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This month's Policy Briefing by the NWTDT Research Centre
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Policy Briefing

January 2017

This is a regular briefing for learning disability commissioners and other associated professionals in the northwest.
 
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This briefing is compiled by Dr Laurence Clark and Colin Elliott from Pathways Associates CIC.

In this issue:
 
A. HEALTH & SOCIAL CARE 
  1. Work, Health and Disability Green Paper Data Pack
  2. The Prime Minister is to tackle ‘everyday injustices’
  3. Suicide Prevention
  4. Five Year Forward View for Mental Health: government response
  5. Secretary of State for Health, Oral Statement to Parliament: Mental health and NHS performance
  6. The Kings Fund proposes Priorities for the NHS and social care in 2017
  7. How hospital activity and funding in England have changed over time
  8. New Change4Life campaign encourages parents to ‘Be Food Smart’
  9. Cold weather forecasts have prompted warnings to take care from Public Health England 
  10. The Nuffield Trust: ‘Quality at a Cost’
  11. Government revises Care Act guidance after Supreme Court loss
  12. Government sets out social care funding plans
  13. Local authority learning disability commissioners survey on Transforming Care
  14. New national Clinical Director for Learning Disabilities for NHS England
B. INCOME & BENEFITS
  1. Disability employment gap: Government won't meet manifesto targets until 2065
C. RESEARCH & ANALYSIS
  1. Social care for Older People: Home Truths
  2. The Hidden Housing Market: A new perspective on the market case for accessible homes
  3. No Place Like an Accessible Home: Quality of life and opportunity for disabled people with accessible housing needs
  4. Spreading change: A guide to enabling the spread of person- and community-centred approaches for health and wellbeing
  5. Caring Homes: how the Carers Strategy can make housing suitable for carers
  6. 1.2m older people don’t get the social care they need
D. RESOURCES 
  1. Preparing for Adulthood information sheet on supported decision making and the Mental Capacity Act
  2. Health Charter in Practise (2nd edition): for providers supporting people with learning disabilities
  3. Our Dementia, Our Rights booklet
  4. Education, Health and Care Plans: Examples of good practice
  5. Transforming Care Empowerment films
  6. People with Learning Disabilities in the Criminal Justice System Guide
A. HEALTH & SOCIAL CARE 

A1. Work, Health and Disability Green Paper Data Pack
On 20th December 2016 The Department of Health announced that people with learning disabilities will benefit from £25 million of funding to help them live more independently in their own homes. The fund aims to improve their quality of life by giving them independence, and helping them feel more included in their local community.
 
The local authority projects will focus on adapting existing housing, creating new accommodation and giving people support so they have more independence and choice.
 
Only 15% of adults with learning disabilities in England have a secure long-term tenancy or their own home. The Department of Health aims to address this by supporting projects, including shared ownership schemes, adapting existing properties with new technology and building new technologically adapted homes.
 
More details can be found here: http://tiny.cc/ohuhiy
A2. The Prime Minister is to tackle ‘everyday injustices’ 
On 9th January the prime minister gave her speech ‘The shared society’ at the Charity Commission annual meeting.
 
Tackling and addressing mental health features as a priority.  Further detail can be found here.http://tiny.cc/4iuhiy

The King’s Fund response, which includes the following statements, can be found at: http://tiny.cc/kjuhiy
 
‘We welcome the Prime Minister’s recognition of the importance of improving mental health care in creating a fairer society that works for everyone.’
 
‘It is now essential that extra funds for mental health reach the front line, as our recent analysis suggested that promised increases in funding have not materialised in many areas.’
 
‘We also welcome her recognition of the vital role of schools and businesses in promoting mental wellbeing. Our concern is how these ambitions will be achieved when public health, early years provision, and other social support services are seeing their budgets cut.’
A3. Suicide Prevention
The third progress report of the cross-government suicide prevention strategy details the activity that has taken place across England to reduce deaths by suicide in the year ending March 2016.
 
