowsley. 080609
Health care for all inquiry makes ten principal recommendations to make healthcare services more accessible for people with
learning disabilities across NHS primary, secondary and tertiary boundaries and other agencies (Appendix 1). Not all of the
recommendations are relevant to Health and Social Care PCT Trusts.
Therefore it is important that Knowsley responds to each recommendation individually:
Chapter 3 – Having a life
Good Health
Making it happen locally and regionally – key recommended actions
KEY RECOMMENDATIONS & DOH RESPONSE:
 SHA’s, PCT’s and NHS’s trust providers to address the recommendations in Healthcare for All and
the government’s response, particularly in ensuring that reasonable adjustments are made to all
health services to reflect the specific needs of people with learning disabilities. Partnership boards
and PCT’s to ensure people with learning disabilities and their family carers are partners in
improving healthcare for people with learning disabilities.
2
References: Valuing People Now: a new three-year strategy for people with learning disabilities
‘Making it happen for everyone’ Jan 2009.
Johanna Lee Clinical Lead Nurse LD NHS Knowsley. 080609
RECCOMENDATION 1:
Those with responsibility for the provision and regulation of undergraduate and post graduate clinical training must
ensure that curriculum includes mandatory training in learning disabilities. It should be competence-based and involve
people with learning disabilities and their carers in providing training.
1: DOH RESPONSE: we accept this recommendation. We are working through education commissioners and education
providers to review and improve training provided for healthcare staff, in line with best practice, to address the needs of people with
learning disabilities. We will encourage the engagement of service users and carers in the design and delivery of this training. We
will expect SHA’s to account to us at the year-end to give appropriate assurances that this is being taken forward.
We will also continue working with the professional regulatory bodies, which are responsible for setting educational standards for
the health and social care professions, to agree what further steps we can each take to support improvements in training.
1: KNOWSLEY RESPONSE:

The Clinical Lead Nurse and LD Nursing Team in partnership with the Knowsley Workforce Development Training
Department offers and provides mandatory and statutory training to all health and social care provider staff in primary and
secondary care service on:
Health and learning disabilities
Health Action Planning.
Epilepsy.
Complex behaviour.
Mental Health.
Understanding Learning Disabilities

Formal and informal training is also offered and delivered in GP surgeries and in other health settings.
3
References: Valuing People Now: a new three-year strategy for people with learning disabilities
‘Making it happen for everyone’ Jan 2009.
Johanna Lee Clinical Lead Nurse LD NHS Knowsley. 080609

The Being Involved Advocacy Group (Learning disabilities) is involved in the design and delivery of training.

People with learning disabilities and their families and carers are also involved in the development and delivery of the
training sessions within Aintree Hospital.
1: ACTION RESPONSE:

Increase the uptake of Knowsley carers and individuals with learning disabilities in the development and delivery of training.

Care provider services to take responsibility to ensure all their workforce attend relevant training re health and Learning
Disabilities.

Training is mandatory and provided in local hospital settings for health care staff.
1: LEAD SERVICE /PERSON:
4
References: Valuing People Now: a new three-year strategy for people with learning disabilities
‘Making it happen for everyone’ Jan 2009.
Johanna Lee Clinical Lead Nurse LD NHS Knowsley. 080609
RECOMMENDATION 2:
All healthcare organisations, including the Department of Health should ensure that they collect the data and information
necessary to allow people with learning disability to be identified by the health service and their pathways of care tracked.
2: DOH RESPONSE: we accept this recommendation. the dh permanent Secretary chairs a group responsible for ensuring
improvements in the data, information and information systems used by the NHS to monitor equality of access to health services
and equality of health outcomes. Building on this work, we will ask the NHS information Centre to work with the public health
observatory for learning disability (see below) to identify the practical changes needed to:
•
Ensure more systematic recording of learning disability within general practice. this will be helped significantly by the new
directed enhanced Service for annual health checks, which will help gap practices ensure that the registers they maintain under the
Quality and outcomes framework reflect information from local authority registers of people with learning disabilities known to
services;
•
develop more consistent systems to ensure that information is shared with other healthcare providers when gap practices
make referrals to other services – supported by the review of disability definitions currently being undertaken by the office of
national Statistics; and
•
Allow appropriate data from GP practice systems to be compared with data from other NHS sources (eg the Secondary uses
Service) to allow better analysis of the uptake of healthcare interventions and health outcomes in relation to people with learning
disabilities.
2: KNOWSLEY RESPONSE: Knowsley GP’s have a standard system in place to identify individuals with learning disabilities:
the Read Code system. Individual’s clinical and medical diagnosis is recorded and information data can be collated as necessary
via PCT Informatics department.
The Clinical Lead Nurse service supports GP surgeries to maintain robust quality registers. All registers are cross referenced with
social care registers.
5
References: Valuing People Now: a new three-year strategy for people with learning disabilities
‘Making it happen for everyone’ Jan 2009.
Johanna Lee Clinical Lead Nurse LD NHS Knowsley. 080609
2: ACTION REQUIRED:

