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Stomp - one year on presentation july 2017

NHS England marked the first anniversary of the STOMP project on Tuesday 04 July with a review of the year and the launch of a play by the MiXIT theatre group in Newcastle. The group includes people with a learning disability, autism or both and shows the effects that over-medication can have on the health and wellbeing of individuals and their families.

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Stomp - one year on presentation july 2017

  1. 1. One year on July 2017 Stopping the over medication of people with learning disabilities, autism or both
  2. 2. The core message Public Health England says every day about 30,000 to 35,000 adults with a learning disability are being given psychotropic medicines when they do not have a diagnosed mental health condition. This is often to manage behaviour which is seen as challenging. It includes medicines used to treat psychosis, depression, anxiety, sleep disorders and epilepsy medication when it is only used for its calming effect, rather than to treat epilepsy. Unnecessary use of these drugs, puts people at risk of significant weight gain, organ failure and even premature death.
  3. 3. STOMP brings together a wide range of people: • People, their families and support organisations • Health, education and social care professionals • Health, education and social care providers • People who buy services eg. commissioners • People who check or monitor services • People who provide health or social care training working together
  4. 4. Aims 1. Improve the quality of life of children, young people and adults with a learning disability, autism or both, who are prescribed psychotropic medicines. 2. Make sure people are only given them for the right reason, in the right amount, for as short a time as possible. 3. Improve everyone’s understanding of these medicines and give everyone the confidence to ask why they are needed. 4. Improve understanding of non-drug treatments and support which may help. 5. Make sure the person with their family and paid carers are involved in any decisions to start, stop, reduce or continue taking them.
  5. 5. Why STOMP? • They are not always the right answer • They can have major side effects • They can reduce people’s quality of life • They can be used as a type of restraint • When people are drugged up the world passes them by. • This is a human rights issue When are they right? • Psychotropic medicines can have an important role in treating many mental health conditions when they are used well. • Sometimes they are right if the person is at severe risk of harming themselves or others • As long as other treatments and therapy are happening so that people will not need them for long
  6. 6. Pledge The STOMP pledge was signed in June 2016 by • Royal Colleges of Nursing, Psychiatrists and GPs • Royal Pharmaceutical Society • British Psychological Society • NHS England • The Minister Alistair Burt They pledged to work together and with people with a learning disability and their families, to take real and measurable steps to stop over medication. 3 year campaign up to
  7. 7. • Royal College of Speech and Language Therapy • British Association Of Social Workers • Learning Disability Professional Senate: Care Quality Commission, Clinical Commissioning Groups, Challenging Behaviour Foundation, Department of Health, Health Education England, clinicians - art therapists, psychologists, occupational therapists, physiotherapists, dietitians, psychiatrists, GPs, social workers, speech therapists and learning disability nurses • British Association of Music Therapy • Voluntary Organisations Disability Group More pledges made in 2017
  8. 8. • All the pledge partners are working with their members to promote the pledge, raise awareness and introduce good practice through methods such as: • education programmes, pilot schemes, presentations, articles in journals, review of professional roles, national conferences, sharing guidelines and partnership work Reaching people, changing practice
  9. 9. • Partnership working with health, social care, voluntary and charity organisations, family and self advocacy. • Partners include the Challenging Behaviour Foundation (CBF), Care Management Group (CMG), Voluntary Organisations Disability Group (VODG) and the National Development Team for Inclusion (NDTi) Learning Disability England, ARC England, and Skills for Care partnership working
  10. 10. • Challenging Behaviour Foundation (CBF) engaged with over 100 families on their experiences of over medication and what information and support they need. • CBF published a report in May 2017 and have also been commissioned to develop a medicines pathway document for families and online resource that will be launched in 2017 • NHS England has also commissioned Change to engage with people with learning disabilities and autism who produced a report • Easy read materials commissioned and more being developed • NHS England commissioned MIXIT an inclusive theatre group to develop a production on STOMP – official launch on 4th July pledge actions
  11. 11. Pledge for social care providers A pledge for social care providers led by VODG was launched in May 2017 Already, more than 100 organisations have signed up who support over 40,000 people. The pledge includes a self-assessment and planning template and can be downloaded from the VODG webpage on STOMP A best practice guide produced by the Care Management Group (CMG) was launched in the House of Commons on June 13 by Normal Lamb, MP
  12. 12. • Centre for Pharmacy Post-graduate Education – online learning for pharmacists launched in October 2016. The course develops awareness, understanding and key skills to help pharmacists deliver high quality care to people with learning disabilities, autism, families and carers. This was sent to 65,000 pharmacy staff across England and In 2017, over 3000 pharmacists have been trained to support STOMP • Five-week pharmacy campaign on learning disabilities including Facebook live, daily challenges and Twitter chat. 685 took part. • Specialist pharmacists and medical colleagues reviewing prescribing for people with learning disabilities, autism or both in the North East of England, Hertfordshire and Manchester • NHS England has appointed 3 pharmacists to a job- share role and a family carer is working as a STOMP adviser pledge actions
  13. 13. • Royal College of Nursing (RCN) guidance for pre-registration education students (across all branches) on learning disabilities includes a section on over- medication. Online and hard copy resource. • RCN worked with Royal College of Psychiatrists on good practice guidance on psychotropic drug prescribing • British Psychological Society articles on STOMP in bulletins, Clinical Psychology Forum, Division AGM and chair’s report. Promoting alternatives to medication, prescribing practice and the use of Positive Behaviour Support (PBS) to membership and other professional groups pledge actions
