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Putting people with learning disabilities at the heart of what we do
In the latest of a series of blogs to mark Learning Disability Week, the Chief Nursing Officer for England, Jane Cumings, discusses NHS England’s ongoing programme of work to transform services:
Learning Disability Week provides us with an opportunity to reflect on what has been achieved in the past year, and what we want to achieve in 2015-16.
There are very few policy areas which have been the focus of more thought, more debate and more work than how we support people with learning disabilities, and there are very few areas where this has been more overdue.
Over the last year we have commissioned and received an independent report on services for people with learning disabilities, written by a panel chaired by ACEVO Chief Executive Sir Stephen Bubb. That report set out a series of challenges for us and our national partners, which we responded to earlier this year.
The Transforming Care for People with Learning Disabilities – Next Steps report set out an ambitious series of measures that we – along with the Local Government Association (LGA), the Association of Adult Social Services (ADASS), the Care Quality Commission (CQC), Health Education England (HEE) and the Department of Health (DH) – are committed to take over the coming year.
Work to realise those ambitions is underway at a ferocious pace between my team at NHS England and their national and local colleagues.
One of our first priorities has been to empower people and their families by giving them the means to challenge their admission or continued placement in inpatient care through an admission gateway process and Care and Treatment Reviews, aimed at reducing the number of admissions and speeding up discharges.
To date we have undertaken more than 1,700 Care and Treatment Reviews, where professionals, patients and family members come together to discuss the best form of care for that individual, and hundreds of those patients have been moved to more appropriate settings.
The next phase of our work focuses on getting the right care in the right place. This means working with local authorities and other providers to ensure that high quality community-based alternatives to hospital are available.
We said at the time of the Next Steps report that this work would begin at speed in the North, Midlands and East regions, where commissioners have been the most likely to use inpatient facilities, and Simon Stevens used his speech to the NHS Confederation Conference to announce where that work will take place.
Commissioners in Greater Manchester and Lancashire, Cumbria and the North East, Arden, Herefordshire and Worcestershire, Nottinghamshire and Hertfordshire will receive extra technical support from NHS England to draw up transformation plans over the summer, and will be able to access a £10million transformation fund to kick-start implementation from Autumn 2015.
The transformation we want to see in those areas will mean strengthening services in the community, closing inpatient beds and improving lives for patients. The work they do will accelerate change in those areas, but also help shape the approach NHS England takes to transforming learning disability services elsewhere.
There’s much more to come over the coming months too: engaging with stakeholders on a new service model, reforms to contracts to strengthen accountability, tightening regulation and inspections to improve quality, and increasing workforce capability by working with patient and carer groups to address gaps in skills and best practice.
At their heart, our reforms are about putting the voice of people with learning disabilities – and the voices of their families, carers and loved ones – at the very centre of how their care is planned and delivered.
By the time Learning Disability Week comes around next year, I’m determined to be able to say that has been achieved.
- For updates on Learning Disability Awareness Week follow #LDWeek15
I saw Jane Cumming this morning on Breakfast from the BBC, explaining how people with learning disabilities are being moved back into the community and cared for locally. A similar movement is happening in the Netherlands, but here it involves mainly the elderly but also younger people with disabilities.
Many elderly people like people with learning disabilities can look after themselves for the majority of the time, but need to have help nearby. By placing a small home in the garden of the primary carer, this his been very successfully achieved. In the Netherlands this primary carer is usually family.
The house, which we call a Family Care Annex differs in a number of ways from normal housing:
1. The house has been designed, both in shape, size and facilities, that both physical and mental disabilities are covered to allow the highest possible level of independence for the inhabitant, but also care externally obtained can easily be given.
2. It is an complete house with all facilities allowing full independence.
3. It can easily be adapted for whatever care is needed.
4. It can be placed in a relatively small garden where normally further building would not be encouraged, since it is on a temporary basis and after its use the garden can be returned to its original state.
5. The house has been specifically designed so that it can be moved and used at a different location when not needed anymore, keeping its value.
6. It is built at a different location, so placing it in the garden and making it fully functional for habitation only takes 2 weeks.
I would love to tell you more about the possibilities and how successful this new way of caring in the community has become in the Netherlands. The above mentioned website explains al lot, but unfortunately all in Dutch. You can contact me through the website or call me at [Edited to remove personal information].