Develop systems in acute hospitals to identify and track vulnerable adults with learning disabilities.
2: LEAD SERVICE / PERSON:
6
References: Valuing People Now: a new three-year strategy for people with learning disabilities
‘Making it happen for everyone’ Jan 2009.
Johanna Lee Clinical Lead Nurse LD NHS Knowsley. 080609
RECOMMENDATION 3:
Family and other carers should be involved as a matter of course as partners in the provision of treatment and care,
unless good reason is given, and Trust Boards should ensure that reasonable adjustments are made to enable them to do
this effectively. This will include the provision of information, but may also involve practical support and service coordination
3: DOH RESPONSE: we accept this recommendation. Valuing People Now recognises the important role that carers play and
the importance of working in partnership with them in the provision of treatment and care. The government’s national Carers
Strategy, published in June 2008, sets out how carers should be included as partners in care. The strategy includes a commitment
to issue information prescriptions to carers and to enable carers to receive other appropriate information, especially in cases where
mental capacity is an issue.
The national Carers Strategy also recognises how the additional stress of caring roles may affect the carer’s own health. it
proposes piloting annual health checks for family carers and ensuring regular access to short break services and support
3: KNOWSLEY RESPONSE: People with learning disabilities, their families and carers are involved and consulted in the
assessment process and delivery of care via treatment and care plans with all NHS Knowsley Primary health and social care staff.
The Clinical Lead Nurse service and Learning Disability Nursing team have a key role in ensuring and assisting individuals to
navigate their way around the NHS.
When requested information regarding health care is available in an easy read language and picture format which is suitable for
people with learning disabilities. The Being Involved Advocacy Group is involved with developing health information into easy read
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References: Valuing People Now: a new three-year strategy for people with learning disabilities
‘Making it happen for everyone’ Jan 2009.
Johanna Lee Clinical Lead Nurse LD NHS Knowsley. 080609
format for health care services. The Learning Disability Partnership Board employs a Communication support worker to assist
health and social care services to make information easy to understand.
3: ACTION REQUIRED: To develop systems and processes within acute hospital care settings to involve family and carers in
the planning and delivery of care.
To raise awareness with all health, social and voluntary care providers, including families, carers and individuals with Learning
disabilities of the need and availability of easy read health information and the role of the Communication Support Worker.
3: LEAD SERVICE / PERSON:
8
References: Valuing People Now: a new three-year strategy for people with learning disabilities
‘Making it happen for everyone’ Jan 2009.
Johanna Lee Clinical Lead Nurse LD NHS Knowsley. 080609
RECOMMENDATION 4:
“Primary care trusts should identify and assess the needs of the people with learning disabilities and their carers as part
of their Joint Strategic Needs Assessment. They should consult with their Local Strategic Partnership, their Learning
Disability Partnership Boards and relevant voluntary user-led learning disability organisations and use the information to
inform the development of Local Area Agreements.”
4: DOH RESPONSE: Class Commissioning programme, we are working with PCT’s to help identify and spread best practice in
commissioning services to meet the needs of people with learning disabilities, including best practice in needs assessment and in
engagement with service users, families and carers, and partnership boards. This should form part of the Joint Strategic needs
assessments undertaken with local authorities and other community partners.
Good commissioning includes working in partnership with healthcare providers, for instance through systems of strategic health
facilitation and acute liaison, to help ensure that people with learning disabilities receive timely, convenient access to the full range
of services needed to meet their health needs and that they receive high-quality, personalised and joined-up care across primary
care, community health services and hospital settings.
It also includes reviewing workforce requirements relating to primary healthcare facilitation and acute hospital liaison to help ensure
that reasonable adjustments are made.
The minimum dataset for Joint Strategic needs assessments, which the inquiry commended, includes indicators on the number of
people with learning disabilities resident in each area, the number in employment and the number in settled accommodation. The
minimum dataset also includes an indicator on carers’ assessments. The number of annual health checks for people with learning
disabilities known to local authorities will also now be collected as part of the NHS vital Sign indicators.
DOH recommends the core dataset as a starting point for Joint Strategic needs assessments. We encourage PCT’s and local
authorities to work with service users and their families and carers to identify additional information that can inform the assessment.
9
References: Valuing People Now: a new three-year strategy for people with learning disabilities
‘Making it happen for everyone’ Jan 2009.
Johanna Lee Clinical Lead Nurse LD NHS Knowsley. 080609
4 KNOWSLEY RESPONSE:

