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To: Directors of Public Health
Copy:NHS Chief Executives / 

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Ar faidhle/Our ref: 2020 Local Delivery Plans

23December 2013

Local Delivery Plans: Tackling the inequalities faced by people with a learning disability

Dear colleagues

I am writing to provide further information on one of the priority areas for Local Delivery Plans – inequalities experienced by people with learning disabilities and to outline the key role of Directors of Public Health in enabling the successful delivery of this commitment.

The Cabinet Secretary’s letter of 29 November 2013 on NHS Scotland Local Delivery Plans refers to LDP guidance 2014. Section 3 page 8 of this document sets out the expectation for all NHS Boards to consider how they intend to address tackling the inequalities faced by people with a learning disability through Local Delivery Plans:

The Keys to life learning disability strategy highlights the stark inequalities faced by people with a learning disability. The invisibility of people with learning disabilities in Scotland’s health information prevents the existing inequalities from being addressed. It is essential that the Improvement and Co-production Plan identifies priorities for action and to drive improvement work at service level. NHS Boards need to identify its population with a learning disability using primary and secondary care NHS services.

A better understanding of the health inequalities within localitieswill also allow NHS Boards to tailor strategies and interventions to address the inequalities experienced by their local population, and to put in place the mechanisms to monitor trends in improvements.

This LDP priority is therefore focused on the important first step of systematically identifying the learning disability population using NHS services, as part of the general population accessing services, to inform future service design and practise development.

Each NHS Board is required to identify a named public health physician to lead on the delivery of this work, reporting through the Director of Public Health to the NHS Board, and the NHS Annual Review and Mid-Year Review (or equivalent persons in the Special NHS Boards) AsDirectors of Public Health you will be expected to lead on the delivery of this LDP component:

  • to reduce the health inequalities experienced by people with learning disabilities by
  • Undertaking a lead role in the ongoing identification of the LD population locally.
  • Identify and support improvements in the quality of primary, secondary and tertiary healthcare services for people with learning disabilities from communicable diseases; effective disease surveillance;immunisation; and screening programmes.
  • Identify and facilitate improvements in priority risk factors and health related behaviours for people with learning disabilities in line with NHS Quality Strategy. These may differ from general population risk factors and should include mental wellbeing.

I recognise that there are already some examples ofgood practise and service improvement within NHS Boards around this issue and that there are good case studies which can be shared.

Additionally, guidance has been developed to support NHS Boards with their Local Delivery Plans around learning disability and I would like to offer you the opportunity to discuss this further, either individually or in small groups.

With all that in mind, I am requesting that each NHS Boards provide a contact name so that our national lead for this work can meet contacts in January 2014 to help support the local effort in scoping, facilitating or undertaking development work on this aspect of the Local Delivery Plan.

I would be grateful if contact details could be sent to Pauline McDonald, 0131 244 4749 by Monday 13th January 2014

Dr Maureen G Bruce

Deputy Director

The Scottish Government, Adult Care and Support Division.

TaighNaomhAnndrais, Rathad Regent, DùnÈideann EH1 3DG
St Andrew’s House, Regent Road, Edinburgh EH1 3DG
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