This report is being used to update the 2012 strategy in 5 main areas:
  • expanding the strategy to include self-harm prevention in its own right
  • every local area to produce a multi-agency suicide prevention plan
  • improving suicide bereavement support in order to develop support services
  • better targeting of suicide prevention and help seeking in high risk groups
  • improve data at both the national and local levels
These updates will help to meet the recommendations of the Five Year Forward View for Mental Health relevant to suicide prevention: to reduce the number of suicides by 10% by the year ending March 2021 and for every local area to have a multi-agency suicide prevention plan in place by the end of 2017.
 
The report is available to download here: http://tiny.cc/5kuhiy
A4. Five Year Forward View for Mental Health: government response
On 9th January the Department of Health published the government’s response to the work of the Mental Health Taskforce. The taskforce report to NHS England, the Five Year Forward View for Mental Health, is an independent and far-reaching overview of what modern mental health services should be.
The government will accept the taskforce report’s recommendations in full and take them forward. This report provides full responses to each of the 58 recommendations made to government. NHS England’s response to their recommendations can be found in Implementing the Five Year Forward View for Mental Health.
 
The government’s response is available to download here: http://tiny.cc/9ouhiy
A5. Secretary of State for Health, Oral Statement to Parliament: Mental health and NHS performance
On 9th January the Secretary of State for Health provided an update to Parliament on Mental Health and NHS performance. Whilst acknowledging serious challenges exist he said that progress is being made to address rising demographic pressures on NHS services and that an additional £1billion will be invested in mental health services by the end of this parliament.
 
Further detail is available here: http://tiny.cc/aruhiy
A6. The Kings Fund proposes Priorities for the NHS and social care in 2017
The Kings Fund states that 2017 promises to be another challenging year for the health and care system, with demand for care increasing faster than the supply of resources.
 
With that in mind the organisation has proposed 5 key priorities for Health and social care over the coming year: 
  • Supporting new care models centred on the needs of patients
  • Strengthening and implementing sustainability and transformation plans
  • Improving productivity and delivering better value
  • Developing and strengthening leadership at all levels
  • Securing adequate funding for health and social care
Further detail can be found here: http://tiny.cc/htuhiy
 
A7. How hospital activity and funding in England have changed over time
On December 20th 2016 The Kings Fund published an analysis of 13 years of data, concluding that rising demand is resulting in increasing hospital activity – from A&E attendances and emergency admissions to referrals to outpatient services, diagnostic tests and elective admissions. There is also evidence that other parts of the health service are facing similar challenges, including general practice, district nursing health services and mental health.
 
The Kings Funds states that:
 
‘Since 2010, this increased activity has coincided with a prolonged funding squeeze. Between 2010/11 and 2014/15, funding slowed significantly, averaging 1.2 per cent per year, and is set to average 1.1 per cent from 2015/16 until 2020/21. The effects of this can be seen in deteriorating financial performance and growing waiting times across secondary care. There is compelling evidence of a health system buckling under the strain of trying to meet increasing demand within constrained resources.’
 
More detail is available here: http://tiny.cc/jwuhiy
A8. New Change4Life campaign encourages parents to ‘Be Food Smart’
Children consume half the daily recommended sugar intake before the morning school bell rings, according to Public Health England (PHE).
 
Further detail can be found here: http://tiny.cc/ixuhiy
A9. Cold weather forecasts have prompted warnings to take care from Public Health England 
Forecasts of the winter’s first nationwide snowfall, likely to be accompanied by cold weather and ice, have prompted take care warnings from PHE. The Met Office said on 9th January 2017 that from later this week snow may fall across England, affecting northern areas first, reaching more southern areas later in the week.