In developing the Joint Strategic Needs Assessment for Knowsley a Stakeholder Event was held with the Being Involved
Group of service users, supported by staff from Knowsley Disability Concern. Carers were involved in a range of events
across the borough.

The Learning Disability Partnership Board, which is co-chaired by a person with a learning disability, was also consulted on
health priorities. The Joint Strategic Needs Assessment gives a strong commitment to commissioning and providing safe
and effective good quality health care to people with learning disabilities and emphasises the importance of access and
inclusion in preventative and health promotion services

Knowsley PCT has invested in employing a Strategic Health Facilitator (Clinical Lead Nurse LD) and a clinical Health
Facilitator who work in partnership with Primary care services to help ensure that people with learning disabilities received
personalised primary and community health services.
A hospital working group was established in April 2008 by the Lead Learning Disability Nurse to identify the needs of the
acute sector in relation to the care of patients with learning disabilities, including training needs and policy and practice
development.


The importance of improving communication was recognised. A “Communication Booklet” was devised and is now available
on all wards in Aintree and Whiston Hospitals to support any patient, relative or carer who has difficulty in communicating.
Ward Staff have received training and are able to access the specialist community team who can provide advice and
support.

A Health Information Passport has been introduced. This is completed by the person with learning disability and their carers,
with the support of staff from the specialist community team, so that hospital staff can understand the every day needs on
the patient and their preferred means of communication.
10
References: Valuing People Now: a new three-year strategy for people with learning disabilities
‘Making it happen for everyone’ Jan 2009.
Johanna Lee Clinical Lead Nurse LD NHS Knowsley. 080609
4: ACTION REQUIRED:

Commissioning services in Knowsley and local PCT’s in Merseyside to explore and scope the development of Acute LD
Liaison Nurse posts to work in partnership with hospitals to ensure people with Learning disabilities receive personalised
care in hospital settings.

LDDF Proposal for funding for an Acute Liaison LD nurse post to support the Clinical Lead Nurse to proactively work with
local hospitals.
4: LEAD SERVICE / PERSON:
11
References: Valuing People Now: a new three-year strategy for people with learning disabilities
‘Making it happen for everyone’ Jan 2009.
Johanna Lee Clinical Lead Nurse LD NHS Knowsley. 080609
RECOMMENDATION 5
“To raise awareness in the health service of the risk of premature avoidable death and to promote sustainable good
practice in local assessment, management and evaluation of services, the Department of Health should establish learning
disabilities Public Health Observatory. This should be supplemented by a time-limited confidential Inquiry into premature
deaths in people with learning disabilities to provide evidence for clinical and professional staff of the extent of the
problem and guidance on prevention.”
5: DOH RESPONSE: we accept this recommendation. we agree that PCT's, as commissioners of health services, would
benefit from better support in assessing the needs of people with learning disabilities in their local population, in assessing how far
these needs are currently being met through the services available, and in understanding comparative health outcomes for people
with learning disabilities.
We agree that a public health observatory would help pacts embed best practice in these areas. We will commission this
programme of work either from a stand-alone public health observatory or from one of the existing public health observatories.
We agree that a time-limited Confidential inquiry into premature deaths in people with learning disabilities would help improve the
clinical evidence base that should underpin commissioning of local services. We are developing a specification for the inquiry and
propose inviting proposals from potential organisations.
5: KNOWSLEY RESPONSE::

