1. Provider Forum A Joint Commissioning Strategy – planning for better lives and better health for Adults with Learning Disabilities

2. Context for the Strategy • Changing commissioning arrangements • Existing plans – personalisation, short breaks, community opportunities, settled housing, carers strategy, campus closure, 6 Lives, Health Checks and Action plans, pathways, etc • Financial climate – LA consultations on FACS and charging • Efficiency • Service user and carer feedback

3. Structure of the strategy (1) Part 1: • policy context – general and specific to LD • Characteristics of good commissioning • Summary of people’s needs for independence, quality of life, healthcare • Messages and trends from JSNA, Register, etc, and implications for trends in service delivery

4. Structure of the Strategy (2) • Part 2: • Whole system approach - overview • Stepped Care: principles; forms of case management; • interventions; proposed stepped care model • Care Pathways: Definitions and principles; pathways • required; core care pathway; specialist pathways; • common features of pathways • Responsibilities of partner agencies • Commissioning priorities: under 3 headings – Maximising • independence and community living; Improving health and • health care; Developing whole system of care • Investment - overview • Efficiency and lower priority service reduction – 7 headlines

5. Key points (1) 1) Expectations on all providers to work within • policy, regulation and quality regimes, legal duties under DDA, etc • personalisation • stepped care approach and care pathways 2) Market shaping in response to personalisation in social care provision 3) Healthcare development in line with VPN Top Targets – campus closure; primary, community and acute healthcare; 6 Lives; strengthening local specialist care; etc

6. Key points (2) 4) Securing inter-agency sign up to whole system approach 5) Priority pathways – transitions; complex need/multiple disabilities; MH; Dementia; ASD; challenging behaviour; forensic; acute hospital care; access to activity, learning and work 6) Further integration of health and social care (less structurally and more practice- focussed) 7) Efficiency

7. Efficiency • Continuous minimisation of residential social/healthcare • Savings in complex high-cost/out-of county care • Development of innovation in non-institutional community opportunities, accessible through self-directed care and personal budgets • Review of eligibility and charging • Workforce efficiency through pathway development • Reduction of management costs in commissioning and provision