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Policy Briefing
July 2018
This is a regular briefing for learning disability commissioners and other associated professionals in the northwest.
You are receiving this briefing because either your organisation subscribes to the North West Training and Development Team; or you subscribed to our policy briefing mailing list on our website. If you no longer wish to receive these briefings then please click on the ‘unsubscribe’ link at the bottom of this email.
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This briefing is compiled by Dr Laurence Clark and Colin Elliott from Pathways Associates CIC.
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A. PATHWAYS ASSOCIATES NEWS
A1. The Staying Healthy Group
Pathways facilitates the NW Staying Health group which provides a resource for commissioners to engage with an informed and passionate group of self advocates and family members on any health related topic. The group has worked on a lot of NW based projects such as the Greater Manchester eye health strategy for people with learning disabilities and some consultation on behalf of Macmillan Cancer Care. Recently the group has worked with NHS Improvement to co-produce the new learning disability Standards for NHS Trusts published in June 2018: http://tiny.cc/a9mvvy
It has also worked with NHS Improvement and NHS Benchmarking to co- produce the survey that will be used to gather the experiences of people with learning disabilities using NHS Trust services. These will be published in the Autumn.
There are 4 standards that Trusts need to meet; doing so identifies them as delivering high quality services for people with learning disabilities, autism or both. These standards are supplemented by improvement measures or actions that trusts are expected to take to make sure they meet the standards and deliver the outcomes that people with learning disabilities, autism of both and their families expect and deserve. NHS Improvement will look at performance against these standards to target support at those trusts that need to improve.
If you would like further information about the Staying Healthy Group and how you might use it to support service design/redesign or any other topic that requires some engagement with experts by experience please contact Janice.Wycherley@pathwaysassociates.co.uk.
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B. HEALTH AND SOCIAL CARE NEWS
B1. Strengthened guidance to protect children at risk
Children at risk of abuse or neglect will now be protected through improved partnerships between local police, councils and health services. Strengthened guidance published on 4th July sets new legal requirements for the three safeguarding partners, who will be required to make joint safeguarding decisions to meet the needs of local children and families.
Senior police, council and health leaders will jointly be responsible for setting out local plans to keep children safe and will be accountable for how well agencies work together to protect children from abuse and neglect. The new advice is aimed at all professionals who come in to contact with children and families and includes guidance on current threats to child protection, such as sexual and criminal exploitation, gangs and radicalisation.
Salford, Tameside and Trafford are amongst 17 local areas that will be implementing the guidance early.
Further information and a link to the new guidance can be found here: http://tiny.cc/ojmvvy
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B2. New law introduced to protect vulnerable people in care
The Mental Capacity (Amendment) Bill was introduced to the House of Lords on Tuesday 3 July and seeks to replace the current system known as ‘Deprivation of Liberty Safeguards’ (DoLs). DoLs is an assessment currently carried out on people who do not have the mental capacity to make their own decisions about their care. It was criticised by a 2017 Law Commission review for being too complex and bureaucratic.
The government has now developed a new system, known as ‘Liberty Protection Safeguards’, which will become law through the bill. The reforms seek to:
- introduce a simpler process that involves families more and gives swifter access to assessments
- be less burdensome on people, carers, families and local authorities
- allow the NHS, rather than local authorities, to make decisions about their patients, allowing a more efficient and clearly accountable process
- consider restrictions of people’s liberties as part of their overall care package
- get rid of repeat assessments and authorisations when someone moves between a care home, hospital and ambulance as part of their treatment
Further information is available here: http://tiny.cc/3kmvvy
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B3. The NHS at 70: How good is the NHS?
To mark the BBC's coverage of the NHS's 70th birthday in July 2018, researchers from the Health Foundation, the Institute for Fiscal Studies, The King’s Fund and the Nuffield Trust have joined forces for the first time, using combined expertise to shed light on some of the big questions on the NHS. The first in a series of five reports compares the NHS against health systems in other developed countries to ascertain its quality in an international context.
This first, main report, How good is the NHS? uses OECD data and a range of other public sources to compare the NHS to health systems in 18 similar developed countries, including France, Germany, Italy, Japan and the USA. It looks at three aspects of what might indicate a good health care system: the speed and accessibility of care, the efficiency of the system, and the outcomes delivered for patients. It also sets the scene by looking at what the health service has to work with, so that we can consider whether it is doing a good job given the circumstances.