Staff in Learning Disability Services in Knowsley has recognised that people with learning disabilities have sometimes
experienced “diagnostic overshadowing” whereby reports of physical ill health have been viewed as part of their mental
health or learning disability and therefore not adequately investigated or treated.
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References: Valuing People Now: a new three-year strategy for people with learning disabilities
‘Making it happen for everyone’ Jan 2009.
Johanna Lee Clinical Lead Nurse LD NHS Knowsley. 080609

This has been addressed in a number of ways including the establishment of Local and Directed Enhanced Services for GP
services to offer individuals with LD are an annual health check. The purpose of this is to enable early detection of ill health
and disease and refer on to appropriate health promotion services to promote healthy lifestyles.

Proactive person centred preparatory cancer screening sessions are offered by LD nurses to individuals to increase the
uptake of cancer screening programmes.

Promotion or annual health checks, Health Action Plans and Person Centred Planning processes.

Awareness of the health needs of people with learning disabilities in training sessions to carers and health care staff.
5: ACTION REQUIRED:

The Public Health Team has committed resources to compile a local LD population health analysis which will assist to
identify the health needs of people with learning disabilities in the borough of Knowsley.
5: LEAD SERVICE / PERSON:
13
References: Valuing People Now: a new three-year strategy for people with learning disabilities
‘Making it happen for everyone’ Jan 2009.
Johanna Lee Clinical Lead Nurse LD NHS Knowsley. 080609
RECOMMENDATION 6:
The Department of Health should immediately amend Core Standards for Better Health, to include an explicit reference to
the requirement to make ‘reasonable adjustments’ to the provision and delivery of services for vulnerable groups, in
accordance with disability equality legislation. The framework that is planned to replace there core standards in 2010
should also include a specific reference to this requirement.
6: DOH RESPONSE: we accept the aim of this recommendation. As public bodies, NHS organisations are required by the
disability discrimination act 1995 to make reasonable adjustments to the provision and delivery of their services to vulnerable
groups.
Core Standards for better health will no longer be used as the basis for performance assessment of healthcare services once the
Care Quality Commission takes over the role of the healthcare Commission from April 2009. However, the healthcare Commission
is already working jointly with the Commission for Social Care inspection and the Mental health act Commission, with a specific
focus on making sure that the commissioning and provision of services for people with learning disabilities meet the provisions of
disability discrimination and other relevant legislation, including the human rights act 1998.
We have included specific provision in the health and Social Care act 2008 to make sure the Care Quality Commission is able to
take account of all other relevant legislation, including the disability discrimination act 1995.
Earlier this year, the department consulted on a high-level framework for the requirements against which providers should be
assessed from 2010/11 onwards. In doing so, we have been particularly mindful of the needs of vulnerable groups. Our proposals
included requirements that providers safeguard people when they are vulnerable and that they assess, plan and deliver care in a
way that reflects people’s individual needs and diversity. We are currently analysing and considering the responses to the
consultation and will publish the government’s response shortly. Once the high-level requirements are set in regulations, the Care
Quality Commission will develop and consult on the criteria that it will use to assess compliance with regulations.
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References: Valuing People Now: a new three-year strategy for people with learning disabilities
‘Making it happen for everyone’ Jan 2009.
Johanna Lee Clinical Lead Nurse LD NHS Knowsley. 080609
6: KNOWSLEY RESPONSE:
Responsibility is the Department of Health to amend core standards for better health.
Although it is the responsibility of the Department of Health to amend core standards for better health, Knowsley Clinical
Governance Department makes explicit reference to and monitors evidence of compliance to make ‘reasonable adjustments’ to the
delivery of services for vulnerable groups in accordance with disability equality legislation in its Nursing Health Care Core
Standards for Better Health.
There is a strong focus on requiring staff to challenge discrimination, promote equality and respect human rights and to treat
patients, their relatives and carers with dignity and respect
There are systems and services in place to protect vulnerable adults. Knowsley has a multi agency Safeguarding Adults Team and
there is a multi agency policy which is adhered to by all.
There is a Deprivation of Liberty lead person in the Learning Disabilities Health and Social care team.
6 ACTION REQUIRED:
6: LEAD SERVICE / PERSON:
15
References: Valuing People Now: a new three-year strategy for people with learning disabilities
‘Making it happen for everyone’ Jan 2009.
Johanna Lee Clinical Lead Nurse LD NHS Knowsley. 080609
RECOMMENDATION 7
“Inspectors and regulators of the health service should develop and extend their monitoring of the standard of general
health services provided for people with learning disabilities, in both the hospital sector and in the community where
primary care providers are located. The aim is to support appropriate, reasonable adjustments to general health services
for adults and children with learning disabilities and their families and to ensure compliance with and enforcement of all
aspects of the Disability Discrimination Act. Healthcare regulators and inspectors (and the Care Quality Commission,
once established) should strengthen their work in partnership with each other and with the Commission for Equality and
Human Rights, the national Patients Safety Agency and Office for Disability Issues.”
7: DOH RESPONSE: We accept this recommendation. To strengthen assurance of equality throughout the health and social
care system, dh will, from April 2009, be requiring accountable officers of NHS organisations and arm’s length bodies to provide
assurance that their organisation is complying with equalities legislation through annual statements of internal control. Statements
of internal control are published as part of each organisation’s audited annual accounts.
We will work with the new Care Quality Commission to help it to take forward the lessons learned from the current regulators’ work
and to support the partnership approach set out in this recommendation. In addition, we welcome the commitment of the equality
and human rights Commission to work with the regulatory agencies to ensure a coordinated approach to delivering change
7: KNOWSLEY RESPONSE:

