Good Health Group Presentation to the Partnership Board – 22nd July 2010 Action Plan Update

West Kent Good Health Group Presentation to the Partnership Board – 22nd July 2010Action Plan Update Zoe Davis, Co-Chair Jeanette Dean-Kimili, Commissioning Manager, LD Services Jimmy Kerrigan, Lead Commissioner (Mental Health/Learning Disabilities) Eastern and Coastal Kent PCT Dr Hemant Karkera, GP East Coast Kent PCT

GHG Action Plan Update • At the last meeting we discussed with you the “Regional Framework Action Plan”

GHG Action Plan Update Continued • Today we will share what we have been doing to put our plan into Action

GHG Action Plan Update Continued • We are working on a Diary Survey to get more feedback from you on how well GPs, hospitals, chemists, opticians, x-ray and scan services are doing

GHG Action Plan Update Continued • We are giving out over 600 diaries to DPGs, day services, advocacy groups, carers and some providers to get a varied and good response

GHG Action Plan Update Continued • The diaries will be given out at the beginning of August for people to carry around with them until the end of September, to say how good or not good a service was.

GHG Action Plan Update Continued • We will count and measure all of the responses and put them in a report to share with the Partnership Board at the beginning of November.

GHG Action Plan Update Continued Other things we are doing include: • We keep reminding the hospitals that they must use the Hospital Communication Folder……

GHG Action Plan Update Continued • Maidstone District Partnership Group is busy making posters on the Hospital Communication Folder for all hospitals in Kent

GHG Action Plan Update Continued • The hospitals have put in place a flag alert that will let ward matrons know if a person with a learning disability was admitted overnight onto their ward, to check if there are special needs.

GHG Action Plan Update Continued • We have reminded all GPs that the Annual Health Check is to continue for another year

GHG Action Plan Update Continued • The PCTs and Community LD Teams have trained more GP practices on LD awareness training

GHG Action Plan Update Continued • The Community LD Teams are getting in touch with all GPs in their area to make sure they know specialist LD services are available to help GPS.

GHG Action Plan Update Continued • Practices signed up to do Annual Health Checks this year: • West Kent – 68 (64%) • East Kent – 87 (74%)

GHG Action Plan Update Continued • Practices that have so far done the learning disability awareness training: • West Kent - 56 (53%) • East Kent – 70 (60%)

GHG Action Plan Update Continued • The Community LD Teams always make sure when they see someone that they have a Health Action Plan (HAP).

GHG Action Plan Update Continued • We are just starting to do an “Audit” of HAPs to make sure that if actions were required (such as a referral for a blood test), that it happened

Response Regarding Cleaner Hospitals • At the last Kent Learning Disability Partnership Board it was asked – “Hospital floors were not very clean, what was happening with this?" • We have been in touch with all the big hospitals in Kent.

…. Continued…They responded by saying: • The Government said by law all Hospitals had to be clean. • This is in the Health and Social Care Act 2008. • The Government said less people should get ill because of being in Hospital. • This is called Healthcare Acquired Infections (HCAI)

…. Continued… • The Government asked the Care Quality Commission to make sure Hospitals are clean. • You can find out what the Care Quality Commission says about your local hospital on the internet. Go to http://healthdirectory.cqc.org.uk/findcareservices/informationabouthealthcareservices/summaryinformation.cfm

…. Continued… • In each hospital in Kent senior nurses and matrons regularly check their wards to make sure they are clean. • If you would like some more information on this, please contact: Daniel Marsden, East Kent Hospitals Karen Davies and Christine Steele, Maidstone Hospital Claire Hall, Kent and Sussex Hospital Leslie Goldsmith, Darent Valley Hospital

GHG Action Plan Update Continued • We have told our MH provider that they must make mental health services easy to use

TheGreen Light Toolkit for Mental Health • An Action Plan for the Green Light Toolkit for mental health has been developed - it is being put in place • The care pathway for people with learning disabilities and mental health problems has been changed to ensure access to mainstream services • This will include mental disability awareness training for all mental health staff

TheGreen Light Toolkit for Mental Health - Service Changes • In East Kent, funding has been agreed for two Learning Disability Community Psychiatric Nurses (CPNs) for people with learning disabilities in East Kent • An application for funding for two mental health learning disability nurses in West Kent will also be made

TheGreen Light Toolkit for Mental Health - Service Improvements • A review is being undertaken of the mental health in-patient units for people with learning disabilities in Kent • We will ensure that people with learning disabilities and their carers and families will be involved in this

GHG Action Plan Update Continued • We have been working with Dr Hemant Karkera who has been helping us understand how good Annual Health Checks are

Annual Health Check for People with Learning Disabilities Dr Hemant Karkera

What is Learning Disability ? People with significantly reduced ability to understand new or complex information, to learn new skills A reduced ability to cope independently Started before adulthood (18 years), with a lasting effect on development

What is LD (continued) WHO classification Mild-IQ 50-70 Mod IQ 55-69 Severe to profound IQ<55 However IQ alone is not used in isolation. How the person is functioning in the environment is important.

Who are not Included? Higher level autistic disorder with average or above average intelligence Specific difficulties with learning such as dyslexia IQ<70 is not the only criteria in isolation In case of doubt, referrals to Community LD Teams (CLDTs) may be necessary

Reasons for the Annual Health CheckHealth inequalities experienced by people with LD Great difficulty and barriers in accessing health care 2.5× more likely to have physical condition requiring medical attention Lack of early intervention 4 times likely to die of preventable disease 58× more likely to die before age of 50

Advantages of a Health Check A study of similar health check in Australia showed 60× detection of problems with eye sight 30× increase in hearing testing Increase in immunisation updates Improvement in women's health screening

Preparation Appointment letter Health Check Questionnaire (HCQ) Pre-appointment phone call? Remind to bring Health Action Plan Carer support ? At the end of the check, HCQ to be completed and agreed CLDT to be contacted if required

Community Learning Disability Team (CLDT) Community learning disability nurses Psychologists Speech and language therapists Occupational therapists Physiotherapists Psychiatrists Social workers Administrative and team support

Advantage of a Health Check (continued) Previously unidentified, hence untreated conditions (Baxter et al, 2006) Diabetes Hypertension High cholesterol Thyroid disorders Dental problems Cardiac conditions Dental problems Asthma Mental health problems

What do we do in a Health Check Physical examination including system exam Medication review Enquiry of chronic illness and systems Epilepsy Syndrome check Review of coordination arrangement with secondary care Health promotion

Thank you

Good Health Group Presentation to the Partnership Board – 22nd July 2010 Action Plan Update