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…What’s the story with Learning Disabilities…. …so far…. Pól Toner Head of Mental Health and Learning Disabilities East of England NHS Chair National Learning Disabilities Leadership Group. 1 st to be Frank . So what's the big issue?.

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What s the story with learning disabilities l.jpg

…What’s the story with Learning Disabilities…

…so far…

Pól Toner

Head of Mental Health and Learning Disabilities

East of England NHS

Chair National Learning Disabilities

Leadership Group


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1st to be Frank


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So what's the big issue?

  • People with learning disabilities frequently have greater health needs than the general population, with a higher than average proportion having complex and multiple health needs.


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Explain!

  • People with learning disabilities, particularly Down’s Syndrome, have an increased risks, although overall life expectancy in this population has increased over time.


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Explain!

  • Given the frequent co-existence of long term conditions such as coronary heart disease, services are frequently not equipped to meet the needs of this group.


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Explain!

  • Dementia and other mental health problems,

    • 21% of people aged 65 years and older being diagnosed with dementia compared with

    • 5.7% in the general population.

  • Mental illness rates are approximately 3 times higher than in the general population,

  • and people in this group are more likely to be prescribed psychotropic medication than someone without a learning disability.


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Health care for all

  • AT LAST you may say!!


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Health care for all and what it means

  • People with learning disabilities should be able to access the same range of services available to anybody else in the population. Indeed, given the propensity for this group to experience greater complexity in their health status, there is strong evidence that services should be targeted at this group, through the introduction of health facilitators and annual screening in primary care.


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…but why do we need to be told to do this??

  • Nationally, we know that there are inconsistencies in health provision for people with learning disabilities and that there is evidence that people with learning disabilities have trouble accessing the help they need. Mainstream services are frequently not equipped to meet the needs of this group


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For example

  • Population screening programmes for people with learning disabilities have also been highlighted as an area of concern, particularly in cervical screening where only 19% of the female population with a leaning disability receive screening compared with 77% of women in the general population!!


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Key interventions to meet the health needs of people with learning disabilities include:

  • explicit and targeted efforts to increase uptake of cervical and breast screening among women with a learning disability;

  • ensuring equitable access to mental health services;

  • targeted health checks in primary care;

  • ensuring that all secondary care services are routinely accessible to people with learning disabilities on the basis of need;

  • provision of health information in a range of learning disability orientated media.


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So if we continue to do the same as we have always done ? learning disabilities include:

  • Well, we will then get the same as we have always got so.

  • So, its…


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We need to do this strategically and in partnership locally learning disabilities include:

  • Otherwise we will end up…


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In the East of England learning disabilities include:

  • Made our pledges via the next stage review (Darzi Review)

  • Consulted on the pledges

  • Moving towards implementation


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Our pledges… learning disabilities include:

  • Ensure people with a Learning Disability receive appropriate health care (Healthcare for All)

    • Re-establish/ re-vitalise partnership boards

    • Introduce LD self assessment

    • Ensure completion of commissioning/ funding transfer


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Our pledges… learning disabilities include:

  • No one living in the NHS by 2010 (campus closure)

  • Implement Valuing People Now (now)

  • Commissioning :

    • All contracts for health care include LD and disability requirements.


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Our pledges… learning disabilities include:

  • All training contracts to promote greater awareness of LD and disability

  • 2008/9 use of new DES in 50% of GP practices

  • Commissioning specific training for primary care staff to aid identification and support for people with a LD


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Our pledges… learning disabilities include:

  • Reduce unwarranted disparity in access to screening programmes for people with Learning Disability

  • And then…

  • Mainstream this agenda…


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Where are the National Variations? learning disabilities include:

  • Joint Commissioning

  • Involvement

  • Strategy Development

  • Commissioning Capacity

  • Needs Assessment & Use of Data


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World Class Commissioning learning disabilities include:

Market Stimulation

Contracting/ Procurement Capacity

Robust Needs Assessment

Choice

Personalisation Agenda

Understanding the needs of your consumers including those yet to use services

Commissioning for Outcomes

Recovery/ Wellbeing

Joint Commissioning

The scale of the commissioning challenge


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‘Silo-ed Thinking’ learning disabilities include:

We are All a bit ‘Guilty’ of this and..

  • unless addressed we will not fully..

  • ..maximise the Benefits for the Consumer

  • ..flex Commissioning ‘Muscle’.

    So we must..

  • ..Sell Collective Priorities = Collective Gain

  • ..Promote cross agency and in own organisation, and

  • ensure Best Value


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Health learning disabilities include:

Acute

‘Working Age’

CAMH

MHSOP

LD

Local Authority

DWP

Housing

Supporting People

Police

Probation

Home Office…

…To name but a few.

Now is the time to…

Which Silos?


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Market management learning disabilities include:

For too long services for people with a learning Disability have been served by what’s available in the local trust

Is that really what we want??


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If its not ? then what can you do a bout it learning disabilities include:

  • Provider stimulation (without destabilisation)

  • Bring new providers in around the table

  • Develop what models of care you want

  • Work with commissioners to turn that into specifications and put you plan to the market

  • Its not easy but…


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Acknowledge that we have never had a bigger platform to shout from

  • We need to get on with it and own the solution, not hang onto the problem

  • And above all…


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Work in Tandem shout from


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