Health Self Assessment Framework 2011/12

1. Health Self Assessment Framework 2011/12 Learning Disabilities Health Self Assessment and Performance Framework An assurance system for Learning Disabilities and Autism

2. There are 3 tools to support local implementation:

3. The process to complete the Self Assessment Framework is continues and should inform next years business planning

4. The process in more detail Big Health Check Up Day Getting Ready Meetings • Nominated Lead: A lead should ideally be from the PCT, have a good knowledge of the mainstream health agenda, and have sufficient seniority to influence their provider and commissioner partners. Where this is delegated to the Learning Disability Lead in the Local Authority, such as a joint commissioner, then support needs to be provided from the PCT. The nominated lead is not expected to have all the answers but he or she has a crucial role in facilitating the responses. • Getting Ready Meetings: These are crucial so everybody has a clear understanding of their role. They are preparation for the Big Health Check Up Day. They will enable people with learning disabilities and family carers to have time together to think through some of the targets and objectives. They should be coordinated by the nominated lead. It would be useful to get a good written record of what people have said. People should bring that with them to the Big Health Check Up Day, and it should also be handed in so that it can be used in the feedback report to the SHA. The different targets often involve very different people, so it is useful to hold ‘target specific’ meetings. In London we will hold a number of central getting ready meeting to help localities. Flyers have been send out to self advocates and family carers. • Big Health Check Up Days:The aim of this day is to discuss and vote on the targets in the self assessment framework and identify actions to progress. This step is key in fulfilling the vision laid out in the White Paper ‘Local Democratic Legitimacy in Health’ Nominated Lead identified

5. The process in more detail • Collecting Evidence and Submission: the process followed should now enable the health lead to fill out the self assessment framework with qualitative and quantitative information. The lead will benchmark their local progress against the national framework This is then submitted to the Strategic Health Authority (SHA). Any previously submitted evidence won’t need to be submitted again. 5. Validation: The Health Lead in the SHA will now critically appraise the scoring and evidence and provide feedback. A Validation Meeting will be held where a final agreement on the scoring will be made. In some instances additional evidence may be submitted to help reach agreement on the right scoring. Collect Evidence and submit Validation meeting

6. Reporting and information flow Report submitted to Partnership Board Reporting to PCT Board Report to Local Authority Cabinet Data and outcomes are provided to the Public Health Observatory Overview Report provided to Department of health Reporting to Acute Trust Board Report to Health and Well Being Board Reporting to LD/ MH specialist Trust Board Briefing to GP consortium Regional Overview Report is completed by SHA based on all local reports Report submitted to Safeguarding Board

7. The Self Assessment tool as a benchmark: • The Self Assessment Tool has been adopted throughout the NHS in England, as the best way to review the capacity and capability or providers and commissioners. It has therefore become useful as a benchmarking tool, as well as an assurance tool. • It incorporates specific learning disability recommendations such as those outlined in: • Healthcare For All • 6 Lives and the provision of public services for people with learning disabilities • Valuing People Now • Bradley Report • It is aligned with, and helps meet the requirements of, these wider legislative and policy frameworks : • Mental Capacity Act • Autism Bill • Disability Discrimination Act • The tool is framed around 4 health targets with 25 sub-objectives. There are three levels of achievement (R-A-G) and each level outlines what a locality needs to achieve and provide as evidence. • Evidence is required for each self assessment decision. It may be useful to categorise the evidence as: user experience; action plan and audit; or strategic policy and intention. • The framework is not static and reflects changes in the policy landscape. Explanatory notes and definitions will help you work through the targets. There is also a guide about key roles who could provide information and data for each of the targets.

8. Target 1: People who are who were formerly in NHS provided long term care have settled accommodation that reflects their person centred plans and there is a system in place to ensure minimum of annual review The self assessment framework provides assurance for the whole local health economy. Therefore different people will be involved with providing evidence for the individual target. The people who will help and should be involved will vary from locality to locality, but this will provide the nominated lead with a broad idea of who to involve: NHS campus Closure Project Managers Joint Commissioners/ Commissioners with Learning disabilities in their portfolio Person Centred Planning Officers Care Managers Finance Leads The people involved need to ensure that supporting evidence is provided in a timely fashion so that this can inform the Big Health Check Up Day and the return to the Strategic Health Authority.

9. Target 1: People who are who were formerly in NHS provided long term care have settled accommodation that reflects their person centred plans and there is a system in place to ensure minimum of annual review

10. Target 2: Health and social care commissioners are working closely with local Partnership Boards and statutory and other partners to address the health inequalities faced by people with learning disabilities. The self assessment framework provides assurance for the whole local health economy. Therefore different people will be involved with providing evidence for the individual target. The people who will help and should be involved will vary from locality to locality, but this will provide the nominated lead with a broad idea of who to involve: GP practices and consortia Wider Primary Care Team Public Health Strategic Health Facilitator Acute Liaison Nurses Acute and non acute commissioners IM&T Equality and Diversity Lead Long Term Condition Lead Community Learning Disability Team The people involved need to ensure that supporting evidence is provided in a timely fashion so that this can inform the Big Health Check Up Day and the return to the Strategic Health Authority.

11. Target 2: Health and social care commissioners are working closely with local Partnership Boards and statutory and other partners to address the health inequalities faced by people with learning disabilities.

12. Target 2: Health and social care commissioners are working closely with local Partnership Boards and statutory and other partners to address the health inequalities faced by people with learning disabilities.

