“Learning from Good Practice in Health Services for
    people with Learning Disabilities across the
                  Wes...
“Welcome”

Ivan Burchess
 Health & Social Care Engagement Lead
 for Learning Disability, NHS West
 Midlands


Andrew Powel...
• Why am I a Service User Consultant?


• What did I do in the Self Assessment
  Framework?


• What have I got out of bei...
The Health
  Self Assessment Framework
in the West Midlands, 2009/10




               Ivan Burchess
       Health & Soci...
The Self Assessment Framework (SAF)
               • The government and the people
                 who work in the NHS kn...
How are the West Midlands doing?
           At the end of March, each district handed
           in their Self Assessment ...
The Report of the SAF
      We will now show you:

      • A “RAG” rating for each area – which
        means “Red, Amber ...
A Reminder of the Top Targets
        1. Campus
           Make sure campus homes are closed by 2010 and
           that p...
The Top Four Targets
Top Target 1: Campus
   Campus

   •   The target is to close all campuses by
       December 2010.
   •   5 districts sti...
Top Target 2: Health Inequalities
         Acute liaison nurse/officer posts

         •   Some districts had good models ...
Top Target 2: Health Inequalities
        Profound/ Multiple Learning Disabilities (PMLD)

        •   Some areas showed g...
Top Target 3: Safety
   Complaints

   •   Some areas had some creative models of supporting
       people with a learning...
Top Target 4: VPN objectives
      Transitions – focus on young people in transitions

      •   Some areas showed models ...
Top Target 4: VPN objectives
       Workforce

       •   There was little evidence of strategic workforce
           deli...
Good Practice

• Many examples of good practice
  were seen across the region.



• Two areas of good work have been
  sel...
• Next week we will be talking to all
  the Chief Executives of each district
  on July 16th. These are the Big
  Bosses!
...
The Plan for Next Year




 Ranjit Senghera             Ivan Burchess
Programme Specialist,        Health & Social Care
 N...
The Peer Review Process
     • From 2011 the SAF will be joined with another
       method to look at health services call...
Health Checkers and the Peer Review
    ?

           • Some of the questions we asked in the
             Self Assessment...
What will happen?
   •   Steering group
        – This will need regional representation from service
          users and ...
Thank You.

Do you have any questions?
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SAF Presentation July 2010

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  • 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

    1. 1. “Learning from Good Practice in Health Services for people with Learning Disabilities across the West Midlands”
    2. 2. “Welcome” Ivan Burchess Health & Social Care Engagement Lead for Learning Disability, NHS West Midlands Andrew Powell Service User Consultant, Wolverhampton City PCT
    3. 3. • Why am I a Service User Consultant? • What did I do in the Self Assessment Framework? • What have I got out of being involved?
    4. 4. The Health Self Assessment Framework in the West Midlands, 2009/10 Ivan Burchess Health & Social Care Engagement Lead for Learning Disability, NHS West Midlands
    5. 5. 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 Disabilities. • 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
    6. 6. 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 services. 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.
    7. 7. 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 to do.) • Information on the 4 Top Targets – showing the main things that we found.
    8. 8. A Reminder of the Top Targets 1. Campus Make sure campus homes are closed by 2010 and that people who lived in long stay hospitals have all moved. 2. Health Inequalities Make sure people with learning disabilities can use the same health services, and get as good a service, as everyone else. 3. Safety Make sure people are safe in our health services and that the service is learning from mistakes in the past. 4. Valuing People Now objectives Make sure we are doing the things that Valuing People Now says will help people’s health.
    9. 9. The Top Four Targets
    10. 10. Top Target 1: Campus Campus • The target is to close all campuses by December 2010. • 5 districts still have people living in campus. • Areas have plans in place to meet the target by Dec. • 2 areas have re-thought plans to close by March 2011. Out of Area • There are big differences between districts in the numbers of people who are placed out of area. • There are also differences in the plans to address this.
    11. 11. 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 officer. 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.
    12. 12. 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 region. Equal access to benefits of computer technology • Some areas were able to show good use of technology systems. • 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.
    13. 13. Top Target 3: Safety Complaints • 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 making complaints. 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)
    14. 14. 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.
    15. 15. Top Target 4: VPN objectives Workforce • There was little evidence of strategic workforce delivery in relation to learning disability services. • This area needs more consideration for 2010/11. Offender Health • 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 2010/11.
    16. 16. Good Practice • 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 West Midlands.
    17. 17. • Next week we will be talking to all the Chief Executives of each district on July 16th. These are the Big Bosses! • 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 them.
    18. 18. 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
    19. 19. The Peer Review Process • From 2011 the SAF will be joined with another method to look at health services called a “Peer Review”. • 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 – Carers – Professionals • These people will be called “Peer Reviewers” or “Health Checkers”.
    20. 20. 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 better. • These will be put together once everyone has been involved and agreed.
    21. 21. 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 right ones. – 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.
    22. 22. Thank You. Do you have any questions?

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