The healthcare needs of people with learning disabilities have been well charted in the literature, although the response of healthcare services to these needs has often been poor. Recent reports including Mencap’s Death by Indifference, which told the stories of six people with learning disabilities who died in the care of the NHS, the Disability Rights Commission’s report Equal Treatment which detailed discrimination in terms of access to healthcare and the report of subsequent independent inquiry Healthcare for All have highlighted the issue and made a number of very clear recommendations for improvements.
The recent appalling treatment of people with complex needs in Winterbourne View also highlighted the importance of good commissioning for people who challenge services.
There is no shortage therefore of evidence and indeed no shortage of guidance. But as the new commissioning arrangements in the NHS begin to take shape, there is a need to bring this guidance together in one place and clearly identify the responsibilities of the new Clinical Commissioning Groups (CCGs) for commissioning services.
These responsibilities will cover commissioning services for people with learning disabilities detained under the Mental Health Act and for people for whom health have a responsibility under NHS Continuing Health Care (CHC) criteria as well as a responsibility to work in partnership with Local Authorities and Learning Disability Partnership Boards, for the commissioning of good local services for people who challenge services and those with complex needs.
This newly published guide therefore brings together previous recommendations and also sets out some specific commissioning actions for CCGs, related to the Health Self-Assessment indicators which the authors believe will help achieve positive outcomes and cost-effective service delivery. The Health Self Assessment Framework (SAF) brings together in one place, standards of care for people with learning disabilities that are found in other guidance. The SAF is an annual assessment carried out in local health areas which enables comparison with other areas.
The guide covers actions and SAF indicators in five broad areas:
- Primary Care
- Acute Care
- Specialist Learning Disability Services
- Wider Health and wellbeing and Public Health Issues
- Cross Cutting Commissioning Considerations
The authors have worked with a wide group of stakeholders to produce the guide and believe that working to the practice recommendations it contains should help the new commissioning groups to work with local partners to enable them to commission health services in ways that achieve better health outcomes for people with learning disabilities in a challenging financial climate.
As well as the guide, there is a presentation summarising key points as well as easy read versions of both documents. You can download all the documents here Improving the Health and Wellbeing of People with Learning Disabilities: An Evidence-Based Commissioning Guide for Clinical Commissioning Groups (CCGs) Improving Health and Lives, Royal College of GPs and Royal College of Psychiatrists