Learning DisabilitiesSelfAssessment 2010 - Feedback Forms

LocalityHertfordshire

Health Check – Top Target 1
/ 1. Plans are in place to meet the needs of people who are no longer receiving treatment which requires in-patient care in an acute/long-stay residential facility or hospital / How we are doing overall on this standard
Please tick where you think are overall on this target / 
/ 
/ 


(1)
Top Targets and Key Objectives / (2)
Good things happening / (3)
Where things need to
get better / (4)
How do we score? / (5)
One thing we want to be better in 12 months (Key priority)
 /  / 
1.Plans are in place to meet the needs of people who are no longer receiving treatment which requires in-patient care in an acute/long-stay residential facility or hospital
1.1The resettlement of identified people from long stay hospitals, is complete / Hertfordshire does not have any long stay hospitals open / 
1.2All NHS Residential Campuses are to be closed by 2010 / All 15 people who meet campus definition and are the responsibility of Hertfordshire commissioners have plans in place that mean they will be able to move on by the end / LDPB and commissioners to continue to monitor the situation for any slippage /  / By March 2011, when the next Self Assessment will be completed, NHS Hertfordshire wants to be in a position where all people with a learning disability who meet ‘campus definition’ are in alternative accommodation that meets their individual needs.
1.3 (formerly 4.1) Discharge planning is in place for people (not already included in the campus target) both in and out of district, and in both NHS and private sector hospital provision, whose treatment is either complete, or nearing completion / The Placement Panel continue to meet to monitor admissions, length of stay and safe discharge processes and the JCT continue to work closely with service providers to inform this meeting and raise areas of concern as early as possible. / There are still instances of delayed discharge as a result of poor communication between providers /  / By 2011, discharge planning will be robust, as described in the new LD service specification for assessment and treatment; the LDPB and SCG will be kept informed of progress through regular reports.
Health Check – Top Target 2
/ The PCT is working closely with the Partnership Board and other local partners. This means that people with a learning disability can use the same health services and get the same treatment as everybody else / How we are doing overall on this standard
Please tick where you think you are overall on this target / 
/ 
 / 
(1)
Top Targets and Key Objectives / (2)
Good things happening / (3)
Where things need to get better / (4)
How do we score? / (5)
One thing we want to be better in 12 months
(Key priority)
 /  / 
2. PCTs are working closely with local Partnership Boards and statutory and other partners, to address the health inequalities faced by people with learning disabilities
2.1 Systems are in place to ensure the following are identified within GP Registers:
Childrenand adults with a learning disability
Older family carers
Those from minority ethnic groups
Carers of those from minority ethnic groups
 Parents or carers with a Learning Disability / All adults with a learning disability known to ACS are now registered with a GP with an appropriate Read Code
Most adults not known to ACS are also registered with a GP
There is a systematic update of the PCT database provided by ACS on an annual basis to ensure registration is at an optimum
The PCTs are working with a variety of partners (including the LA, voluntary organisations and the wider health community) to build a full picture of the LD community and carers through engagement with people and encouraging registration with GPs
There is a PCT pledge for carers to be systematically identified in primary care, with a pilot running in one locality / Carers in the county do not feel that the ‘carers register’ is being well used or that practice has altered as a result
At the present time, there is no electronic method for collecting information about older family carers, people with LD from BME groups or parents and carers with a learning disability, which makes systematic evaluation of the data difficult. /  / During 2010, the PCTs and partners will continue to work with groups who are typically not well known to primary care. In particular, the priority groups are people with a learning disability and carers from BME communities and older family carers.
