Campus The target for Campus re-provision is December 2010. Five localities still have people living in such provision. However, all areas have submitted plans to the SHA highlighting actions to meet the December 2010 deadline. It is anticipated two localities will not meet the target, and have submitted revised plans to close 14 beds by March 2011. The revised plan have been received by the SHA and declared to DH. Out of area There appears to be a significant variation in the proportion of people out of area across districts. Similarly, there is variation in impetus to develop local responses to support people at risk of being placed out of area. Where it has been addressed, this has largely been restricted to commissioning initiatives e.g. improved monitoring of cost and quality of placements, some “repatriation”, rather than investing in local infra structure to avoid out of area placements. Priority areas for the QIPP programme relate to improving: - transition planning - services for people with complex needs - people with challenging behaviour
Acute liaison nurse/officer posts Within the region there are good models of joint working through the establishment of acute liaison nurse /officer posts. The absence of such a post reflected in lower ratings for supporting people with a learning disability and their family carers in acute health care settings. Although there were numerous examples of good work in this area without a dedicated senior post embedded within the hospital this work had limited impact. In terms of ensuring equal access, experiences and outcomes for people with learning disabilities and their carers. It is strongly recommended each area should establish an acute liaison nurse. BME There was some good practice in the region on work being done to identify people from minority groups and their carers, for example in Dudley, Telford and Wrekin, and some areas have developed cross cutting themes on equalities through the Pacesetters sites such as Walsall. However, overall the region needs to work to improve the planning and delivery of services to people from ethnic minority groups.
Profound/ Moderate Learning Disabilities (PMLD) Whilst areas such as Coventry, Dudley and Shropshire provided good evidence of strategies and action plans to support this particular client group. The overall consensus was that this client group was easily lost and forgotten, and seems to be a challenge for many districts across the region. Equal access to benefits from the development of computer technology - IM & T Within the region Walsall, Dudley and Coventry were able to demonstrate good use of IM & T systems. Dudley’s exceptional model of ensuring each GP Practice engaged in implementing the Special Needs Register (SNR) for people with learning disabilities clearly proved the value in planning and monitoring service delivery. Whilst there are some examples of good practice, IM & T has not been used systematically across the region, and some areas had poor monitoring of data and registers. Improving the use of IM &T for monitoring service delivery and planning clearly is a priority.
Complaints From the returns Coventry and Telford & Wrekin clearly demonstrated interesting models of support for assisting people with a learning disability and their carers to access the complaints procedure. This included; easy read information, advocacy and support to follow through the complaints, training and peer support through to volunteering. However across the region there was little evidence that people with a learning disability were actually making complaints, and how these were being responded to in relation to service delivery and planning.
Transitions – focus on young people in transitions Although this area is previously identified in the Out of Area QIPP priority; it clearly remains a key challenge for the region. Whilst Coventry and Telford & Wrekin have clearly demonstrated clear models and approaches to improving their plans for specialist services for young people in transition; overall this is an area not just specific to Learning Disabilities agenda; where the focus on most services are ‘adultcentric’; where partnership working requires joint working not clashes with children’s services. Stronger collaboration across sectors/agencies across the region is a priority for 2010/11. Autism Spectrum Condition (ASC) Whilst Coventry has presented an good model of joint working on ASD, most localities in the region have highlighted ASC as a priority area and would wish for direction and support from the SHA, in light of the recent national strategy and delivery plan. This will relate to where autism services best fit, service models and lead responsibility. ASC is a key priority area of work for 2010/11.
Workforce Overall across the region, there was very little evidence of strategic and meaningful workforce planning in relation to learning disability services. Worcester and Shropshire were able to share worked up strategies. However these strategies have yet to demonstrate effective implementation and delivery in the localities. Furthermore, the evidence of workforce plans highlighting evidence of PSA 16; supporting people with Learning Disabilities to access employment, education and training opportunities, where virtually non existent and requires additional focus for 2010/11. Offender Health From the returns there was limited evidence of localities working to address the health needs of offenders with a learning disability in prisons and in the community. There was little reference to local plans to address the recommendations of recent Lord Bradley Review. Although, Coventry, Dudley, Solihull and Shropshire highlighted plans and systems in place to address issues of offender health. There is a need to develop approaches along the whole learning disability offender health care pathway systematically and not as ‘an add on’ to the existing system. This is a challenging area, requiring collaboration of key agencies and a priority area for 2010/11.
SAF Presentation July 2010
“Learning from Good Practice in Health Services for
people with Learning Disabilities across the
Health & Social Care Engagement Lead
for Learning Disability, NHS West
Service User Consultant,
Wolverhampton City PCT
• Why am I a Service User Consultant?
• What did I do in the Self Assessment
• What have I got out of being
Self Assessment Framework
in the West Midlands, 2009/10
Health & Social Care Engagement
Lead for Learning Disability, NHS
The Self Assessment Framework (SAF)
• The government and the people
who work in the NHS know that
Health Services need to get
better for people with Learning
• The idea of the SAF was for
each area to look at their health
services for people with learning
disabilities and find out:
– What the good things were
– What needed to get better
How are the West Midlands doing?