Further information and the full report are available here: http://tiny.cc/jomvvy
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B4. Facts and figures on the NHS at 70
To help journalists, commentators and others interested in the 70th anniversary of the NHS the Nuffield Trust has compiled a set of facts and figures comparing the NHS in 1948 with now. The slide pack contains information on NHS spending, staffing, biggest killers, life expectancy, death rates and more.
The slide pack is available to download here: http://tiny.cc/7pmvvy
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B5. The NHS 10-year plan: how should the extra funding be spent?
On 12th July the King’s Fund published an article that responded to the government’s announcement of increases in NHS funding over five years, beginning in 2019/20, and government’s request that the NHS to come up with a 10-year plan for how this funding will be used.
The King’s Fund proposes that after eight years of austerity, growing financial and service pressures within the NHS and the damaging and distracting changes brought about by the Health and Social Care Act 2012, there is now an opportunity to tackle the issues that matter most to patients and communities and to improve health and care.
The full article is available here: http://tiny.cc/irmvvy
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B6. NHS publishes guidance to help trusts learn from deaths
On 11th July the NHS published guidance to help trusts work with bereaved families and carers.
Over 70 families and carers worked with NHS England on the guidance which will provide advice to hospitals, mental health and community trusts on how to involve families following the death of a loved one. This follows a Care Quality Commission (CQC) report which said families’ experiences and insights are a valuable source of learning; and that families and carers should be treated as equal partners to identify opportunities for improvement.
Further information can be found here: http://tiny.cc/htmvvy
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B7. Thousands of patients to benefit from innovative new treatments on the NHS
Stroke-reducing heart implants and a life changing surgical procedure for children with cerebral palsy are among a host of new treatments that will now be routinely available for thousands of patients on the NHS.
The NHS announced its plan to provide the latest innovative treatments for patients on 7th July.
More detail is available here: http://tiny.cc/xwmvvy
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B8. Help shape modern primary care says NHS England as part of NHS Long Term Plan
GPs, patients and healthcare professionals are being given the chance to have their say on plans by the NHS which will help shape the future of a modern general practice. The NHS is looking at ways to reform the GP contract to provide a stronger and more sustainable general practice for patients as part of the new NHS Long Term Plan.
In particular, with a wide range of partners, NHS England has reviewed the Quality and Outcomes Framework (QOF) which provides payments for achieving outcomes that reflect high quality care in general practice. It is also looking at how general practice payments might change to fairly support the rollout of digital technology across the country. The changes to the current GP Contract, which was agreed nearly 15 years ago, are being looked at to meet the changing needs of a growing and ageing population and increased use of digital services locally.
Further detail is available here: http://tiny.cc/30mvvy
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B9. A‘Red bags’ to be rolled out across England’s care homes getting patients home from hospital quicker
Innovative ‘red bags’ that help care home residents admitted to hospital be discharged quicker are being rolled out across the country. The bags, which contain key paperwork, medication and personal items like glasses, slippers and dentures, are handed to ambulance crews by carers and travel with patients to hospital where they are then handed to the doctor.
Since April, the first parts of the country formally begin to work as integrated care systems, a key milestone as England makes the biggest national move to integrate care of any major western country. So far the initiative in Sutton has showed:
- Reduced hospital stays by three to four days, saving £167,000 a year
- Stopped patients losing personal items such as dentures, glasses and hearing aids worth £290,000 in a year
- Improved communication between care home and hospital staff saving time, resources and duplication
More information is available here: http://tiny.cc/s3mvvy
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B10. LGA responds to latest delayed transfers of care figures
Cllr Izzi Seccombe, Chairman of the Local Government Association’s Community Wellbeing Board, responds to latest delayed transfers of care figures published today by NHS England:
“The further reduction in delays due to social care is testament to the fantastic work by councils which have now reduced this figure by 39 per cent since July 2017. To help reduce pressures on the NHS, adult social care needs to be put on an equal footing with the health service and councils need urgent funding to invest in effective prevention work to reduce the need for people to be admitted to hospital in the first place”.
Further detail and a link to the delayed transfers of care figures for May 2018 are available here: http://tiny.cc/p5mvvy
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B11. Brexit: Moving the conversation on
The Local Government Association has published a response to the government’s Brexit White Paper. In the report the LGA:
- put forward their advice and recommendations to UK and EU negotiators
- set out how the final exit treaty could deal effectively with the differing risks and opportunities for local communities across the UK
- set out the risks and opportunities that should be addressed under different scenarios on exit, including no deal
- identify some important milestones to judge the impact of Brexit on local communities.