The PCTs have committed to providing a robust system for collection of this data
By 2011, there will be a plan for how this data is used to inform commissioning of services in the future
2.2Primary Care Teams are tackling health inequalities and promoting the better health of those with learning disabilities registered with their Practice / Almost 80% of GP practices are now signed up to the LD DES and are providing health checks (due to data collection, this number cannot be confirmed until the end of the financial year)
Feedback from carers and people with a learning disability reflect that health checks are a good experience and are contributing positively to people’s wellbeing
All GP practices have a lead person for LD and they are being supported by LD commissioner and the Health Facilitation Team
All GP practices have a link community learning disability nurse / Due to the problems with the reporting systems for the LD DES, the full data set is not yet available
Some people with a learning disability have expressed disappointment that they have not yet had their health check
A commissioning strategy is still to be put in place for those surgeries not offering the DES (being confirmed in the middle of March) /  / In summer 2010, the operational policy and updated Health Action Plan (My Purple Folder) will be launched to the community of health professionals
An audit in 2011 by the Health Liaison Team will reflect that the Health Action Planning process is being used and leading to improvements in communication, care and flexible services
In 2010/11 more training is going to be made available to look at learning from the first year of the health check and consolidate learning
2.3People with learning disabilities access disease prevention, screening, and health promoting activities in their practice and locality, to the same extent as the rest of the population / The PCT provided some money for an accessible DVD about sexual health services to be made
Feedback in the Self Assessment Framework reflects that people are being encouraged to give up smoking, lead healthier lifestyles and lose weight
The LD DES training that has been provided makes specific reference to the poor uptake of screening and prevention in people with learning disabilities and practices were asked to actively encourage people to do so
The training also provided GPs with the dysphagia assessment tool, highlighted the increased incidence of diabetes and the importance of not excluding women with LD from cervical screening on the assumption they are not sexually active
The PCT has pledged to improve screening uptake for vulnerable people and the Health Liaison team have committed to support them with this / Due to the late start of the LD DES, the data asked for in the self assessment framework has not been collated; this is a result of the way in which data is collated /  / In 2011, the PCTs will have a baseline of measures from the first year of the LD DES/annual health check
The diabetes pathway will reflect reasonable adjustments made to ensure that people with a learning disability are equally able to access screening and early intervention
The number of people with a learning disability reporting having screening will increase by at least 20%
2.4The wider primary care community is demonstrably addressing and promoting the better health of people with learning disabilities / Feedback from people with a learning disability in 2009 reflects that there is some very good practice in mainstream primary care services– there are many opticians and dentists who are actively engaging with people and making reasonable adjustments.
The Health Liaison Team and HCHS are working together to share good practice, offer training, peer support and mentoring to improve access and outcomes for people with a learning disability – in particular offering support for people with challenging behaviours and complex needs
The primary care community have expressed interest in using the Health Action Plan (‘My Purple Folder’) to improve support to people with a learning disability
The PCTs commitment to improving access to and outcomes of healthcare for people with a learning disability has meant that there are champions for change across the organisation /  / In 2011, there will be an increase in positive feedback from people using a variety of primary care services and the PCT will visit some providers at random to find out about flexible reasonable adjustments made for people
2.5Service Agreements with providers of general, specialist and intermediate health care, demonstrably secure equal access to healthcare for people with learning disabilities / All contracts now reflect the duty of health care providers to make reasonable adjustments for access and equity for people with a learning disability
The PCT has committed to monitoring providers for access
The Intermediate Care Strategy for Hertfordshire makes specific reference to the needs of people with a learning disability and is considering this during a workshop in March
The Health Liaison Team are expanding to reflect the increased workload in general hospitals and posts have also been funding to work in primary care and with HCHS
There are robust procedures in place in the hospital trusts to analyse complaints and incidents involving people with a learning disability and amend practice / More work is required to support people with a learning disability understand and access the choice agenda in primary care
Some service providers still require more work to demonstrate that they are making reasonable adjustments in a systematic way
Communication between commissioners, providers and the LDPB to demonstrate the work being done by the health system to improve outcomes for people with a learning disability need to happen /  / By 2011, all contract review meetings will include mention of reasonable adjustments and reflect their effectiveness on a quarterly basis
For the Self Assessment Framework meetings next year, hospital trusts will commit to attending and presenting information on reasonable adjustment initiatives in an accessible format