13. Target 3:People with learning disabilities who are in services that the NHS commissions or provides are safe The self assessment framework provides assurance for the whole local health economy. Therefore different people will be involved with providing evidence for the individual target. The people who will help and should be involved will vary from locality to locality, but this will provide the nominated lead with a broad idea of who to involve: Director Nursing Safeguarding Lead Partnership Boards IMCA service and commissioner Equality and Diversity Lead MCA Implementer Complaints and PALS teams The people involved need to ensure that supporting evidence is provided in a timely fashion so that this can inform the Big Health Check Up Day and the return to the Strategic Health Authority.

14. Target 3:People with learning disabilities who are in services that the NHS commissions or provides are safe

15. Target 4: Progress is being made in developing local service for those needing more help to be healthy The self assessment framework provides assurance for the whole local health economy. Therefore different people will be involved with providing evidence for the individual target. The people who will help and should be involved will vary from locality to locality, but this will provide the nominated lead with a broad idea of who to involve: Mental Health Provider Mental Health Commissioner Children with Disability Team/ Children Commissioner Transition Workers Engagement Officers Public Health Older People Commissioner Autism Lead Challenging Behaviour Lead Workforce Lead/ Training Departments Offender Health/ Criminal Justice Team The people involved need to ensure that supporting evidence is provided in a timely fashion so that this can inform the Big Health Check Up Day and the return to the Strategic Health Authority.

16. Target 4: Progress is being made in developing local service for those needing more help to be healthy

17. Glossary • Integrated Assessments – This means assessments of what a person needs, done by health and social services employees as an official part of their job. The aim is that there is an up to date record of a person’s needs that everyone who is helping that person – and the person him/herself knows about and agrees with • Person Centred Plans – This is a plan about a person and what that person wants to do with his/her life. It is flexible, and puts no limits to the person’s wants, needs and dreams in life. Making a plan brings together all of the people who are important to the person including family, friends, neighbours, support workers and other professionals – all to focus on that person • A&T – Inpatient Assessment and Treatment services • Campus provision – See the most up to date Department of Health Definition of this in the Appendices attached to the full Framework document • PCT – Primary Care Trust. Primary Care Trusts buy and organise health services in local areas • QOF – Quality and Outcomes Framework. This is a voluntary annual reward and incentive scheme for all GP surgeries in England. Its aim is to resource - and then reward - good practice • HAP – Health Action Plan. This is a guide to a person’s health. It is made by the person with a learning disability and the people who know him/her best. • It can be used to tell doctors and hospitals about the person’s health and the best ways to support them to get the right treatment and health care

18. Glossary • DES – Directed Enhanced Services are special services or activities provided by GP Practices that have been negotiated nationally. A DES specifically for people with learning disabilities came into force from April 2008 and GP’s will be deciding at the moment if they are going to provide the special services contained in that DES • LES – Local Enhanced Services relate to the optional commission of services based on local needs. These were originally introduced GP’s a major opportunity to expand and develop Primary Care. • Read Code – A code which allows clinicians to make best use of computer systems. Codes help to access information from patient records, in order to more easily audit and research information across a lot of people, and also help to cut down on repetitive tasks • Annual Health Check – People with Learning Disabilities can have a special meeting with their Doctor or nurse to check all parts of their health. This can help people stay safe and healthy • BMI – Body Mass index. This is a useful way of working out a healthy body weight, based on how tall a person is • Dysphagia – medical term for the symptom of difficulty in swallowing • PALS – Patient Advice and Liaison Service provide information, advice and support to help patients, families and their parents. The NHS plan in 2000 required the establishment of such a service in every NHS Trust • LINks – Local Involvement Networks, expected to be up and running in every locality by 2008. LINks were introduced to help communities influence the care they receive.

19. Glossary • Clinical Network or Managed Clinical Network – is a network of a variety of health staff and organisations working together to make • sure that everyone can gain access to good quality clinical services in their area • NSF – National Service Framework • P&VSector – Private and Voluntary Sector • DED – Disability Equality Duty. This means that people who work in the public sector - like health or social services - have to consider the impact of their work on disabled people, and to make sure people with disabilities are not placed at a disadvantage when using their services. This should mean that disabled people have good access to health services, education, housing, jobs, etc. It should also help promote positive attitudes towards disabled people in everyday life. • Since 4 December 2006, public authorities including Trusts, PCTs and SHAs (Strategic Health Authorities) etc have had to publish a 'Disability Equality Scheme' saying how they make sure this happens. • DH – Department of Health • LA – Local Authority • JSNA – Joint Strategic Needs Assessment is a process that will identify the current and future health and wellbeing needs of a local population. This assessment is used to decide the priorities and targets contained in Local Area Agreements (LAAs). • ASC – Autism Spectrum Conditions. This is the term used for a range of conditions linked to Autism, including Asperger Syndrome, ADHD, etc. • LIT – Local Implementation Team, this is the mental health equivalent of the Partnership Board. The LIT is accountable for making sure the national service framework for Mental Health is implemented in a locality • VP – Valuing People

20. Timelines • Briefing April • Returns to SHA by 23rd September 2011 • Validation Meetings 7th-22nd November 2011@SHA/NWTDT • Regional Report February 2012 • Best PracticeMarch 2012

21. Best Practice • All presentations can be found at: • http://wwwnorthwestjip.co.uk/resources/downloads/nwjip-events