Sally CornfieldPublic Health

2012

Launched Regionally in January 2012The initial stages of the work programme included: Gaining an understanding of the agendas, policies and challenges

effecting people with Learning Disabilities (LD) Developing an understanding of the relationship between obesity and

LD Understanding the challenges of maintaining a healthy weight for

people with LD Developing knowledge of the programmes of work and effective

practice happening already to tackle obesity within this specific group.

At it’s heart is the “Valuing People Now” vision (2009)“All people have the right to leave their lives like any others, with

the same opportunities and responsibilities, with the right support to make this possible and be treated with the same dignity and respect”

Promote and support prioritisation of the needs of people with LD to inform effective commissioning and delivery of specialist and community services to aid weight management

Strengthen commissioning processes and advise on the standards expected of providers when delivering services

Aid the local prioritisation of services that maximise opportunities for people with learning disabilities, their carers and families to be supported to maintain a healthy weight

The Charter provides a framework for developing effective practice, meeting service user’s expectations and a common set of values to aid commissioning.

Learning Disability◦ Includes the presence of:

a significantly reduced ability to understand new or complex information, to learn new skills (impaired intelligence)

a reduced ability to cope independently (impaired social functioning) which started before adulthood, with lasting effect on

development

About one person in three with a LD is obese compared to one in five of the general population

Less than 10% of adults with LD in supported accommodation eat a balanced diet, with an insufficient intake of fruit and vegetables

Carers generally have a poor knowledge about public health recommendations on dietary intake

People with more severe LD and people living in more restrictive environments are at increased risk of inactivity

The rate of Type 2 Diabetes in people with LD

Implementation of the Charter will: Improve practice relating to the commissioning and delivery of weight

management and related services for people with learning disabilities, their carers and families

Standardise the services offered to people with learning disabilities, their carers and families regarding weight management

Advise on the standards that are expected when commissioning and delivering services to people with learning disabilities to support them in maintaining a healthy weight

Action Plan -Five Priority Areas:1. Local Policy Development2. Research3. Training4. Alignment of Joint Priorities5. Profile

Charter Element Target Audience People with

Learning Disabilities

Family and Friend Carers

Service Deliverers – Workforce including paid Carers

Service Deliverers - Management

Public Health, NHS, Social Care Commissioners & Contract Managers

Public Health, NHS, Social Care Strategic Management

Full Charter Document       x x x

Easy read Charter Document – “What you can expect from services”

x x        

Workforce guide to the Charter

    x      

Commissioning Checklist       x x x

Commissioning & Contracting statements (contained in the Full Charter document)

      x x x

Training & Resources To consider reviewing elements of social care resources

ensuring that they are updated and standardised to provide quality support to these professionals.

To develop a list of (local) resources available to support professionals working with people with LD to enable cross fertilisation of training and support opportunities through professionals being able to access resources that are currently not easily found within their own professional domain.

To recognise the training and support requirements of staff involved in data collection and ensure that these are met to improve the robustness of data.

Consultation To explore the support needs of people with LD and how they

would like to be provided with information or support in making healthier lifestyle decisions. Ensure that this is embedded into the West Midlands approaches to making reasonable adjustments to services.

Networking To consider developing a LD health network, that can provide

peer support, expertise, shadowing/ mentoring opportunities and advice between professionals as and when it is needed. This may include a ‘skills swap shop’ approach to generic training and induction programmes.

Data – Primary Care To improve local data to provide demographic information that

includes disability and distinguishes between physical disability, LD and limiting chronic health conditions.

To maximise the opportunities that the LD Health Checks provide for data collection and analysis to aid service planning.

GP practices to implement systems to monitor the number of people with LD who are overweight/obese and those referred/ involved in practice and community based weight management/ physical activity/healthy eating services.

Data – CCG / Local Authority / Public Health To identify opportunities to facilitate discussions on data

collection with Local LD Partnerships as part of the on-going commitment to the “Valuing People Now” assessments

Data – Public Health / Local Authority To develop systems to determine the number and type of

organisations providing physical activity, healthy eating and weight management services for people with LD to enable gap analysis to be undertaken.