Dr Thomas Waite, of the Extreme Events and Health Protection team at Public Health England, said:
 
Although some will enjoy the winter’s first widespread snow, others may find getting out and about a challenge. It’s worth thinking ahead now about what you may need before the snow arrives, such as food and medicines, so you don’t have to make trips out during bad weather. Critically keep a close eye on the Met Office weather forecasts over the coming days. There’s lots of useful advice online, particularly the Keep Warm, Keep Well webpages.
 
For more detail follow the link: http://tiny.cc/pyuhiy
A10. The Nuffield Trust: ‘Quality at a Cost’
Quality at a cost is the fourth annual statement from QualityWatch, a joint research programme from the Nuffield Trust and Health Foundation. 
 
QualityWatch monitors over 300 indicators spread across all domains of quality. This report considers a selection of areas from within this set, covering different stages of a patient’s experience of the health service, to give a picture of quality in 2016. It looks across six main areas: 
  • Public health 
  • Primary care
  • Ambulances
  • Hospital care
  • Mental health
  • Condition-specific care (stroke and hip fracture)
It concludes that the pressure of austerity did not impact on quality measures straight away, but took a few years to be felt. Authors conclude that further ‘delayed decline’ could occur in other aspects of care quality, such as effectiveness of treatment or patient safety, given the extent of the challenges faced and ongoing austerity in health and social care spending.
 
The report is available to download here: http://www.qualitywatch.org.uk/quality-at-a-cost
A11. Government revises Care Act guidance after Supreme Court loss
The government has updated the Care Act statutory guidance after it lost a Supreme Court case on ordinary residence disputes.
 
The Department of Health has reviewed and updated the guidance following the Supreme Court judgment in July in the case of R (on the application of Cornwall Council) v Secretary of State for Health.
 
The updates, which can be read from paragraphs 19.17 to 19.43 of the guidance, set out changes in the approach that should be used to determine ordinary residence or disputes between councils in relation to adults who lack capacity to decide where to live and looked-after children who are transitioning to certain adult social care services.

For more information please see http://tiny.cc/ohvhiy
A12. Government sets out social care funding plans
On 14th December the government has announced a package of reforms it says will generate nearly £900m extra for adult social care services over the next two years.
 
Communities and local government secretary Sajid Javid said a £240m ‘adult social care support grant’ will be introduced next year to be divided by local authorities based on need. Councils will also be handed more flexibility in how they use the social care precept so that they can bring forward more funding in 2017-18 and 2018-19.
 
Councils were previously allowed to raise council tax by up to 2% per year under the precept. However, from next year local authorities will be allowed to use the social care precept to raise council tax bills by 3% in 2017-18 and a further 3% 2018-19.
 
The government claims the precept reforms will allow councils to raise £208m more for adult social care in 2017-18 and £440m in 2018-19. The adult social care support grant will be funded through savings generated by reforms to the government’s ‘new homes bonus’ that currently goes to councils, said Javid.
 
Richard Humphries, assistant director for policy at The King’s Fund, said the government’s changes were “nowhere near enough” to address the funding gap facing authorities next year.

For more information please see http://tiny.cc/0mvhiy
A13. Local authority learning disability commissioners survey on Transforming Care
In August 2016, learning disability leads at all councils with adult social services responsibility were asked to complete an online survey regarding delivery of the Transforming Care programme.
 
The aim of the survey was to:
  • Identify the key challenges for local authorities as part of Transforming Care Partnerships
  • Better understand the support needs of local authorities to inform the LGA support offer, and the wider Transforming Care programme sustainable improvement programme
The survey was completed by 68 councils, representing 45 per cent of those with responsibility.
 
Following analysis of survey responses, a series of information packs have now been published.  These can be accessed at: http://tiny.cc/0myhiy
A14. New national Clinical Director for Learning Disabilities for NHS England
As of 1 January 2017, Dr Jean O’Hara is the new National Clinical Director for Learning Disabilities for NHS England.
 