At the end of March, each district handed
in their Self Assessment Framework.
After this a team of people from each
area came to speak with us about their
Now we are here to show you what we
found out in our report.
We would also like to talk about the “Peer
Review” process, which will follow on from
the Self Assessment Framework.
The Report of the SAF
We will now show you:
• A “RAG” rating for each area – which
means “Red, Amber and Green” – to
show how each region is doing.
(Red does not mean it is bad or dangerous, it
shows a district has started to do things to
improve health services, but there is still more
• Information on the 4 Top Targets –
showing the main things that we found.
A Reminder of the Top Targets
Make sure campus homes are closed by 2010 and
that people who lived in long stay hospitals have
2. Health Inequalities
Make sure people with learning disabilities can
use the same health services, and get as good a
service, as everyone else.
Make sure people are safe in our health services
and that the service is learning from mistakes in
4. Valuing People Now objectives
Make sure we are doing the things that Valuing
People Now says will help people’s health.
Top Target 1: Campus
• The target is to close all campuses by
• 5 districts still have people living in campus.
• Areas have plans in place to meet the target by
• 2 areas have re-thought plans to close by
Out of Area
• There are big differences between districts in
the numbers of people who are placed out of
• There are also differences in the plans to
Top Target 2: Health Inequalities
Acute liaison nurse/officer posts
• Some districts had good models of joint working
through an Acute Liaison Nurse/Officer post.
• It is strongly recommended that each area should
establish a post for an Acute Liaison nurse or
Black and Ethnic Minority Groups (BME)
• There was some good practice in the region on
work being done to identify people from minority
groups and their carers.
• But the region needs to do more to improve the
planning and delivery of services to people from
ethnic minority groups.
Top Target 2: Health Inequalities
Profound/ Multiple Learning Disabilities (PMLD)
• Some areas showed good work to support this
particular client group.
• But there are concerns that this client group seems
to be a challenge for many districts across the
Equal access to benefits of computer technology
• Some areas were able to show good use of technology
• But some areas had poor use of technology to
monitor data and registers.
• Improving the use of technology to monitor service
delivery and planning is a priority.
Top Target 3: Safety
• Some areas had some creative models of supporting
people with a learning disability to make a complaint.
• This included; easy read information, advocacy &
support and peer support volunteers.
• However across the region there was little evidence
that people with a learning disability were actually
Six Lives and Healthcare For All
• All areas have put in their reports and these were
ok. We will make sure we keep an eye on this.
– Better working with ambulance services
– Better working with hospitals (acute)
Top Target 4: VPN objectives
Transitions – focus on young people in transitions
• Some areas showed models of improving specialist
services for young people in transition.
• Working together across sectors/agencies within
the region is a priority for 2010/11.
Autistic Spectrum Condition (ASC)
• Coventry presented a good model of joint working
on ASC and most localities have highlighted ASC as
an area to work on.
• ASC is a key priority area of work for 2010/11.
Top Target 4: VPN objectives
• There was little evidence of strategic workforce
delivery in relation to learning disability services.
• This area needs more consideration for 2010/11.
• There was not much evidence of areas working to
address the health needs of offenders with a
learning disability in prisons and in the community.
• This is a challenging area and needs many agencies
to work together. It is a priority area for
• Many examples of good practice
were seen across the region.
• Two areas of good work have been
selected from each district and are
on display today – so you can see
the good things going on in the
• Next week we will be talking to all
the Chief Executives of each district
on July 16th. These are the Big
• We will show them what we found
from the Self Assessment
Framework and tell them where
things need to get better.
• We hope to use some video-clips
from today to share your views with
The Plan for Next Year
Ranjit Senghera Ivan Burchess
Programme Specialist, Health & Social Care
NHS West Midlands Engagement Lead for Learning
Disability, NHS West Midlands
The Peer Review Process
• From 2011 the SAF will be joined with another
method to look at health services called a
• A Peer Review is where lots of people from
one area go to see the health services of
another area and talk to the people that work
and use services there.
• These people can be a mix of:
– People with learning disabilities
• These people will be called “Peer Reviewers”
or “Health Checkers”.
Health Checkers and the Peer Review
• Some of the questions we asked in the
Self Assessment Framework will also be
asked by health checkers.
• But there will also be a chance for people
with learning disabilities, carers and
professionals to design and ask their own
questions on how health services can get
• These will be put together once everyone
has been involved and agreed.
What will happen?
• Steering group
– This will need regional representation from service
users and carers.
• Recruitment - How can people get involved?
– You can speak to me (Ranjit Senghera) or your local
learning disability lead.
• Consultation – making sure the questions are the
– We will be involving people at both local and
regional groups and forums.
• Training and Certificate
– People will be trained as “Health Checkers”.
– Travel expenses will be paid.
• Health Checkers will start!
– in January 2011. This will probably last 6 months.