Within primary care, GP contracting with the Directed Enhanced Service has enabled monitoring of the standard of care and
treatment. The Service includes an annual health check, specifically focused on health issues pertinent to people with
learning disabilities; a Health Action Plan; the maintenance of robust patient registers; participation in training to understand
people with learning disabilities and their health needs; take-up of health screening by people with a learning disability and
the pro-active follow up of any missed appointments.
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References: Valuing People Now: a new three-year strategy for people with learning disabilities
‘Making it happen for everyone’ Jan 2009.
Johanna Lee Clinical Lead Nurse LD NHS Knowsley. 080609

A hospital working group was established in April 2008 by the Lead Learning Disability Nurse to identify the needs of the
acute sector in relation to the care of patients with learning disabilities, including training needs and policy and practice
development.
7: ACTION REQUIRED:
7: LEAD SERVICE / PERSON:
17
References: Valuing People Now: a new three-year strategy for people with learning disabilities
‘Making it happen for everyone’ Jan 2009.
Johanna Lee Clinical Lead Nurse LD NHS Knowsley. 080609
RECOMMENDATION 8:
The Department of Health should direct primary care trusts (PCTs) to secure general health services that make ‘reasonable
adjustments’ for people with learning disabilities through a Directed Enhanced Service. In particular, the Department should direct
PCTs to commission enhanced primary care services which include regular health checks provided by GP practices and improve
data, which include regular health checks provided by GP practices and improve data, communication and cross-boundary
partnership working. This should include liaison staff who work with primary care services to improve the overall quality of health
care for people with learning disabilities across the spectrum of care.
DOH agreement with the British Medical association (BMA) to introduce a directed enhanced Service for annual health checks for
people with learning disabilities known to local authorities. This means that all PCT’s in England are under a direction to
commission annual health checks from GP practices in their area and to arrange appropriate training for GP’s and GP practice
staff. These arrangements will initially run until 31 March 2010. The number of people with learning disabilities known to local
authorities who receive annual health checks will be a new vital Signs indicator. Over the next year, we will work with groups
representing patients, families and carers and professional groups to review the effectiveness of these arrangements and consider
improvements for the future.
GP’s and GP practice staff will receive training in meeting the needs of people with a learning disability provided by Strategic health
facilitators or local Community learning disability team staff in partnership with self-advocates and family carers. We are also
promoting the development of practitioners with a Special interest in learning disability. This will be focused initially on GP’s and
pharmacists but we hope it will expand to include other professionals, who can then serve as a resource to other health
practitioners in their area.
8: KNOWSLEY RESPONSE:

In April 2005 NHS Knowsley developed the Clinical Lead Nurse service which includes a Strategic Health Facilitator and a
Clinical Health Facilitator; this is a designated designed service to work in partnership with primary and secondary health
care services to improve access, care and treatment outcomes for people with learning disabilities, their families and carers.
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References: Valuing People Now: a new three-year strategy for people with learning disabilities
‘Making it happen for everyone’ Jan 2009.
Johanna Lee Clinical Lead Nurse LD NHS Knowsley. 080609

In April 2007 NHS Knowsley commissioned and primary care services deliver a Local Enhanced Service (LES) via GP
surgeries offering and providing annual health checks and Health Action Plans to patients with a learning disability who are
registered at their surgery.

