Valuing People Now vision

1. How can we help people with learning disabilities and their family carers to look after their weight? • What do we need to do to support people? • How can we work together to make a difference? • Ranjit Senghera • Programme specialist

2. Valuing People Now vision • ‘All people have the right to lead their lives like any others, with the same opportunities and responsibilities, with the right support to make possible and be treated with the same dignity and respect”

3. Areas to cover? • Background to programme and development of Charter and resources • Strategic context of the Charter and Framework for action • Values of resources for commissioners and providers • What differences the resources can make? • Ideas for Implementation

4. Background and context • Charter has ‘Valuing people Now’ vision at the heart and approach was innovative: • strives to tackle health inequalities related to weight management in people who have learning disabilities and works on ways to improve quality of life and outcomes. • why should we take this approach?

5. Why we should care? • The Facts: • One person in three (1 in 3) with a learning disability who are obese (compared to one in five (1 in 5) of the general population) • This means 328,333 people with Learning disabilities being obese in England. • What else do we know?

6. The real facts? • Women, people with Down’s syndrome, people of higher ability and people living in less restrictive environments are at increased risk of obesity . • Less than 10% of adults with learning disabilities in supported accommodation eat a balanced diet, with an insufficient intake of fruit and vegetables. • Carers generally have a poor knowledge about public health recommendations on dietary intake. • Over 80% of adults with learning disabilities engage in levels of physical activity below the Department of Health’s minimum recommended level, a much lower level of physical activity than the general population (53%-64%), • People with more severe learning disabilities and people living in more restrictive environments are at increased risk of inactivity. • The rate of Type 2 Diabetes in people with learning disabilities is double that of general population.

7. Where to start? • We know that better support and services could be provided for these individual’s • This charter sets out to raise the profile of the needs of this population regarding • weight management services, • support commissioning and prioritisation and • provide clear standards for service deliverers to adhere to through contracting processes. This approach will empower people with learning disabilities, their carers and family members to make healthy choices the norm no matter what their circumstances.

8. Aims of the Charter • The implementation of the charter will: • Improve practice relating to the commissioning and delivery of weight management and related services for people with learning disabilities, their carers and families. • Standardise the services offered to people with learning disabilities, their carers and families regarding weight management. • Advise on the standards that are expected when commissioning and delivering services to people with learning disabilities to support them in maintaining a healthy weight.

9. The Charter aims to: • Promotes and supports the prioritisation of the needs of people with Learning Disabilities regarding the commissioning of specialist and community services to aid weight management. • Strengthens commissioning processes and advises on the standards expected when delivering services. • Aids the determining of strategic direction and the requirements for contracting services that maximise opportunities for people with learning disabilities, their carers and families to be supported to maintain a healthy weight.

10. The Rights and Values of the Charter • People have the right to a healthy life and to be given the appropriate support to achieve this. • All people with a learning disability, their families and carers have an equal right to support and advice that will enable them to make healthy lifestyle choices and maintain a healthy weight. • This support should be person centred with services that are developed to take into account individuals communication needs. • Services should be individually tailored, flexible, responsive to changes in individual circumstances and delivered in the most appropriate local situation. Services should be delivered by individuals with the right values, attitudes, training and experience. • People have the right to environments that enable individuals, their families and carers to make healthy choices regarding lifestyle. • Services should be developed on the principles of positive behavioural support and other evidence based approaches that will respond to all the needs of the individual. • All services and professionals delivering services should put valuing the lives of people with a learning disability at the heart of their work and provide a high standard of care and support regarding weight management.

