Learning disabilities (health and wellbeing needs in South Tyneside)

South Tyneside has a local learning disabilities strategy " Learning Disabilities Transformation plan Working 2014 - 19". The Learning Disabilities Transformation Group supports the strategy and monitors the action plan. The group also has responsibility to make sure that all partners are aware of the plan. This strategy includes people with a Learning Disability who have low or moderate social care needs and may not be eligible for specialist social care and health support. The five main priority areas which were agreed on after consulting with stakeholders include:

1. people have access to affordable housing options and are supported to live in ordinary housing;
2. people have access to health services which lead to improved health outcomes;
3. people are supported to be part of their community, have friends and relationships, and access to work, leisure and education opportunities;
4. family carers are supported to care for their relatives and have access to a range of services to enable them to have a break from their caring role; 
5. people have access to a clear community infer structure to support people in a crisis.

Within the strategy, commissioned services will promote independence, health and wellbeing and where possible prevent, delay or minimise a persons need for formal care and support by providing greater access to universal services and through the increased use of tele care assistive technology which can make supported living and living at home with families safer.

Identified Gaps

• A recent audit of Acute Health Care highlighted that fewer than 50% of Acute Health Care generated specific health improvements.
• There is a low proportion of people with learning disabilities in paid employment.
• Need for an agreed way to flag that person has a Learning Disabilities on all the IT systems used in health and social care that follow the patient and ideally a portable care plan that can be seen by all professionals involved in the person's care.
• An agreed standard of training for healthcare professionals and their non-clinical staff to recognise people with Learning Disabilities and to make reasonable adjustments and a way of monitoring the uptake of training and that it is repeated on a regular basis. For all commissioned services to have a Learning Disabilities champion who ensures the Learning Disabilities agenda is highlighted regularly.
• Contractual levers for all service providers to ensure that they meet the 9 principles above where relevant to their service and that there is an agreed way of capturing and monitoring this data.
• Access to easy read documentation to help with health promotion and advice.

Recommendations for Commissioners

Working in partnership with people with Learning Disabilities, their families and providers, commissioners need to take into consideration the following recommendations when commissioning services;

• Officers from the Council and Clinical Commissioning Group to work alongside key stakeholders and the local community to raise Learning Disabilities awareness and to ensure that information (in line with the Accessible Information Standard) and mainstream services are reasonably adjusted for people with Learning Disabilities. In particular alcohol and substance misuse, forensic and mental health services
• To increase the uptake of annual health checks that lead to health action plans amongst people with Learning Disabilities to 50% of the eligible population and to work to improve screening rates (cancer) amongst people with Learning Disabilities.
• To develop local housing options for people with Learning Disabilities who have challenging needs, including the provision of a short term accommodation for people who need crisis intervention and are at risk of placement breakdown.
• To increase the offer of settled accommodation (recommended nationally) by remodelling and to evaluate the impact of settled accommodation on outcomes locally in 2 years.
• Reduce the usage of assessment and treatment inpatient beds by 40% (national target).
• Ensuring people have choice and control over how their health and social care needs are met by offering personal budgets and personal health budgets (recommended nationally) with access to information, advice and support to help people understand the choices available to them. To evaluate the impact of personal budgets and personal health budgets on outcomes locally in 2 years.
• Increase the numbers of people with Learning Disabilities who are supported to access training, work experience, apprenticeships, and voluntary and paid employment.