  14. 14. • Royal College of GPs has updated and published Step by Step guide for annual health checks. This includes advice on medication reviews and the need to reduce psychotropic medication • NHS England published an updated guide for GPs and others who prescribe June 2017 • Royal College of Psychiatrists (RCP) launched an online survey for members about STOMP • RCP hosted a joint conference with the Challenging Behaviour Foundation • The RCP has produced guidance on the use of anti-epilepsy drugs for the management of behaviour problems pledge actions
  15. 15. • Care and Treatment Reviews (CTRs) – New NHS England policy and tools include a section on reviewing the use of psychotropic medication • Annual Health Checks (AHCs) – NHS England worked with partners to refresh and publish a new annual health check template which now includes psychotropic medication reviews. • July 2017 launch of ‘Better health for people with learning disabilities - What social care providers can do to help people with learning disabilities get health checks’ innovative-film-to-support-better-health- for-people-with-learning-disabilities/ pledge actions
  16. 16. • Public Health England Learning Disability Observatory – June 2017. Pharmacy Guidance on best practice for supporting people with learning disabilities • NHS England has commissioned Public Health England to carry out four studies a year from autumn 2017. To show if fewer psychotropic drugs are being prescribed as awareness of STOMP improves. • CQC- have reviewed their inspection framework in light of STOMP to include checking use of psychotropic medicines • A Children and Young People’s STOMP sub-group has been established. • NHS England Regions each have an action plan on STOMP working with local areas pledge actions
  17. 17. • Raising awareness – STOMP presented at many national, regional and local events and conferences eg. in 2017 - One Year On national launch July, Positive Choices Conference for learning disability student nurses, STOMP workshop at the NHS England national ‘Better Health, Better Lives’ conference • Social media coverage from events and publications. NHS England has also shared case studies through Twitter eg. andrews-psychotropic-medication-in-hertfordshire • STOMP web information being improved by NHS England and other pledge partners pledge actions
  18. 18. “Every person who is taking psychotropic medication will have their own STOMP action plan.” ”We will ensure that everyone who is on medication for behaviours that may present as challenging has a positive behaviour support plan.” ”We will audit the use of psychotropic medication on a quarterly basis”. Quotes: Social Care Pledges
  19. 19. “Questions about the use of psychotropic medication will be included in trustee visits to services.” ”We will ensure that everyone has easy-read information regarding their medication.” . “We will include STOMP in our staff induction.” “We will use video conferencing to involve families who live far away in decisions about medication.” Quotes: Social Care Pledges
  20. 20. “Stomp is important as we have got to make sure that people aren’t overmedicated. If they are this can cause physical health problems, and it can stop people being discharged from hospital. It can also stop people being able to take part in decisions about their future life. It’s a huge issue.” Jenny Carter- Director- “Together All Are Able” & Expert by Experience- working with Pathways Associates statement of support
  21. 21. “The Royal College of Psychiatrists and the Learning Disability Professional Senate are determined to make STOMP happen. We will work in our Learning Disability Teams and with General Practice colleagues to reduce the harm caused by inappropriate use of psychotropic medication. We will promote comprehensive monitoring of medication, and the timely use of evidence based psychosocial interventions.” Dr Ashok Roy Chair, Faculty of Intellectual Disability Psychiatry, The Royal College of Psychiatrists and Co-chair Learning Disability Professional Senate statement of support
  22. 22. The Learning Disability Professional Senate pledges our commitment to supporting this initiative. This is about fundamentally rethinking the role of psychotropic drugs for the management of behaviours that challenge in learning disabilities. We fully endorse that it is the role of all professions to challenge medication issues and to provide alternative psychological and other therapeutic interventions for behaviours that challenge, using a Positive Behaviour Support framework. pledge commitment
  23. 23. “ Josh used to be prescribed a number of anti-psychotic and sedative type medications when he was in hospital far away from home. He has now come off virtually all of these drugs. I have seen Josh improve physically and emotionally. He seems more alert and, in my opinion, his long term memory, of places and people has improved greatly.” Phil Wills, dad of Josh Wills age 16 who has autism and a learning disability and who was in an assessment and treatment unit for three year, and who was discharged to a tailored package of education, health and care in November 2015 statement of support
  24. 24. Bringing Us Together’s project Stronger Together has been working with NHS England and families across the country to have their views listened to, acted upon and for families to take an active part in changing policy and practice. Families who have loved ones in Assessment and Treatment Units and hospital settings have been determined over recent years to make a difference to the lives of their own children and young people whilst at the same time making sure that young people don’t end up in crisis, sent out of their communities and into inappropriate settings where we have heard heart breaking stories of the overuse of medication leading to a downward spiral. Families are absolutely behind this campaign as they know that over reliance on medication may cause substantial side effects. As one parent told us “STOMP could mean that a person’s condition is treated respectfully and holistically rather than automatically given drugs to keep them quiet and sedated”. We will continue to support STOMP and congratulate all those involved in raising awareness of this very important issue. For more information statement of support
  25. 25. Raising awareness of STOMP amongst the Speech & Language Therapy profession as a whole and in doing so: • Promote a better understanding and response to the communication needs of people with a LD in order to reduce challenging behaviour and the current over reliance on medication • We will use the 5 Good Communication Standards to empower people in understanding their medication , helping carers to know how service users can be proactively involved in their reviews and therefore decisions about their medication RCSLT commitment