www.england.nhs.uk Learning Disabilities: Share and Learn Webinar 27 October 2016 Topic One: What makes a successful Care and Treatment Review? Anne Webster, Gavin Harding and Maggie Graham, Improving Health & Quality Team, NHS England Topic Two: Guidance for TCPs in relation to Children and Young People Phil Brayshaw, Service Model Lead (Children and Young People), Learning Disabilities Programme, NHS England #improvingLD @NHSEnglandSI
Transcript
www.england.nhs.uk
Learning Disabilities: Share and Learn Webinar
27 October 2016
Topic One:
What makes a successful Care and Treatment Review?Anne Webster, Gavin Harding andMaggie Graham, Improving Health & Quality Team, NHS England
Topic Two:
Guidance for TCPs in relation to Children and Young PeoplePhil Brayshaw, Service Model Lead (Children and Young People), Learning Disabilities Programme, NHS England
#improvingLD @NHSEnglandSI
www.england.nhs.uk/learningdisabilities
Care and Treatment Reviews
27 October 2016
www.england.nhs.uk/learningdisabilities
Thankyou for inviting us today
• Anne Webster
• Gavin Harding MBE
• Maggie Graham
Improving Health and Quality Team
www.england.nhs.uk/learningdisabilities
In the Learning Disability Programme• Work stream delivery - • Learning disability advisers:
1. Gavin Harding MBE2. Carl Shaw3. David Gill4. And looking to appoint a family carer
adviser to start in the New Year
• Engagement team -• Learning disability network managers:
1. Aaron Wood2. Katie Matthews
Employing people with lived experience
Gavin
Carl
David
Aaron
Katie
Gavin
www.england.nhs.uk/learningdisabilities
• We have had feedback from over 200 people about the CTR policy
• We are analysing the feedback and meeting with our advisory group soon to agree what it means for the policy
• The feedback will make the policy even stronger
• We aim to publish a revised policy by the end of January 2017
• At the same time we are working with Inclusion East to develop ‘Gold Standards’ for Care and Treatment Reviews eg• What makes a good CTR chair?• What makes a good expert by experience?• What makes a good clinical expert?• What makes a good CTR?
The Care and Treatment Review Policy Review
Maggie
www.england.nhs.uk/learningdisabilities
What makes a good…CTR Chair
Maggie
www.england.nhs.uk/learningdisabilities
Is the commissioning lead with current knowledge of processes.
Independent – never worked in or for that provider and should declare any interests.
Brings out the skills and knowledge of the people involved – supporting panel members to be equally involved.
Qualities and credentials
Is assertive and critical of poor practice when they see it.
Maggie
www.england.nhs.uk/learningdisabilities
Knowledge about Transforming Care and empathy for the person – “hospital is not home”.
Has understanding of person centred approaches and tools.
Supportive of other panel members when they identify issues.
Knows about the contract with the setting.
Qualities and credentials
Gavin
www.england.nhs.uk/learningdisabilities
Knows about innovative alternatives to hospital. This could be through visits or finding out about examples of good practice where people live in the community.
Is prepared to ask and encourage very basic questions.
Qualities and credentials
Reflects with others to develop their skills as the chair
Gavin
www.england.nhs.uk/learningdisabilities
• Has the skills to make sure that everyone is working together to improve the person’s care and plans
• Takes a shared approach to problem-solving
• Enables difficult topics to be discussed in a constructive way
Qualities and credentials
Anne
www.england.nhs.uk/learningdisabilities
Asks for the information needed for the Care and Treatment Review from the hospital setting.
Sets the agenda and establishes what each panel member should do according to skills and knowledge.
Requests panel members to say if there may be a conflict of interest.
Visits the ward even when not meeting the person.
Takes Action
Anne
www.england.nhs.uk/learningdisabilities
Arranges to report back to panel members about urgent actions.
Makes sure that the next review will use the same expert by experience to maintain consistency – unless there is a reason why it should be somebody else.Pick up on any challenges for panel members that might need further discussion.
Takes Action
Gavin
www.england.nhs.uk/learningdisabilities
• Some points to add….
