The purpose of this report is to raise awareness of the LeDeR programme with a view to providing opportunity for the key objectives and priorities of the programme to be aligned with Health and Wellbeing Board priorities and workstreams.

The Associate Director of Nursing and Quality (ADNQ), NHS Herefordshire and Worcestershire CCG, introduced the annual report, the principal points of the presentation included:

·       The report reflects the past 12 months and how the Covid19 Pandemic has impacted on people with learning difficulties. Herefordshire has been in a strong position where it was reported that no single confirmed Covid related death for somebody with a learning disability has been registered.

·       The report reflects the third full year of data for Herefordshire and Worcester and for the first year provides clear understanding of the context for people living in Herefordshire compared to other areas. This has given some helpful reflections in particular: The mean age of death for Men is significantly better than the England average. The percentage of younger people, particular those aged 24 and younger with a learning disability who die within Herefordshire is better than the England average.

·       The programme is a quality improvement program and is founded in listening to and working with experts with lived experience in local communities to understand their perspective.

·       The priorities highlighted in the annual report will be taken in to a strategy which is required to be produced by March 2022, it will be a three year strategy and will provide much more details of how we are collectively working together to improve outcomes for people.

Board members were invited to comment, the principal points included:

·         It was queried where links could be made in terms of social care for people with learning difficulties. One of the priorities in the report focused on obesity along with mental health and the prospect of combining this with opportunities to exercise, walking etc. was raised. The example was given of a programme in Leominster “Walking for Health programme” for people for learning.

The ADNQ explained that the strategy would go into much more detail in terms of how priorities were taken forward. A Learning action group existed represented by all agencies, from health and social care, public health, family carers and people with lived experience. The group reviewed themes as they arose and discussed how best priorities can be taken forward, address best practices, identify gaps and propose solutions.

·       It was noted that Health Watch supported the document and were closely involved in groups looking at the right kind of investment into the future.

·        It was queried whether work was ongoing with hospices and if the service had enough resources to do everything they wanted to do.

The ADNQ confirmed that although hospices are not directly linked to the LeDeR programme they are working closely with the end of life network across Herefordshire and Worcestershire. It was highlighted that Herefordshire may be one of the best areas in the region for people not dying in an acute hospital bed. There have been a number of examples where people have utilized hospice beds appropriately, or have been supported to have really good end of life care at home and to learn much more about how that has been enabled for it to be shared within Worcestershire. In terms of resources, the programme was working really well together to make absolute best use of the resources that they have available to get the best outcomes for people. A national policy has just been published on the LeDeR programme and there is a review coming up. Commissioners are very much involved in the conversations to make sure that the resources go to the right places to address the priorities.

·       It was suggested that a recommendation could be formed to address opportunities for upstream and preventative information, interventions around health and well-being for example: exercise, mental health and wellbeing.

In addition to the recommendation suggested in the report and reflecting upon the comments from the board surrounding the opportunities for people with learning difficulties’ to take part in activities such as walking and exercise.  The resolution below was then approved by the board.

Resolved: That

a)    the Health and Wellbeing Board note the Herefordshire and Worcestershire Learning from Lives and Deaths- People with Learning Disability Annual Report for 2020/21 and the programmes key findings for people with a learning disability in Herefordshire.

b)    The board encourages collaborative working between the LeDeR working group and the HWBB for looking at upstream prevention and participation opportunities.