The media response and full report is available here: http://tiny.cc/a7mvvy
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B12. Adult social care green paper delayed until autumn
The government has postponed the review's publication following the announcement of a long-term funding plan for the NHS. It was announced last November that the government would publish a green paper on care and support for older people by summer 2018. Damian Green, then first secretary of state, said it was important that the government “took the time needed” to debate the “many complex issues” which surround adult social care.
Further detail can be found here: http://tiny.cc/zpnvvy
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B13. Matt Hancock MP writes in the Health Service Journal
The new Secretary of State for Health and Social Care sets out his ambitions for the future of the NHS and talks about the potential of technology to improve healthcare.
The article can be found here: http://tiny.cc/34ovvy
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B14. Transforming Care Parliamentary Debate, Thursday 5th July
The Parliamentary debate on the future of Transforming Social Care programme took place last Thursday. Despite the short notice, we were pleased a number of people including many families were able to attend to watch the debate and meet with Norman afterwards.
You can watch the debate here: http://tiny.cc/njpvvy
The Hansard account is here: http://tiny.cc/jkpvvy
Norman Lamp and the MPs who spoke in support of the motion, presented the issues well and there were consistent messages. However, the Minister’s response was less detailed.
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C RESEARCH
C1. Latest NHS Learning Disability Statistics
This publication noow brings together the LDA data from the Assuring Transformation collection and the LDA service specific statistics from the Mental Health Statistics Data Set (MHSDS).
There are differences in the inpatient figures between the MHSDS and AT data sets and work is underway to better understand these.
ASSURING TRANSFORMATION
Data collected for LDA inpatients at the end of June 2018 show that:
- 2,405 patients were in hospital at the end of the reporting period.
- 130 patients were discharged/transferred from hospital in June 2018, 90 (67%) were discharged back into the community.
- 1,400 (58%) had a total length of stay of over 2 years.
- 1,190 (49%) were in a general security ward.
MENTAL HEALTH SERVICES DATASET: LEARNING DISABILITY AND AUTISM STATISTICS
Data collected for LDA inpatients at the end of April 2018 show that:
- There were 3,135 people with learning disabilities and/ or autistic spectrum disorders in hospital.
- 1,305 were discharged from hospital and 1,250 were admitted to hospital
- 1,085 had been in hospital for over 2 years.
- 1,345 were in a secure setting.
There was a difference of 610 LDA inpatients recorded for April 2018 between the AT and MHSDS data sets.
More data can be accessed at http://tiny.cc/2xpvvy
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C2. Nothing About Disabled People Without Disabled People
This excellent easy read research report by Hammersmith and Fulham Disabled People’s Commission highlights many areas relevant to other local authorities too.
The report can be read at https://gallery.mailchimp.com/fb87a0648757436c218703f51/files/0a8e4543-fd36-490c-a874-7e7cc4b6ee53/EDITS_6_DPC_Report_2018_Easy_Read.pdf
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C3. The health and social care interface
The National Audit Office (NAO) has published a report assessing the challenges preventing health and social care from working together effectively. In a move to encourage the government to create a long-term plan for a sustainable, joined-up care sector, the head of the NAO, Amyas Morse, urges further and faster progress towards a service that centres on the needs of individuals, meets growing demands for care and delivers value to the taxpayer.
The report can be read at http://tiny.cc/8qpvvy
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D RESOURCES
D1. Mental capacity and tenancy agreements: common mistakes local authorities make
This article comprises of excerpts taken from a new guide on Community Care Inform Adults about mental capacity, tenancy and licence agreements. The guide is written by Aasya Mughal, a director of Edge Training & Consultancy Ltd.
The article can be accessed at http://tiny.cc/tunvvy
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D2. Dementia and people with learning disabilities: making reasonable adjustments
This NDTi guide is to help staff in public health, health services and social care to ensure that their services are accessible to people with learning disabilities who may have, or be developing, dementia or be at particular risk of doing so. The guide is also intended to be of use to families and friends of people with learning disabilities. There are links to resources to use when supporting people as well as good practice case studies.
The guide can be accessed at http://tiny.cc/x3nvvy
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D3. Count Me In: Coproduction toolkit
Excellent coproduction resource and toolkit from East of England ADASS. It can be accessed at http://tiny.cc/3xovvy
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D4. What the Mencap sleep-in payments judgment means for the sector
Belinda Schwehr analyses the Court of Appeal ruling which means sleep-in staff will not automatically get the minimum wage for every hour of their shift
The blog can be read at http://tiny.cc/1gpvvy
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