• Gives the person time to take part in the review in the way they feel most comfortable
• Makes sure that people use words that everyone can understand
• Makes sure the report is written in words that everyone can understand
• Makes sure that someone is following up on the actions
• Makes sure that any problems with carrying out actions are dealt with quickly
• Any more points to add?
Takes Action
Gavin
Questions
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www.england.nhs.uk/learningdisabilities
Transforming Care Partnerships (TCPs)
• 48 Transforming Care Partnerships
• 48 sets of Plans to transform local services for local people and families
• 48 sets of Milestones that will enable us to tell the story of change
www.england.nhs.uk/learningdisabilities
Building the Right Support and the National Service Model
www.england.nhs.uk/learningdisabilities
• Every Transforming Care Partnership should have a lead for Children and Young People
• Clear links between Transforming Care Planning, work around the Special Educational Needs and/ or Disability (SEND) Reforms and CAMHS transformation programme
• Local areas should understand legislative framework• Service Model should be implemented from the point
of view of Children and Young People (and their commissioning needs)
Supplement to the Service Model for Children, Young People and their Families
www.england.nhs.uk/learningdisabilities
Child, Young Person and
Family/ Parent Carers
I have an enjoyable and interesting life
My care and support is well
planned
I have choice and control about my care and support
My family and paid staff get the help
they need to support me to live in the
community
I have a choice about where I live and who I live with
I get good care and support from
mainstream health services
I get expert health and social care support in
the community if I need it
I get help to stay out of trouble with the law if I need it
If I need to stay in hospital because of my mental health or behaviour it is good
quality
The 9 Principles of the Service Model
www.england.nhs.uk/learningdisabilities
I have an Enjoyable and Interesting Life
My Care and Support is Well Planned
I have Choice and Control about my Care
and Support
• Supported by people with high aspirations (social model training)
• Join in everyday local activities - playgroups, leisure etc.
• Attend their local school with the right support
• Have friends and positive relationships
• Local Offer/ Timely Access to Information
• Integrated Personalised Commissioning
• Personal Budgets Should be Offered
• Independent Advocacy
• Understand the local population and their changing needs – dynamic register
• Person Centred Approaches• Single Assessment and Planning • Keyworking for families
www.england.nhs.uk/learningdisabilities
My Family and Paid Staff get the Help they Need to Support me to Live in the Community
I Have a Choice about Where I Live and Who I
Live With
I Get Good Care and Support from
Mainstream Health Services
• Early support and intervention • Healthy Child Programme• Evidence based Parenting programmes • Family support – information, emotional
support, and practical support• Specialist short Breaks
• Timely diagnosis with concurrent support
• Hospital passports and liaison• Paediatric assessment and access
to health checks age 14+• Early access to flexible specialist
support
• Comfortable, well-adapted home• Accessible information on housing• Timely planning and support
(transition planning)• Provision for children living away from
home
www.england.nhs.uk/learningdisabilities
I Get Expert Health and Social Care Support in the
community if I need it
I Get Help to Stay out of Trouble with the Law if I Need it
If I Need to Stay in Hospital because of my Mental Health or Behaviour it is Good
Quality
• Integrated, community based, specialist support
• Specialist staff support early intervention• Positive Behaviour Support and other
specialist intervention (IAPT, SALT etc.)• Flexible support and services
• Multi-agency, preventative approach to support and intervention (Family Support)
• Access to the same early intervention and prevention services (YJS)
• Recognise and signpost learning disability and/ or autism
• Consultancy, supervision and training• Liaison and Diversion Schemes
• Community/ pre-admission Care and Treatment Review (CTR)
• Relationships with friends and family• Clear rationale for any specialist admission/
inpatient stay• Independent advocacy• Governance of out of area placements
www.england.nhs.uk/learningdisabilities
Questions?
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Date Topic Guest speaker
24 Nov 2016 Enhanced Care Service
and
Strategic resettlement, personalisation at scale and pace
Caroline Kirby and Angie Simmons, Adult Services and Health Commissioning Unit, Worcestershire
