To report on progress following the approval of the Learning Disability 10 year strategy in June 2018.

The senior commissioning officer presented the learning disability strategy update (appendix 1 to the report), the key points included:

a.    The learning disability strategy was a ten-year, joint strategy of Herefordshire Council and NHS Herefordshire Clinical Commissioning Group (CCG).

b.    The strategy and implementation plan aligned to the four themes: where I live; what I do during the day; being healthy and safe; and having choice and control.

c.    The Learning Disability Partnership Board involved a broad range of partners, including service users and providers.

d.    A learning disability dashboard was being developed to capture key data and track progress across the health and social care system.

e.    The implementation plan actions were currently on track to be delivered within the identified timescales.

f.     Examples were given of developments in progress to meet the priorities, including:

•        Where I live: joining together with Worcestershire County Council to commission specialist provision.

•        What I do during the day: improving the opportunities for people into paid employment through a staged employment project.

•        Being healthy and safe: the Herefordshire and Worcestershire Sustainability Transformation Partnership aligned the national priorities, developed local delivery plans, shared best practice and provided governance.

In response to a question, the senior commissioning officer and Jade Brooks, the acting director of operations of the CCG, both emphasised the importance of national programmes and working collectively to reduce health inequalities.  The chairperson noted the premature mortality profile of people with learning difficulties.

•        Having choice and control: embedding user engagement and promoting advocacy in all areas, with a number of initiatives to be launched during learning disability week (17 June).

g.    It was reported that there was significant work being undertaken to reposition services to deliver the strategy and the implementation plan would continue to be updated, with input from experts by experience.

The chairperson invited comments and questions from committee members, the principal points included:

1.       Committee members welcomed the high quality of the report and the presentation.

2.       Attention was drawn to the fact that all GP surgeries except one had improved systems to indicate on patient records when a person has a learning disability.  Jade Brooks confirmed that all the GP surgeries were expected to implement this measure.

3.       The senior commissioning officer advised the committee that the supported employment service focused on the individual, so opportunities in the localities and would be explored.  She added that a piece of work was being undertaken with community transport providers with a view to working together more closely.

4.       The chairperson noted that Herefordshire Council was a major employer and questioned what it was doing to encourage employment for people with a learning disability.  The senior commissioning officer recognised that more could be done to make job roles and the recruitment process more accessible.

5.       The senior commissioning officer said that the Learning Disability Partnership Board had undertaken work to promote bus passes and travel trainers were available to provide support.

6.       The senior commissioning officer clarified that the development of the market position statement, and some other actions, had been deferred to ensure that the components were understood fully, and the right decisions could be made going forward.

7.       The senior commissioning officer explained that, informed by an event for user groups and providers, there would be an ongoing user engagement cycle, including a ‘you said this, we did that’ element.

8.       The council was working with around 600 people who were eligible for social care support but it was acknowledged that there was a broader cohort of people with a learning disability in the county.

9.       Reflecting on what had been achieved in the relatively short time since the strategy had been approved (June 2018), the senior commissioning officer commented that it took time to move to a position to deliver outcomes but, in particular, it was satisfying to see people moving into their own homes.

10.     The committee was advised that data was being gathered to understand who was living at home and the ages of parents / guardians in order to plan for the future and to support people to make early choices.  The need to build trust and work collectively was emphasised.

11.     It was noted that the Whitecross flats development blended in well with the wider estate and, using new models of support, there was real potential for the tenants to be more independent.

12.     There were currently six people in out of county placements.  It was noted that there was a need to understand those that were well placed and those that were misplaced.

13.     The senior commissioning officer reported on work with the Autism Partnership Board on top tips to raise awareness and improve accessibility to health services.  Jade Brooks commented that good practice had been articulated across primary care services, such as increasing appointment times and improving waiting environments, but some GP practices needed to do more.

14.     A member noted that the children and young people scrutiny committee was due to receive a task and finish group report on special educational needs and disability provision shortly.

Professor Jane Melton, the director of engagement and integration of 2gether NHS Foundation Trust, commented on the benefits of involving people with learning disabilities in the development of strategies and implementation plans.

The director of public health noted that there was some excellent practice which should be communicated more widely.

The chairperson said that the committee welcomed the good start that had been made and looked forward to hearing about further progress in due course.

Resolved:

That progress with the implementation plan for the learning disability strategy be noted.