Jean is clinical director at South London and the Maudsley NHS Foundation Trust, King’s Health Partners (KHP) Academic Health Sciences Centre, and a consultant psychiatrist in intellectual/learning disabilities. Originally from Hong Kong, she qualified from the London Hospital Medical College in 1983 and took up her first consultant post in 1992. Jean is passionate about improving quality of care and developing future generations of clinicians. Throughout her career, she has held formal management and leadership roles within the NHS, Royal College of Psychiatrists, Royal Society of Medicine and the London Deanery.  Jean is visiting senior lecturer at the Institute of Psychiatry, Psychology and Neuroscience.

 Her full bio can be accessed at: http://tiny.cc/e2yhiy
B. INCOME AND BENEFITS

B1. Disability employment gap: Government won't meet manifesto targets until 2065

A new report from the All-Party Parliamentary on Disability highlights the Government will miss its manifesto target to halve the disability employment gap
 
The report entitled ‘Ahead of the arc’ highlights the current disability employment gap of 32 per cent will reduce by just 2.6 percentage points by 2020 on current rates of progress, and that it will take until 2065 to reach the target of 16 percentage points. The report focuses on three currently under-utilised or neglected policy areas; Institutional discrimination, Public sector procurement and Data collection.
 
The report highlights a lack of reliable data on the scale and distribution of disability employment gaps. It recommends that all organisations, and especially those funded by and contracting with the public sector, are required to collect and record the disability status of their employees, users and applicants, and that this information is used to develop plans and monitor progress towards hiring and retaining more people with disabilities, or providing better services to them.
 
The report can be accessed at http://tiny.cc/e8uhiy
C. RESEARCH & ANALYSIS

C1. Social care for Older People: Home Truths
This report, published jointly by the King's Fund with the Nuffield Trust, looks at the current state of social care services for older people in England, through a combination of national data and interviews with local authorities, NHS and private providers, Healthwatch and other groups. It considers the impact of cuts in local authority spending on social care providers and on older people, their families and carers.
 
There is reference the evidence about the importance of housing in reducing the need for health and social care services and offering care options that achieve better outcomes at lower cost. Importantly, there is also recognition of the uncertainty of the future of supporting housing funding under the government's proposals and the implications this is having for existing provision and the development of new schemes.

The report can be accessed at http://tiny.cc/1ujkhy
C2. The Hidden Housing Market: A new perspective on the market case for accessible homes
New research report by Habinteg and Papworth Trust highlights the hidden housing market for 1.8m disabled people. Its findings clearly show the demand for accessible housing to rent and buy.
 
The report can be accessed at http://tiny.cc/ogwhiy
C3. No Place Like an Accessible Home: Quality of life and opportunity for disabled people with accessible housing needs
Habinteg Housing and Papworth Trust commissioned CASE at LSE to report, primarily in relation to working age disabled people, on:
  1. The extent of need for housing which has accessible features
  2. How far unmet need for accessibility features is associated with disabled people not being in work
  3. The impact of the above factors on housing choices
 The report can be accessed at http://tiny.cc/xhwhiy
C4. Spreading change: A guide to enabling the spread of person- and community-centred approaches for health and wellbeing
Nesta and the Health Foundation have published a guide that shows how people can take an active role in their health and care. It identifies a range of evidence-based approaches to health and wellbeing that engage people and communities, and tools to support implementation across the NHS and local communities.
 
The report can be accessed at http://tiny.cc/uwxhiy
C5. Caring Homes: how the Carers Strategy can make housing suitable for carers
Caring Homes examines the impact of inaccessible and unsuitable housing on carers and their families. The report draws together evidence on the impact of housing on health and outlines some of the key housing challenges for care.
 
