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Our plans for learning disabilities focus on transforming care. These plans are based strongly on the transforming care for people with learning disabilities – next steps report which follows on from the Winterbourne View Concordat.  

The author of the report, Stephen Bubb, states: "over the past few years people with learning disabilities and / or autism have heard much talk but seen too little action". Transforming care for people with learning disabilities - next steps, therefore focuses on improving services for people with learning disabilities and / or autism, who display behaviour that challenges (including those with a mental health condition). This will drive system-wide change and enable more people to live in the community, with the right support, and closer to home.

The programme reinstates that children, young people and adults with a learning disability and / or autism have the right to the same opportunities as anyone else to live satisfying and valued lives, and to be treated with dignity and respect. They should have a home within their community, be able to develop and maintain relationships, and get the support they need to live healthy, safe and rewarding lives.

Over the past 10 years, we have been making strides to ensure this vision becomes a reality. Locally Bradford’s changing lives programme has been the vehicle to implement this strategy for people with learning disabilities. However, for a minority, we continue to remain reliant on inpatient care - a view often held by families.

We are also following the NHS England policy and guidance following a care and treatment review

How are we doing? 

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Transforming care programme - building the right support

The NHS is committed to a programme of closing unsuitable and outdated inpatient facilities and establishing stronger support for those with learning disabilities in the community.

In Bradford, the Transforming Care Partnership have established plans for a year-on-year reduction on the reliance on specialist inpatient care for people with learning disabilities and / or autism.

The commissioning of inpatient beds for those with learning disabilities and / or autism is split between our CCG and NHS England. Per million population, by 2019 no area should need more inpatient capacity than is necessary at any one time to cater for;

  • 10-15 inpatients in CCG commissioned beds
  • 20-25 inpatients in NHS England commissioned beds
  • In our local transforming care programme (developed across Airedale, Wharfedale & Craven CCG, Bradford City CCG and Bradford Districts CCG), there are 13 beds for our population of 662,004
  • this is based on 20-25 beds per million of the population.

Number of people with learning disabilities and/or autism receiving specialist inpatient care (per million population);

  • in our CCG, 30 per million population
  • across Bradford and Airedale planning footprint the CCGs are on track to deliver use of between 20-25 beds per million of the population by 2020. 

Across Bradford, there are six beds which support people with learning disabilities who require inpatient services. This is considerably lower that the recommended number as described by NHS England. The aim of our local transforming care plan is to reduce this to two beds over a three year period. At the same time we will be developing robust and flexible community support for people with complex needs, including complex behavioural presentations. We believe that this number of beds will meet the needs of people in Bradford. In January 2016, in our CCG, four people accessed this service. 

Annual health checks

GPs conduct annual health checks for people with learning disabilities who are over the age of 14. The aim of these annual health checks is to ensure that people with a learning disability are in good health and receive care and support from mainstream health services. 

The number of annual health checks is assessed using the general practice learning disability register.

In our CCG for January 2016:

  • we have been rated as one of the best CCGs in the country for annual health checks,
  • 59.8% (three out of every five) people with a learning disability received an annual health check,
  • this is also higher than the average in West Yorkshire where 48.1% (less than half) of people with a learning disability received an annual health check,
  • the national average for annual health checks is just over 45%.

What you have told us

We make sure that we are listening, engaging and involving patients in the planning and design of their local NHS. To do this, each programme of work has the infrastructure to engage and collect information from people through:

learning-disabilities-experience

The insight and feedback you give us makes sure that we don't just collect information, but that we have the means and ability to use it to inform our commissioning activity and improve quality. All the insight and feedback is pulled together in a system we call grass roots.

For each programme of work, in addition to the above, we tailor engagement to ensure we are reaching people who use the services.

Grass Roots

Grass Roots pulls together information reported through NHS Choices, Patient Opinion, Healthwatch, complaints, local groups and direct patient, family and community feedback to inform CCG planning and decision making

The following represents feedback received in to Grass Roots:

LD - grassroots

Case study 

2015/16 - what have we done?

Work has been ongoing to make sure that children, young people and adults with a learning disability and / or autism have the same opportunities as everyone else to live satisfying and valued lives, and, that they are treated with dignity and respect.

Transforming care for people with learning disabilities - next steps will become the vehicle to continue delivering on the local changing lives programme.  

The aim of this plan is to continue reshaping services in Bradford. We are doing this so that local services are able to respond in a person-centred way to meet the needs of people with learning disabilities and / or autism who present with complex needs. 

201516 what have we done BD

What we are doing in 2016/17

We are committed to transforming care for people with learning disabilities, autism and behaviour problems.

Over the next three years we will be further developing community services and closing unnecessary inpatient services. This will be done in partnership with Bradford City CCG, Airedale, Wharfedale and Craven CCG, the local authority and NHS England specialised commissioners. 

We are also working with key partners across Bradford and Airedale to develop and deliver our Transforming Care Plan (TCP) for people with learning disabilities

Our transforming care plan BD

What we are doing over the next five years

Over the next five years we plan to improve care and the quality of the services we commission. We will be doing this by creating a system-wide model for the delivery of planned care.

Our focus is on transforming both mental health services and learning disability services. The main aim is to make sure that those with mental health problems, learning disabilities and autism get the same standard of health and care as the rest of the population.

There are also a number of recommendations that have been set out by the national Mental Health Taskforce that we will be addressing, namely:

For children, we have a school liaison and prevention project. This is a model of therapeutic integrated care for vulnerable children and young people. The project is currently also implementing a single point of access to preventative support.

The main things we will be doing are...
LD - next five years