Commissioners should include data collection for LD and Obesity within service specifications and commissioning contracts

Commissioning Consider rolling out the NHS West Midlands CQIN relating to the

coding and flagging of LD within provider trusts to incorporate weight management related data linked to LD status

To consider developing a suite of resources for professionals to help them apply their current topic expertise and experience i.e. visual handouts suitable for people with LD, tips and pointers on how to help people with LD, evidence summary of what works, lesson plan, presentation pack, recipes and interactive activities.

To consider developing the resources suggested above in collaboration with the information sources that professionals most frequently use, including: Change4Life, British Heart Foundation, NHS Choices and Mencap, as this is likely to increase awareness and use of existing and new resource.

To consider developing training or resources that provide professionals with generic information on LD, working with adults and children with learning disabilities, and how to adapt main stream services to maximise the engagement of adults and children with LD.

To work together to establish a core criteria for the local delivery of training relating to LD, healthy eating, physical activity and weight maintenance.

To investigate the potential for LD read coding to be linked to chronic conditions through QOF so that data extraction queries can include cross referencing of patients with a LD who are overweight/obese at consortia and practice level to aid service planning and development.

Regional Support To support the roll out of the Equality Metrics Framework

in the West Midlands localities with physical activity and obesity included within the healthy living indicators.

To adopt data collection as a key strand within the peer review process for “Valuing People Now” in the West Midlands

Valuing People Now and the Valuing People Now Summary report on progress (2010)

The NHS White Paper, Equity and excellence: Liberating the NHS (2010) Healthy Lives,

Healthy People: Our strategy for public health in England (2010) Social Care White Paper 'A vision for adult social care: Capable

communities and active citizens’ Public Health White Paper; Healthy Lives, Healthy People (2010)

and the healthy Lives Healthy People update and way forward document published in July 2011.

No Health Without Mental Health Strategy (2011) The Quality, Innovation, Productivity and Prevention (QIPP) agenda Forthcoming Green Paper on Special Educational Needs and

Disability Healthy Lives, Healthy People: A call to action on obesity in England The 2011 update for the UK Physical Activity Guidelines

Services launched in 2006 (Weight Watchers) 2012 – 8 services LD clients accessing these services ?? Success ?? what, if any reasonable adjustments are

required ?? appropriate rate of weight loss ?? outcome measures other than weight Slimmers Kitchen - NICE

Public Health & Health Access Service Timeline of Partnership

Dec 2008 Learning Disabilities Training

Sept 2010 Closing the Gap Bid

Dec 2010 Launched ‘Learning Disability Slimmers Kitchen’ (LDSK)Foundation Programme

Jan 2011 First 12wk LDSK programme

Apr 2011 Health Access Service Counterweight (CW) Training

Sept 2011 LDSK Evaluation

Jan 2012 SHA Learning Disability & Obesity Charter Launch

Feb 2012 First 15wk LDSK programme & 6wk Carers TrainingProgramme

Organisation/Partnerships (O/P) sign up to embed the charter and its principles into practice at a leadership level

(O/P) inform partners, contractors that they are signed up to the Charter and will be embedding

the principles within commissioning/ delivery

mechanisms

(O/P) inform staff that they are signed up to the Charter and will be embedding the

principles within commissioning / delivery mechanisms. Provide staff with the Charter

annexe, which documents what they can expect

(O/P) action plan how they will embed the appropriate actions within their work

Commissioners within (O/P) to embed the use of the

“Commissioners Checklist” into commissioning systems to

support effective contracting

Deliverers of services should use the commissioning statements to develop their services to meet commissioners and service

user’s needs. This could be as part of developing service tenders or service

improvement plans

Commissioners to use commissioning statements for

specific services within commissioning specifications

and contracting

(O/P) should monitor the implementation of the Charter actions / checklists/

commissioning statements / service improvement statements and identify

the outcomes for service users