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Our plans for supporting people with learning disabilities across the Bradford district continue to focus on transforming care and reducing the health inequalities that people face.

Transforming care programme for people with learning disabilities – next steps will continue beyond March 2019. There have been a number of positive outcomes from the Transforming Care Programme that is leading to different ways of working and supporting people with learning disabilities. These are collaborative commissioning initiatives such as:

Locally we are working to deliver the aims to transforming care within ‘business as usual’. To that end we have replaced our Transforming Care Board with Transforming Lives Board. The priorities of this board is to support the delivery of Bradford districts health and social care strategy Happy, Healthy and at Home

In supporting this regional work, our local health workstream for Transforming Lives Board has focused on a number of areas to reduce health inequalities across the district over the last two years, including:

To continue with the positive work and build on the new initiatives, our priorities for the next three years are: 

  • delivery on our housing plans and support to prevent unnecessary admission to hospital
  • local delivery of the West Yorkshire ATU model and the FOLS service
  • review of our local community clinical and social care offer in light of the West Yorkshire work
  • develop a model to support people with attaining a diagnosis of autism
  • develop an action plan and pathway for people with autism (with and without a learning disability) in response to our autism self-assessment, health needs assessment and Healthwatch report
  • promoting and monitoring the impact of STOMP
  • promoting awareness raising and ownership across health and social care for LeDeR.

NHS Improvement Learning Disability Improvement Standards for NHS trusts

Improving the quality of life of people with learning disabilities across the district is reliant on all statutory services working together with people with learning disabilities and their carers to get the best care possible.  

CCG Improvement and Assessment Framework

Star ratings

Reduce specialist inpatient care

2starSMALL

Two stars - similar to the English average. For all three NHS Bradford district and Craven CCGs the rate of specialist inpatients is 41 per 1 million population. We aim to reduce this by at least half.

We have taken ownership of two properties. One is now operational and the second one has the first tenant moving in at the end of March 2019.

We will continue to deliver on the housing options for people with learning disabilities and autism. By 2020 we will have in circa 92 tenancies for people. We will review how the support is procured in order to comply with CQC recent interpretation of ‘registering the right Support’. We are working with Specialised Commissioning to ensure people identified as needing secure service does meet the criteria of the transforming care.

We will continue to promote and embed CTR/CeTR across adults, children’s, and education and health provisions.

Annual health checks

3starSMALL

Three stars - better than the English average. Two out of every three people aged 14 or over with a learning disability receive their annual health check. This result is amongst the highest across England.

We will be working with GP practices to promote the benefits of being on the Learning disability register, as some families and individuals are still reluctant to have their name on a register that indicates they have a learning disability. However, being included within this register helps GPs to offer physical health checks to people and is one way of reducing health inequalities.

In particular work needs to be done to improve the uptake of annual health checks to young people. Paediatricians are being encouraged to share easy read information leaflets about annual health checks with their patients & families who have learning disabilities to promote this to the 14+ age group. 

Bradford District Care NHS Foundation Trust’s learning disabilities team also promote annual health checks - they produced an easy read leaflet with BTM and have distributed this to GP surgeries as well as people with learning disabilities to raise awareness.  This publicity material describes the importance of having an annual physical health check in an easy read format.

Self-advocacy group have previously done training and raised awareness to people with learning disabilities about the importance of annual health checks.

The CCG clinical lead for learning disabilities has also provided training to GP clinical forums and practice nurse forums to raise awareness and confidence in completing health checks.

Learning from deaths of people with learning disabilities (LeDeR)

Training has been done to ensure Bradford district has a team of people who can complete LeDeR reviews. There is now a data base of reviewers held by the local area contact in the CCG.

Bradford District Care Foundation Trust (BDCFT) have developed a LeDeR reviewer’s forum to share leaning which is open to any reviewers across the district. We have also worked with other CCGs and employed a LeDeR regional reviewer to support multi agency LeDeR reviews and to share learning across the district.

Internal mortality review findings within BDCFT have found that palliative care services are being accessed by a number of people with learning disabilities.

Internal mortality review findings will also be shared at a regional LeDeR event in Leeds to compare and learn from other areas.

STOMP - stopping over medication of people with learning disabilities - in particular focusing on anti-psychotic medications

Our CCG medicines management team and clinical lead for learning disabilities are currently reviewing rates of prescribing. These can be compared to national averages and identify which GP practices require further support.

We are also planning STOMP awareness sessions at GP clinical forums. Training sessions have been offered by Bradford District Care NHS Foundation Trust (BDCFT) to raise awareness across service providers. 

At the Healthier Lives meeting in March 2019 we engaged with people living with learning disabilities about the easy read leaflet produced by NHS England. We agreed to look at producing a localised easy read leaflet to support people locally with medication reviews, subject to funding.

Audits within BDCFT of psychiatry prescribing rates found that STOMP was being addressed within some clinical consultations, however, further audits are required.