11. Who charter aimed at? • Support organisations to meet legislative frameworks of the Equalities Act 2010 • Disability discrimination Act • Disability Equality Duty – all public bodies to make reasonable adjustments to meet needs • Public Health, NHS and Social care Commissioners and strategists • Front line health services • Service deliverers (service managers)

12. Charter allows you to.. • Work done for you: • Commissioners and contracts statements • CQC mapping against meeting CQC essential standards for quality and safety

13. Learning Disabilities and Obesity West Midlands Framework for Action

14. Framework for Action • Framework is: • A partnership approach of DH West Midlands and its partners in 2009/10 to develop a focus on the needs of people with learning disabilities regarding: • maintaining a healthy weight, • participating in physical activities and • making healthy food choices

15. Framework s focus: • The initial stages of this focus included: • Gaining an understanding of the agendas, policies and challenges effecting people with learning disabilities • Developing an understanding of the relationship between obesity and learning disabilities • Understanding the challenges of maintaining a healthy weight for people with learning disabilities • Developing knowledge of the programmes of work happening already to tackle obesity within this specific group in the community

16. Partnerships are important – regional seminar • DH West Midlands Public health and social care teams • West Midlands public health observatory • NHS West Midlands SHA and Pan-WM • Specialists practitioners in LD, physical sport, transport, dance, healthy eating, obesity, commissioners • People with learning disabilities and their carers

17. WM Framework for Action • Seminar identified: • Strategic hooks and leavers to support work • Identified areas of work in the region and identified good practice • Looked at challenges facing people with Learning disabilities and their carers in accessing and participating in physical activities, healthy eating

18. Context of framework • Facts on Learning disabilities and Obesity • Numbers are scarce as recording is low, yet people with Learning disabilities is 2% of population • Sports and recreational activities – access is low, therefore take up is low • Diet and nutrition – people with LD have access to limited range of foods, people in traditional long stay units and nutritional problems • People with Prader-Willis – syndrome where people with a LD have an insatiable appetite and eat excessively even when full, often leading to chronic obesity.

19. Strategic Policy context • Valuing People Now – Making it happen for everyone outlined: • Rights, Independent Living, Control and Inclusion • The NHS White Paper, Equity and excellence: Liberating the NHS (2010)Healthy Lives, Healthy People: Our strategy for public health in England (2010) • Greater control to people over their health and care • Greater accountability for patient outcomes for both the NHS and Social care • Health and care professionals being encouraged and supported to work more effectively across boundaries to achieve improved outcomes. • Social Care White Paper 'A vision for adult social care: Capable communities and active citizens' • Public Health White Paper; Healthy Lives, Healthy People (2010)

20. Policy context • No Health Without Mental Health Strategy (2011) • The Quality, Innovation, Productivity and Prevention (QIPP) programme • Forthcoming Green Paper on Special Educational Needs and Disability • Healthy Lives, Healthy People: A call to action on obesity in England • The 2011 update for the UK Physical Activity Guidelines • NHS Operating Framework 2012/13

21. Coalition commitment • The Coalition Government have stated their commitment to fulfil the priorities laid out by the previous Government in the Valuing People Now strategy, reiterating a pledge for equity, excellence and personalised services for all people with learning disabilities. The vision stated in Valuing People Now is reinforced in the valuing People Now Summary Report as; • “All people have the right to lead their lives like any others, with the same opportunities and responsibilities, with the right • support to make this possible and be treated with the same dignity and respect”

22. Policy context • The Obesity and Physical Activity papers are due to be published in spring 2011. The document also makes links to the Local Transport White Paper and the Natural Environment White Papers that are due out imminently. • The new Public Health Service will focus on key outcomes developed into a framework that will include 5 domains: • Health protection • Tackling wider determinants • Health improvement – promoting the adoption of health lifestyles • Preventing ill health • Healthy life expectancy

23. Mapping to Outcomes • Measuring outcomes is key • Framework for action maps outcomes to: • The Public Health Outcomes Framework • NHS Outcomes Framework • Social care Outcomes Framework

24. Value of Charter and resources • Commissioners and strategists • Service Providers and Practitioners • Organisations – Advocacy, Health-watch, LINKS • Individual and family carers • Health and Well Being Boards • Learning Disability Partnership Boards • Clinical Commissioning Groups (CCGs)

25. Differences resources can make? • Turn evidence into action • Examples from Telford and Coventry • Examples of how the Charter and the Framework for action can work to make a difference to the lives of people with learning disabilities and their carers

26. Ideas for action: Process for organisations and partners

27. Thanks....