2.6PCT commissioning work-streams - and projects developed to implement them – apply equally to people with disabilities. The needs of people with learning disabilities are explicit in all such work-streams across the SHA area / The delivery of annual health checks has seen an increase in the number of people with learning disabilities accessing the appropriate pathway for long term conditions
As an inclusive organisation, the PCT reflects that people with a learning disability are able to access all mainstream health services and health promotion activities and would not be excluded on the basis of having a learning disability / Carers of people with a learning disability have reported that it can be difficult to get heath services to make reasonable adjustments to projects to allow them to be accessed (e.g. diabetes self management course)
People with a learning disability and self advocacy organisations have reported that health promotion activities are not always provided in an accessible format and would like to support health organisations to do so /  / In one year, people with a learning disability will be represented in a meaningful way on key clinical work streams/networks to ensure they are able to derive benefits from them
2.7The benefits for patients derived from the development of computer technology are of equal benefit and equally open to people with learning disabilities and those who provide services to them / People with a learning disability have noted that as a result of training for GPs and surgery staff which highlighted the difficulty of using some of the practice IT systems, that they have been adapted for ease of use, or other systems have been put in place
The PCT has committed to ensuring that the IT systems required for the LD health checks and self assessment framework will be developed / People with a learning disability are not yet routinely using information systems available from the NHS as they are inaccessible
Methods for flagging people with a learning disability across the health service are not in place /  / During 2010, work will be undertaken to enable systematic collection of data required for the self assessment framework (identification of carers, people from BME communities) and analysis of LD health needs
2.8PCTs have agreed with local partner agencies a long term ‘across system’ strategy to address services to people with learning disabilities from ethnic minority groups, and their carers / As part of the self assessment, a joint health and social care event was held for people with a learning disability from BME communities and carers; these will be held regularly during the year
Improving the health and wellbeing for people from BME communities is a priority for the PCT and is reflected in its pledges – the PCT offers inclusive services and includes people with learning disabilities
All key policies have been assessed for equalities, with Equality impact Assessment training provided in all organisations
The Health Liaison Team have included meeting the needs of people from BME communities as one of the priorities for their action plan – this will encourage registration with GPs, using health services and reporting on the particular health needs of the group
One of the objectives for the Involving People Project is to do some mapping work on the best way to engage with people from BME communities / At the present time, people from BME communities are not well represented in the working groups of the LDPB, including the Health Working Group
At the present time, health data about people with a learning disability from BME communities is not being systematically collected and analysed
We know that there are many people from BME communities who are still not well engaged or using health services and need to target work with these groups /  / In one years time, the learning from engagement events with people and carers from ethnic minority groups will be translated into an action plan that all partners are able to sign up to
In one years time, the PCT will have collected health information (through GP registers and health checks) about how many people with a learning disability and how many carers are registered
In one years time, the work of the Health Liaison Team will reflect engagement with BME groups through increased numbers of people accessing health services and having a positive experience
2.9There is a long-term strategy in place to achieve inclusion and equality of healthcare and outcomes for people with profound disabilities and their carers / The Joint Commissioning Strategy (NHS Hertfordshire and HCC) makes specific reference to individuals with complex needs and the importance of listening to carers – this will be reflected in the implementation plan.
Through work with Adult Care Services, we know how many people there are with a learning disability and complex health needs, we are adding to this number through work with health partners to see if there are more people
Planning for future services for young people in transition is happening via the transition team
One of the tasks for the joint commissioned Involving People Project is to provide a network map for working with people with complex needs and their families. / Progress in this area has been slow, which is a cause of frustration for carers of and people with complex disabilities
There is still a feeling from people that people with the most complex needs receive the poorest service, with people being passed from service to service
The needs of people with complex needs and a learning disability are not well reflected in health planning – in particular communication systems and information
People with complex/multiple disabilities are not represented on all of the working groups of the partnership boards /  / By 2011, the PCT will be confident that the needs of people with complex needs/disabilities are reflected in the panning for Long Term Conditions and have included engagement with people and their carers
The Joint Commissioning Strategy Implementation Plan will have key indicators on improving services for this group of people
Health Check – Top Target 3
/ People with a learning disability are safe in National Health Service services / How we are doing overall on this standard
Please tick where you think you are overall on this target / 
/ 