Learning Disability Commissioning
Improving the lives of People with Learning Disabilities
All our work is focussed on improving the life chances and experiences of people with a learning disability, their carers and families. We work with key partners and local providers to ensure individuals are provided with equal access to services that matter to us all, and that individuals with care and support needs receive help that is skilled, enabling and life enhancing.
See the tabs below for our programmes of work which includes transforming care plan, care and treatment reviews, improving access to health care, Quality Checkers, Learning Disability Mortality Review Programme and STOMP
Transforming Care: A national response to Winterbourne View Hospital (December 2012) and subsequent reports, including Building the Right Support (2015), set out a national commitment to improve services for people with learning disabilities and/or autism, who display behaviour that challenges, including those with a mental health condition.
As a result, 48 Transforming Care Partnerships have been formed across the Country to drive a system-wide change and enable more people to live closer to home in their community with the right support. The Northamptonshire Transforming Care Partnership consists of Northamptonshire County Council, NHS Northamptonshire Clinical Commissioning Group (CCG) and NHS England Specialised Commissioning.
The Northamptonshire Transforming Care Plan sets out a focus on prevention and early intervention so our work will concentrate on strengthening services to ensure individuals can remain in their preferred community based setting for as long as possible, even during periods of ill health. We will also focus on new models of care that integrate health and care services to make it easier to keep people healthy and ensure individuals can access the right services when they are required. A Northamptonshire Learning Disability Transformation Board will hold us all to account in delivering the local Plan. The Transformation Board will monitor our progress against the Plan and the things we said we would do.
CTRs were developed as part of NHS England‘s commitment to improve the care of people with learning disabilities and or autism who either have been or may be about to be admitted into a specialist Mental Health/Learning Disability hospital. The purpose of the CTR process is to reduce admissions and reduce unnecessarily lengthy stays.
The Policy was refreshed in 2017 to include Education for children and young people so becoming Care, Education and Treatment Reviews (CETRs).
A Care and Treatment Review will be held for anyone with learning disabilities or autism or both who is at risk of a hospital admission, or are already in a specialist learning disability or mental health hospital or in a 38 week or 52 week residential placement.
NHS Northamptonshire CCG and Northamptonshire Healthcare Foundation Trust have developed a local register that ensures that individuals are known about and identified as early as possible to ensure that there is an appropriate package of support to prevent admission wherever possible. The CTR register is for adults and there is a separate CETR register for children and young people.
People with a learning disability often have poorer physical and mental health than other people. This does not need to be the case.
People with learning disabilities are admitted to hospital more often and when admitted they stay longer than the general population. They also have more hospital admissions that should have been avoidable.
In response to these startling findings NHS Northamptonshire CCG employ 4 Learning Disability Strategic Health Facilitators whose role is to support health services to understand the health needs of people with learning disabilities and support them meet them equally and effectively. Their overall aim of their work is to reduce avoidable illness, preventable admissions and premature deaths of people with learning disabilities.
The team of four experienced learning disability practitioners work alongside the 74 GP practices and both Acute Hospitals; Northampton General Hospital and Kettering General Hospital. They have the knowledge and skills to provide training, advice and support for Primary care and Acute care staff in meeting the health needs of people with a learning disability.
NHS Northamptonshire Clinical Commissioning Group (CCG) is pleased to have bought (also known as commission) a Quality Checkers Service.
Quality Checkers are people with learning disabilities that have experience of using health and council services, they are experts by experience. The Quality Checkers speak to people with learning disabilities (and staff) in health and social care and then write a report to tell us how the services can be made better. They send their reports to us so that we know what is working well, what’s not working so well and what needs to change. The Quality Checkers tell providers about things that can improve so people have a better experience of their care.
The National Learning Disabilities Mortality Review (LeDeR) Programme has been established as a response to the recommendations from the Confidential Inquiry into premature deaths of people with learning disabilities (CIPOLD 2013).
CIPOLD reported that people with learning disabilities are three times more likely to die from causes of death that could have been avoided with good quality healthcare.
The LeDeR programme aims to:
- Review deaths of People with learning disabilities to make recommendations based on learning
- Drive improvement in the quality of health and social care service delivery for people with learning disabilities
- Help reduce premature mortality and health inequalities in this population
- To influence practice at service, individual and professional level
NHS Northamptonshire CCG made a commitment to implementing this programme and commenced the review process in September 2017. The programme is overseen by the LD Mortality Steering Group.
On 16 July 2020 A full copy of the 2019 LeDeR Annual Report was published, you can view the full report here: https://www.bristol.ac.uk/news/2020/july/leder-report.html. You can also read the NHSE/I LeDeR – Action from learning report here: https://www.england.nhs.uk/publication/leder-action-from-learning-report/.
NHS Northamptonshire CCGs annual local Learning Disabilities Mortality Review (LeDeR) report for April 2020 – March 2021 can be viewed here.
STOMP is a health campaign to stop the over-use of psychotropic medication to manage people’s behaviour. It is estimated that on an average day in England between 30,000 and 35,000 people with a learning disability, autism or both are taking prescribed psychotropic medication without appropriate clinical justification. The CCG has completed an audit as a baseline to continue to work on monitoring and achieving best practice locally.