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Building the Right Support for Learning Disabilities

Turning improvement ideas into local action

Kia Oval, Surrey County Cricket Club, London SE11 5SS

19 July 2016

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Help us to Help you

Pól Toner RN MScHead of Improvement and enablement

Strategic Resettlement“Thinking and Planning for a Better Future”

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Supporting Service Changes Locally

• We, as a national team are here to support you e.g.• Practical support locally to help you improve more quickly• Housing people working with us to help move more

quickly• Service people working with us to get the care right and in

the right place for the many people we need to support• Maggie and team will say how we will do this with

your help• We welcome your views• The help is about your needs

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Two Main Parts to Thinking and Planning better services

• Thinking and Planning ahead to meet the needs locally.

• Working to ensure new services that are in place provide what local people say they need and that they are involved

• Sustainable and permanent positive change for people with Learning Disability and ASD.

• “Personalisation at scale”

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• Firstly this is about thinking and planning ahead

• It relies on the partnerships locally having good plans developed and prepared to meet the needs for this patient group so changes can happen for many patients quickly.

• Secondly the future needs to allow for other service ideas so we can continue to meet the needs , for people with Learning disabilities and ASD, both now and for future Generations.

The basis

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What is Thinking and Planning ahead?

• Its about Planning

• Understanding the needs of the people you need to plan ahead for

• Impact of much fewer beds in the system

• Understanding many people will be leaving hospital sooner and how to make sure this goes smoothly

• Its about putting new services in place to meet changing needs

• Care and housing for many individuals

• Supporting people who give care now to understand why change is happening and how they can help to meet the needs of the new services as they happen

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How it fits• Its business as usual but a little faster

• Planning is about Building the Right Support

• Fits with Discharge planning guidance

• We need to make sure we can do everything we said we will do in our plan with the people and money we have locally at the right time to meet local needs

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Strategic planning

Transforming Care Partnerships need to understand the needs of people with Learning Disabilities in their local area

Housing, care providers’ and workforce people need to be involved and work to making sure the new services are supported by the right workers and the right housing and right care in the right place at the right time

Plan to support people outside hospital rather than in hospital beds

Solid discharge planning and arrangements in place

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Strategic commissioning

• Bring all commissioning work together in the local area

• Thinking and planning ahead should mean that contracts in place support reducing beds

• Involve people who provide care

• Make sure the care system is in a good place for now and the future

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In the Regions• Regional teams all work slightly differently but will

need to ensure everything is working well

• Regional teams will support the changes planned or underway locally

• The team can do this face to face or make it easier using technology

• Managing a steady and consistent development of community services and bed reduction as set out in their plans.

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In the RegionsMuch work is already underway

• Regional team should establish a resettlement team function

• This resettlement function should develop expertise

• Ward/ unit/ hospital closure level changes should be led by the local Transforming Care Partnership commissioners including specialised commissioning, with providers.

• National Team will support the regions with provider engagement Regions will have a good understanding of the entirety of the patient cohort

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Commissioning Development We need to consider the wider context of commissioning, including

Local Authority and Clinical Commissioning Group commissioners and consider the impact on and expertise and leadership required within these teams going forward.

We need to strengthen coordinated commissioning for people a learning disability or Autistic Spectrum Disorder.

We need to strengthen admission and discharge management, through length of stay and escalation management

Encouraging life planning

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Over the summer and where work is beginning

• Regional teams will be supported to expand their ideas about how they will work with everyone else on this,

• Over July and august and by September 2016, each Transforming Care Partnership and Region to have developed local thinking and starting to plan ahead for engagement with housing and care providers,

• Need to ensure those who organise more specialised care and others who provide care are talking and working together

• Transforming Care Partnership’s to map out their plans and what the issues are and what do we need to do to reduce any risks around our plans

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• During the summer, regions will have identified, from this information collectively from Clinical Commissioning Groups, wards and units for Transforming Care Partnerships to earmark for closure and start to plan closure,  We can then support with next steps.

• Where units and wards have patients from outside the region, regions and Transforming Care Partnerships will need to work together (and where this is the case) identify a lead Clinical Commissioning Group to manage the process and closure, based on a fairness model.

• At Regional level to enhance their plans to deliver the changes around their patients at a steady state between then and march 2019, including a ward/ unit closure programme.

• By October 2016, a full meeting will have been held to outline new community model of care being proposed and new reducing based model

Work will continue

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• As a goal we want Transforming Care Partnerships to manage discharges/ movements and follow individual bed closures

• We want regions to work together and to follow regional closure profiles and ensure Clinical Commissioning Groups work together on ward and into closure

• Nationally we want to follow ward and unit closures • So every patient is managed and their progress

recorded and help given if necessary

Prioritise Discharge Management

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The tasks/ expectation:• Its not just about bed reduction, for all regions;

• its also about repatriation back nearer home and the development of new service models

• Identify wards and units affected as part of their 3 year profile to achieve the 50% closure.

• Expectation will be to now strategically discuss discharges and ward and unit changes/closures, with providers, at Transforming Care Partnerships and Regional Level based on ambitions for new models of care and services,

• but local teams will still need to concentrate on patient centred case management and personalised delivery of effective care.

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• Transforming Care Partnership planning process, will be about moving the plans from planning to transformation and closures.

• This is not just at patient level but at ward and unit closure level and to permanently close the door to increased admissions

• Effective provider engagement• ensuring the new service model is sustainable and supports

people living well outside hospital with the right support locally• We will work with the systems to monitor and support practical

progress on this

In Conclusion

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“safe and sustainable personalised care planning at scale and pace”.

Thank You