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Improving Lives: Supporting Adults with Learning Disabilities conference
- 1. www.england.nhs.uk Carl Shaw, LearningDisability Advisor Fiona Mcmillan-Shields, Head of Transformation (Delivery) Transforming Care, transforming lives: Learning Disability Programme January 2017
- 2. www.england.nhs.uk • Carl Shaw,Learning Disability Advisor • Fiona McMillan-Shields, Head of Delivery (Transformation) Hello, my name is: 2
- 3. www.england.nhs.uk • Making sureless people are in hospitals by having better services in the community • Making sure people don’t stay in hospitals longer than they need to • Making sure people get good quality care and support in hospital and in the community • The national plan is called ‘Building the right support’ (published October 2015) – 48 Transforming Care Partnerships (TCPs) are doing the work locally The transforming care work has three big aims: 3
- 4. www.england.nhs.uk Equal access toservices Keep people healthy Strengthening people’s rights More: • housing options • employment • personalisation We need to change culture to achieve our big aims. We are ambitious! 4
- 5. www.england.nhs.uk • Building theRight Support says that people should have choice and control over how their health and care needs are met; • they should be able to choose where they live and who they live with. https://www.youtube.com/watch?v=eyffDUgqD8g Empowerment 5
- 6. www.england.nhs.uk • Fewer peoplein hospital • New community services opened • People moving home • Signing the Stopping Over Medication (STOMP) pledge • Care and Treatment Reviews (CTRs) continue to be done, including Community CTRs • A new set of hospital discharge standards – coming soon • Reducing health inequalities; mortality review programme rolling out Examples of progress on our ‘big aims’: 6
- 7. www.england.nhs.uk What is a Careand Treatment Review? • The CTR panel is led by the person’s commissioner • Plus two expert advisers, • A clinical adviser. • And an expert by experience – either a person with a learning disability or a family carer with experience of services • They meet the person being reviewed and all the people involved in the person’s care • They make recommendations to improve the person’s care • Policy review due February 2017
- 8. www.england.nhs.uk STOMP – Stopover medicating people February 1, 2017 • Stopping the over-medication of people with psychotropic medication • Helping people have a better quality of life • Empowering people to have more choice and control • Alternatives and other support • Influencing the health professionals and prescribers • Programme of work over next 2 years • Awareness-raising • Commissioning theatre company production • Campaign with people and families • Change professional practice
- 9. www.england.nhs.uk Hospital discharge standards •New standards and steps for commissioners which will be part of the new CTR policy • Focus on timely discharge from hospital • Standards around named people supporting the person • Good quality of person-centred planning and involvement • Respecting the importance of families • Steps to guide the commissioner and others through the process
- 10. www.england.nhs.uk Raising a complaintor a concern • We are having a workshop in February to get stakeholders views. • We are having another workshop in March to get the views of people with learning disabilities autism or both which will be hosted by NHS England’s Engagement team. • We have already had some really good thoughts and comments from the Learning Disability Engagement Team Advisory Board2/1/2017
- 11. www.england.nhs.uk There are fivepeople with a learning disability working for NHS England • Three Learning Disability Advisers • They work to make healthcare better • And help to write policies to show the NHS how to make its care better • And carry out work to make that happen • They work with people with learning disabilities, family carers, NHS, social care, Transforming Care and others • There are also two people with learning disabilities in the Engagement Team, working with people and their families Employees with a learning disability
- 12. www.england.nhs.uk • We arestill admitting too many people into hospital – including children and young people. • The experience for some people and their families could be better • Some plans aren’t good enough yet – more ambition needed. • Plans don’t make change – actions do • Money! • Lots still to improve in general health care and tackling health inequalities – in primary, acute and specialist care. We could do better
- 13.
- 14. www.england.nhs.uk More people livingin homes in the community, fewer in hospital Commissioners will be working with clear plans to improve things Help local commissioners build community services and close hospital beds Better access to NHS services for people with a learning disability, What we want to do by the end of 2016/17
- 15. www.england.nhs.uk GPs willknow more people with a learning disability- and do more Annual Health Checks More screening for things like cancer and diabetes Better treatment ‘pathways’ Better ways of checking the quality of services for people with a learning disability Better ways of checking people with a learning disability aren’t dying too young Housing options What we want to do by the end of 2016/17
- 16. www.england.nhs.uk • Website: https://www.england.nhs.uk/learningdisabilities/ • E-mail:England.learning.disability@nhs.net How to keep in touch
Editor's Notes
- #4 It is a very ambition programme of work but itis absolutely the right thing to prioritise. As we work together to make the vision set out in Building the Right Support real, we must remember that for each person we are able to move out of unnecessary hospital accommodation our actions are life-changing.