Other elements of the LES includes quality maintained patient registers, person centred appointments with adequate time
for treatment, easy to read health information and training to enable surgery staff to understand the health needs of this
patient group.

In April 2009 the DOH Directed Enhanced Service (DES) replaced the LES and includes the same elements of service. The
DES is subject to a performance management framework which includes quality checking a random sample (25%) of the
health checks undertaken and the resulting Health Action Plans. This is monitored by the Clinical Lead Nurse LD and
Primary Care Management Team.
8: ACTION REQUIRED:

Strategic Health Facilitator to continue to support primary care services to implement and monitor effectiveness of DES.
8: LEAD SERVICE / PERSON:
19
References: Valuing People Now: a new three-year strategy for people with learning disabilities
‘Making it happen for everyone’ Jan 2009.
Johanna Lee Clinical Lead Nurse LD NHS Knowsley. 080609
RECOMMENDATION 9:
Section 242 of the National Health Service Act 2006 requires NHS bodies to involve and consult patients and the public in the
planning and development of services, and in the decisions affecting the operation of services. All Trust Boards should ensure that
the views and interests of people with learning disabilities and their carers are included.
9: DOH RESPONSE: we accept this recommendation. the operating framework for 2008/09 set out the importance of close
partnership working between PCT’s and local authorities, with a particular focus on person centred health plans for people with
learning disabilities. Valuing People Now recommended that PCT’s should be represented on partnership boards. The
strengthened role of partnership boards should give PCT’s access to the views of service users and families and carers, to help
PCT’s to assess needs and review services and commissioning improvements in health and healthcare.
The establishment of local involvement networks (links) in April 2008 provides a key mechanism to improve the commissioning of
services for people with learning disabilities. links provide communities with the opportunity to influence health and social care
services – including disability services – and give citizens the chance to have their say in a much wider range of ways
9: KNOWSLEY RESPONSE:

People with learning disabilities have been instrumental in the development of a patient satisfaction survey which is currently
being ‘rolled' out across all GP surgeries. The outcomes of the survey will be feedback to senior managers, commissioners
and other relevant bodies to review the quality of the service currently offered and if there is a need for redesign and delivery
of the health check clinics.

The PCT is strongly represented on the Partnership Board by the Clinical Lead Nurse LD who co leads the Health Sub
Group.

The LD Partnership Board is regularly consulted by the PCT to ensure that the views and interests of people with learning
disabilities and their carers are included.
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References: Valuing People Now: a new three-year strategy for people with learning disabilities
‘Making it happen for everyone’ Jan 2009.
Johanna Lee Clinical Lead Nurse LD NHS Knowsley. 080609
9 ACTION REQUIRED:

LD Partnership Board, individuals with Learning disabilities their families and carers need to build strong links with PAL’s,
LINK’s and patient forums.
9: LEAD SERVICE / PERSON:
21
References: Valuing People Now: a new three-year strategy for people with learning disabilities
‘Making it happen for everyone’ Jan 2009.
Johanna Lee Clinical Lead Nurse LD NHS Knowsley. 080609
RECOMMENDATION 10
All Trust Boards should demonstrate in routine public reports that they have effective systems in place to deliver effective,
‘reasonably adjusted’ health services for those people who happen to have a learning disability. This ‘adjustment’ should include
arrangements to provide advocacy for all those who need it, and arrangements to secure effective representation on PALS from all
client groups including people with learning disabilities.
10: DOH RESPONSE: we accept this recommendation. It is good practice for trusts to show explicitly how they have adapted
their services to make them accessible to people with disabilities. In addition, it is good practice for trusts to include family carers
and people with learning disabilities as equal partners with expertise, who can support these organisations in achieving this
objective.
10: KNOWSLEY RESONSE:

There is an advocacy group in Knowsley: the Being Involved Advocacy Group and families and carers link to carer groups:
Partners and Policy makers and ‘Knowsley Carers’. All are members of the Learning Disability Partnership Board and are
consulted by PCT health and social care services in the development and delivery of all health services.
10: FURTHER ACTION:

The LD Partnership Board needs to further promote representation from LD Advocacy and Carer groups on mainstream
health and social care patient / public forums.
10 LEAD SERVICE / PERSON:
22
References: Valuing People Now: a new three-year strategy for people with learning disabilities
‘Making it happen for everyone’ Jan 2009.
Johanna Lee Clinical Lead Nurse LD NHS Knowsley. 080609
VALUING PEOPLE NOW (2009) All relevant bodies to follow the guidance and/or use toolkits around health services
for people with learning disabilities. this includes the Specialist Learning Disabilities Commissioning Guidance 2007 and
world Class Commissioning guide for people with learning disabilities published alongside this strategy and guidance on
mental health, health action planning and health facilitation.
KNOWSLEY RESPONSE:
Health Action Planning and health facilitation:
 A Health Action Plan Framework is in place.
 The framework ensures Health Action Plans will be offered to children and young people in transition to adult services and to
adults following their annual health check at their GP surgery.
FURTHER ACTION:

Care Provider services need to take lead responsibility to develop Health Action Plans as part of the Person Centred Plan,
maintaining and monitoring the implementation of the plan to ensure its effectiveness.

There needs to be clear changes via the commissioning process to ensure that within contracts or service level agreements
with care provider services the responsibility for promoting and maintaining healthy lifestyles via Health Action Planning is
identified as the provider’s duty.

Mental Health
To promote access, care and treatment in mainstream secondary care mental health services pathways and strategies need
to be developed.
To ensure the ‘Greenlight Mental Health tool kit’ and the DOH Care Programme Approach is implemented.
LEAD SERVICE / PERSON:
23
References: Valuing People Now: a new three-year strategy for people with learning disabilities
‘Making it happen for everyone’ Jan 2009.
Johanna Lee Clinical Lead Nurse LD NHS Knowsley. 080609
VALUING PEOPLE NOW (2009)
PCT and NHS Trust disability equality schemes to include specific action to address health inequalities facing people
with learning disabilities
KNOWSLEY RESPONSE:

Knowsley Primary Care Trust has developed a Single Equality Scheme (SES) and Action Plan, based on a three year
cycle. Knowsley Metropolitan Borough Council has three separate equality schemes in place and is committed to producing
a SES by 2009. This policy will ensure that everyone associated with Health and Wellbeing Services are aware of both their
rights and responsibilities regarding equality and diversity.
FURTHER ACTION:

LD Partnership Board to promote the involvement of advocates and carers in equality and diversity training which is
mandatory for all health and social care staff.
LEAD SERVICE / PERSON:
24
References: Valuing People Now: a new three-year strategy for people with learning disabilities
‘Making it happen for everyone’ Jan 2009.
Johanna Lee Clinical Lead Nurse LD NHS Knowsley. 080609
VALUING PEOPLE NOW (2009)
SHA’s and PCT’s to support local services to address good practice for local services, as outlined in Healthcare for All.
KNOWSLEY RESPONSE:
See question 1 Knowsley response.
FURTHER ACTION:
LEAD SERVICE / PERSON:
:
25
References: Valuing People Now: a new three-year strategy for people with learning disabilities
‘Making it happen for everyone’ Jan 2009.
Johanna Lee Clinical Lead Nurse LD NHS Knowsley. 080609
VALUING PEOPLE NOW (2009)
Partnership Boards and PCT’s to ensure people with LD and their family carers are partners in improving health care for people
with LD.
KNOWSLEY RESPONSE:

People with learning disabilities and family carers are represented on the LD partnership board.
FURTHER ACTION:

The LD Partnership Board and the PCT needs to further promote representation from LD Advocacy and Carer groups on
mainstream health and social care patient / public forums.

There needs to be a more specific strategy / protocol regarding how self advocates and family carers are involved and
consulted in the development of services.
LEAD SERVICE / PERSON:
26
References: Valuing People Now: a new three-year strategy for people with learning disabilities
‘Making it happen for everyone’ Jan 2009.
Johanna Lee Clinical Lead Nurse LD NHS Knowsley. 080609