In a survey of over 5,000 carers, findings revealed that:
  • 1 in 5 carers (18%) are waiting for adaptations to be made
  • 10% said that their home was in poor condition, damp or disrepair, rising to 15% of carers renting privately
  • 15% of carers said there isn't enough space for someone to provide overnight care, rising to 19% of carers living in social housing
  • 13% of carers said that as a result of caring there isn't enough space to live comfortably, rising to 18% of carers living in social housing
The report calls for a strategic national housing and care policy to support more than six million unpaid carers and their families, who are struggling to provide good and safe care in inaccessible and inadequate housing.
 
The report can be accessed at http://tiny.cc/rvxhiy
C6. 1.2m older people don’t get the social care they need
Age UK analysis addressed the lack of social care provided to older people in the UK. The number of older people in England who don’t get the social care they need has soared to a new high of 1.2 million - up by a staggering 48% since 2010.
 
The report can be accessed at http://tiny.cc/ksxhiy
D. RESOURCES 

D1. Preparing for Adulthood information sheet on supported decision making and the Mental Capacity Act
From September 2014, under Part 3 of the Children and Families Act 2014, the right to make requests and decisions applies directly to disabled young people and those with SEN over compulsory school age (the end of the academic year in which they turn 16) rather than to their parents.
 
This has raised a lot of questions from young people, their families, and professionals working with them, about how young people can be prepared and supported to make important decisions about their future.
 
Preparing for Adulthood (PfA) have worked in partnership with the Transition Information Network (TIN), the Information Advice and Support Services Network (IASSN) and Making Ourselves Heard (MOH) to develop this factsheet. We have considered the practical implications of the key principles of the Mental Capacity Act 2005 and how they link with the duties in the Children and Families Act 2014 and the Care Act.
 
The factsheet can be accessed at: http://preparingforadulthood.org.uk/resources/all-resources/pfa-factsheet-the-mental-capacity-act-2005-and-supported-decision-making
D2. Health Charter in Practise (2nd edition): for providers supporting people with learning disabilities
To support care providers and disability organisations, the LDPHO worked with the Voluntary Organisations Disability Group (VODG) – the leading umbrella group of voluntary sector providers – to develop a health charter. The charter provides a self-assessment framework and guidance for organisations to work through and build their practice upon.
 
The charter can be accessed at http://tiny.cc/gvvhiy
D3. Our Dementia, Our Rights booklet
This guide has been authored by Philly Hare on behalf of the Dementia Policy Think Tank. This group was set up in 2016 by a number of people with a diagnosis of dementia who have a particular interest in promoting rights and influencing policy issues.
 
The purpose of this accessible guide is to bring together in one place the facts about some of the key rights relating to dementia in the UK.
 
The guide can be accessed at http://tiny.cc/7awhiy
 
D4. Education, Health and Care Plans: Examples of good practice
This resource by the Council for Disabled Children has been produced to help practitioners write good quality EHC plans that meet both the letter and the spirit of the Children and Families Act 2014.
 
The first part of this document includes excerpts from real EHC plans that were collected through the local Independent Support network. In the second part there are two EHC plans which draw on real examples but the plans themselves relate to fictional children.
 
The resource can be accessed at http://tiny.cc/x9xhiy
 
D5. Transforming Care Empowerment films
The Transforming Care empowerment steering group have worked together to develop a number of short films about what being empowered means to them. Members of the empowerment group are all experts by experience with a learning disability and/or autism, or family members. They all have experience of long stays in hospital, or have family members with experience, but are now leading good lives in the community. There is an animation about the Transforming Care Programme and the importance of empowerment, a montage film featuring all five of the individuals who shared their stories, and five longer films from the perspective of each person.
 
The short films can be accessed at http://tiny.cc/7iyhiy
 
D6. People with Learning Disabilities in the Criminal Justice System Guide
Arc have written a guide for family carers and services about people with learning disabilities in the criminal justice system. The guide explains:
  • What happens when someone gets into trouble
  • What you can expect
  • What rights people have
  • Where to go for help
 The guide can be accessed at http://tiny.cc/5azhiy
Copyright © 2017 Pathways Associates, All rights reserved.


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