- #5 The things that keep people healthy sit mostly outside of the NHS – like homes, jobs, relationships and social life. Our work is as much about strengthening people’s rights and providing a good life, as it is about keeping people well. We are letting people down until we provide, for everyone: - equal access to services - opportunity to a family life, and a home environment, ready to go and with well thought through planning to make sure people stay there. So we need to make sure that when people leave hospital, they go to live in a good place. Local councils are working with local healthcare providers to join this up and to check that teams have the right expertise across health, social care and wider welfare – like employment and housing support, to give people the best possible chance of quality healthcare and quality of life.
- #6 Together with the 48 Transforming Care Partnerships, we are working to reach the level of ambition and high quality support that’s needed to give people power and influence over their own life - and we have plans that hold TCPs to account for what they say they’re going to do. For this to transform lives in the long term, individuals have to be at the centre of planning, it’s up to us to make that happen. Building the Right Support says that people should have choice and control over how their health and care needs are met; they should be able to choose where they live and who they live with. As we work together to make the vision set out in Building the Right Support real, we must remember that for each person we are able to move out of unnecessary hospital accommodation our actions are life-changing. David’s story Personal budgets are another way of making sure support is tailored to an individual’s need. I caught up with colleagues who work on PHBs when I was getting this presentation ready. They told me about Clare, Claire used to live in residential care. Because of her personal budget she now lives in her own home and can enjoy sailing. she met with Simon Stevens, chief executive of NHS England. They talked for 2 hours about how more people like Claire could get choice and control. PHBs work well for people with the highest support needs. They enable a wider range of possible solutions than traditionally commissioned services. They promotes self-management which reduces reliance on NHS services.
- #7 We’re making good progress – The number of inpatients has reduced from 2,800 at the end of January 2016 to 2,520 at the end of November 2016 and November was the 11th consecutive month that the number of people being cared for in hospital reduced. We are especially concerned about people who are in hospital long-term and there is a real focus on getting these people home. I’m pleased to say that this group of people is also reducing in number. Around 200 CTRs are carried out a month. I recently heard how Derbyshire Transforming Care Partnership have enhanced their CTRs for people with a learning disability and/or autism to have an extra focus on medicines, physical health and making information accessible. Derbyshire have also expanded their CTR process to also cover children and young people, so that CTRs for people of all ages are delivered as part of one joint team.
- #8 They are also for children and young people
- #9 Talk abut the documents like GP leaflet, Mixit company leaflet and the performance. Talk about the events that you have being to. 2 year plan to bring awareness of the issues, talk to care providers about their role, influence GP and prescriber practice and empower people to question and be aware of the meds they take.
- #12 We employ five people with a learning disability in full time roles; they inform our work in all parts of the healthcare system, because our learning disabilities programme is about getting it right for all people with a learning disability, not just those in treatment. We are about to employ a family carer. Employing someone with a learning disability is a good example of giving someone power over their own life, and a good example of how that helps to redress the balance between us doing what we think people need, and allowing people to make their own choices and have influence. Everyone benefits because of it.
- #13 - We need to reduce the number of people being admitted. - Its taking time to get the money right, but we are making progress. - We are still building support in the community and developing the skills of staff; and working towards better integration of health and social care. - We still need to increase people on a health register, and widen access more generally to mainstream health services.
- #14 You need to learn from each other – and from the people whose lives we are trying to transform!
- #16 Equally important as moving people out of hospital is making sure that they’ve gone to a good place, that the right package of support follows them, and they will be well supported in all parts of life. We need to make sure that when someone leaves hospital to live at home or in the community, the right package of care follows them, and they will be well supported in all parts of life. Personal budgets are one way of tailoring that support, to meet individual needs and give people the best chance to do well. Another important thing is making sure that if someone does need to be in hospital, their discharge is being planned for from the very beginning. We are doing a lot of work to make sure those standards are in place, CQC are a key partner in that work – including identifying what are the barriers to discharge for people who have been inpatients for a long time? We also need to make sure that when people leave hospital, they go to live in a good place. Local councils are working with local healthcare providers to join this up and to check that teams have the right expertise across health, social care and wider welfare – like employment and housing support, to give people the best possible chance of quality healthcare and quality of life. Our new Senior Psychiatrist Roger Banks is working with one of our learning disability advisors to do just that. Local councils are working with local healthcare providers to join this up and to check that teams have the right expertise across health, social care and wider welfare, to give people the best possible chance of quality healthcare and quality of life. To support the delivery of both settled and short-term accommodation in the community, NHS England has made £100 million available between 2016 and 2021. This capital will only be granted to develop accommodation which is in line with the service model