Presentation delivered by Pol Toner at the 'Transforming care for learning disabilities' event on 19 July, 2016.

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Building the Right
Support for
Learning Disabilities
Turning improvement ideas into
local action
Kia Oval, Surrey County
Cricket Club, London
SE11 5SS
19 July 2016

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Help us to Help you
Pól Toner RN MSc
Head of Improvement and enablement
Strategic Resettlement
“Thinking and Planning for a Better Future”

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Supporting Service Changes Locally
• We, as a national team are here to support you e.g.
• Practical support locally to help you improve more quickly
• Housing people working with us to help move more
quickly
• Service people working with us to get the care right and in
the right place for the many people we need to support
• Maggie and team will say how we will do this with
your help
• We welcome your views
• The help is about your needs

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Two Main Parts to Thinking and
Planning better services
• Thinking and Planning ahead to meet the needs locally.
• Working to ensure new services that are in place
provide what local people say they need and that they
are involved
• Sustainable and permanent positive change for
people with Learning Disability and ASD.
• “Personalisation at scale”

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• Firstly this is about thinking and planning ahead
• It relies on the partnerships locally having good plans
developed and prepared to meet the needs for this
patient group so changes can happen for many
patients quickly.
• Secondly the future needs to allow for other service
ideas so we can continue to meet the needs , for
people with Learning disabilities and ASD, both now
and for future Generations.
The basis

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What is Thinking and Planning
ahead?
• Its about Planning
• Understanding the needs of the people you need to plan ahead
for
• Impact of much fewer beds in the system
• Understanding many people will be leaving hospital sooner and
how to make sure this goes smoothly
• Its about putting new services in place to meet changing needs
• Care and housing for many individuals
• Supporting people who give care now to understand why
change is happening and how they can help to meet the needs
of the new services as they happen

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How it fits
• Its business as usual but a little faster
• Planning is about Building the Right Support
• Fits with Discharge planning guidance
• We need to make sure we can do everything we said
we will do in our plan with the people and money we
have locally at the right time to meet local needs

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Strategic planning
 Transforming Care Partnerships need to understand the
needs of people with Learning Disabilities in their local
area
 Housing, care providers’ and workforce people need to be
involved and work to making sure the new services are
supported by the right workers and the right housing and
right care in the right place at the right time
 Plan to support people outside hospital rather than in
hospital beds
 Solid discharge planning and arrangements in place

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Strategic commissioning
• Bring all commissioning work together in the
local area
• Thinking and planning ahead should mean
that contracts in place support reducing beds
• Involve people who provide care
• Make sure the care system is in a good place
for now and the future

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In the Regions
• Regional teams all work slightly differently but will
need to ensure everything is working well
• Regional teams will support the changes planned or
underway locally
• The team can do this face to face or make it easier
using technology
• Managing a steady and consistent development of
community services and bed reduction as set out in
their plans.

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In the Regions
Much work is already underway
• Regional team should establish a resettlement team
function
• This resettlement function should develop expertise
• Ward/ unit/ hospital closure level changes should be led
by the local Transforming Care Partnership
commissioners including specialised commissioning,
with providers.
• National Team will support the regions with provider
engagement Regions will have a good understanding of
the entirety of the patient cohort

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Commissioning Development
 We need to consider the wider context of commissioning,
including Local Authority and Clinical Commissioning Group
commissioners and consider the impact on and expertise and
leadership required within these teams going forward.
 We need to strengthen coordinated commissioning for people a
learning disability or Autistic Spectrum Disorder.
 We need to strengthen admission and discharge management,
through length of stay and escalation management
 Encouraging life planning

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Over the summer and where work is
beginning
• Regional teams will be supported to expand their ideas about how
they will work with everyone else on this,
• Over July and august and by September 2016, each
Transforming Care Partnership and Region to have developed
local thinking and starting to plan ahead for engagement with
housing and care providers,
• Need to ensure those who organise more specialised care and
others who provide care are talking and working together
• Transforming Care Partnership’s to map out their plans and what
the issues are and what do we need to do to reduce any risks
around our plans

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• During the summer, regions will have identified, from this information
collectively from Clinical Commissioning Groups, wards and units for
Transforming Care Partnerships to earmark for closure and start to plan
closure, We can then support with next steps.
• Where units and wards have patients from outside the region, regions
and Transforming Care Partnerships will need to work together (and
where this is the case) identify a lead Clinical Commissioning Group to
manage the process and closure, based on a fairness model.
• At Regional level to enhance their plans to deliver the changes around
their patients at a steady state between then and march 2019, including
a ward/ unit closure programme.
• By October 2016, a full meeting will have been held to outline new
community model of care being proposed and new reducing based
model
Work will continue

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• As a goal we want Transforming Care Partnerships to
manage discharges/ movements and follow individual
bed closures
• We want regions to work together and to follow
regional closure profiles and ensure Clinical
Commissioning Groups work together on ward and
into closure
• Nationally we want to follow ward and unit closures
• So every patient is managed and their progress
recorded and help given if necessary
Prioritise Discharge Management

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The tasks/ expectation:
• Its not just about bed reduction, for all regions;
• its also about repatriation back nearer home and the
development of new service models
• Identify wards and units affected as part of their 3 year profile
to achieve the 50% closure.
• Expectation will be to now strategically discuss discharges
and ward and unit changes/closures, with providers, at
Transforming Care Partnerships and Regional Level based on
ambitions for new models of care and services,
• but local teams will still need to concentrate on patient centred
case management and personalised delivery of effective care.

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• Transforming Care Partnership planning process, will be
about moving the plans from planning to transformation
and closures.
• This is not just at patient level but at ward and unit closure
level and to permanently close the door to increased
admissions
• Effective provider engagement
• ensuring the new service model is sustainable and
supports people living well outside hospital with the right
support locally
• We will work with the systems to monitor and support
practical progress on this
In Conclusion

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“safe and sustainable personalised
care planning at scale and pace”.
Thank You