​​Transforming care – learnin​g disability and autism​​

Learning disability

 
The CCG has a number of key programmes around learning disability and has put in place a robust approach to partnership working and participation in this area spanning governance, coproduction, assurance, equalities and inequalities, feedback and evaluation. We have much-valued partnerships with community and voluntary sector partners, and charities.
 
The CCG continually seeks feedback on its approach and the impact of the participation systems and activity and facilitates a coproduction approach to this important work.

Transforming Care

In October 2015, NHS England, the Local Government Association and the Association of Directors of Adult Social Services (ADASS) published ‘Building the right support ', a national plan to develop community services for people with a learning disability and/or autism and who display behaviour that challenges (including those with a mental health condition). The delivery of this plan is being overseen by the national Transforming Care programme.
In south east London, a Transforming Care Partnership (TCP) has been established comprising Clinical Commissioning Groups (CCGs) and Local Authorities from Bexley, Bromley, Greenwich, Lambeth, Lewisham and Southwark, plus NHS England Specialised Commissioning.

The South East London TCP has a vision for people with learning disabilities and/ or autism to achieve equality of life chances, live as independently as possible and have the right support from mainstream health and care services.
To achieve this, the TCP is implementing plans in three key areas:

  1. Improving discharge from inpatient care: ensuring those that require a stay in hospital are able to return to the community as soon as possible
  2. Preventing admissions to inpatient care: ensuring that care services are able to identify and respond to people at risk of admission living in the community
  3. Building community service capacity: ensuring that the correct specialist services are in place to support people living in the community

For more information of learning disability and/ or autism services in your area, please follow this link https://www.greenwichfamiliesinformation.org.uk/kb5/greenwich/fsd/localoffer.page?localofferchannel=0.

Transforming Care Programme engagement approach

The London Transforming Care Programme Board includes a user member who has learning disability who is from Greenwich through Advocacy in Greenwich.  Our Healthier South East London Transforming Care Programme is part of the London Board

The South East London Transforming Care Programme has an operational and strategic board (the strategic boards includes a user member from the South East London Transforming Care Programme learning disability service user forum)

The South East London Transforming Care Programme User Forum (meets bi-monthly) – brings together learning disability service users and carers from across south east London. This forum advises and participates in the CCG commissioning of services across south east London.

The learning disability service user forum is supported by 3Cs advocacy group.
Greenwich has transforming care steering group which meets bi-monthly.
The CCG associate director of commissioning for mental health and learning disability provides regular feedback to the Greenwich learning disability partnership board.

LeDeR (learning disability mortality reviews)

The LeDeR programme aims to improve the quality of care for people with a learning disability.  The programme aims to review the deaths of everyone with a learning disability to identifying learning about good care and where care could be improved.
 
The programme is led by NHS England (NHSE) and led and administered locally by CCGs.
Currently the LeDeR is aligned with the Transforming Care Programme reporting into the SEL Transforming Care Operational Board.  Each borough has a LeDeR steering group(s) which reports to the Operational Board which then ensures learning is embedded into TCP work streams.
 
There is a bi-monthly steering group in Greenwich and LeDeR has a London-wide steering group. A user representative from Advocacy in Greenwich sits on it to champion user voice for all learning disability people. It has facilitated forums and group events to gain views, feedback and experiences of people with learning disability across London.

Learning Disability Partnership Board

The learning disability partnership board meets quarterly. Six MPs (members of the Greenwich Learning Disability Parliament) are voted in by peers in the borough who are people with learning disability and they cover six areas. The learning disability partnership board discusses how people with learning disability manage and are supported in these areas:

  • Choice and control
  • Health
  • Moving on
  • Jobs and activities
  • Housing
Each of the above areas has a sub group to discuss and consider the issues, concerns and learning in that area.  Greenwich CCG co-chair the Health Sub-Group with the Health MP. The associate director of commissioning has regular meetings with the Health MP, and briefing and agenda setting meetings and also pre-cabinet meeting with partnership board members to ensure support.
 
The Health Sub-group meets monthly with key stakeholders from Royal Borough of Greenwich, Oxleas NHS Foundation Trust and voluntary and community sector colleagues to discuss the health inequalities of people with learning disability within the borough of Greenwich and how best manage this for best outcomes and impact. 
 
The group also discusses changes to practice, identify learning opportunities and good practice to share. The group share ideas and opportunities for training.  For example for the annual health checks programme we used ResearchNet group to provide training to GP surgeries, Queen Elizabeth Hospital and other health providers. This has a direct impact on reducing health inequalities for people with learning disability. CCG administration support the group and all papers and minutes are accessible and produced in easy read, facilitated by the CCG.
 
Materials for the annual health checks and other programmes have been co-produced in partnership with people with learning disability and representatives and advocates including Mencap, Advocacy in Greenwich, national and local organisations as well as acute liaison learning disability nurses. Materials coproduced in 2018 include a pharmacy card to tell pharmacies an individual has learning disability; how to ask for a black book, and hospital passport.
 

Events and campaigns accessibility

The CCG uses Advocacy in Greenwich, Greenwich Mencap and the Can You Understand It Group, and ResearchNet (both facilitated by Oxleas for accessibility needs) for any user engagement events.  We held targeted events in 2018 including the Treat Me Well campaign during 2018 Learning Disability Week.
 
The associate director of commissioning works collaboratively with the Royal Borough of Greenwich  including recent Transformation work regarding the ‘Custumer Journey’ which involved two ‘Have Your Say’ days to gain learning disability user voice on health services for the population of Greenwich. 

For more information of learning disability and/ or autism services in your area, please follow this link.

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