The Senior Responsible Officer for Bradford Transforming Care Partnership for Learning Disabilities and Autism will submit Document “L” which provides an update to the Board on the progress made in the Transforming Care Programme (TCP).

 The report highlights key pieces of work that will improve the quality of life and opportunities for people with a learning disability and autism in the district. In doing so, it highlights the need for changes in service delivery across health and social care.

Recommended-

That the progress already made in delivering the national transforming care programme for people with learning disabilities and autism and to be aware of the identified financial risks as they are currently understood be noted.

                                                            (Mairead O’Donnell – 01274 431517)

The Senior Responsible Officer for Bradford Transforming Care Partnership for Learning Disabilities and Autism submitted Document “L” which provided an update to the Board on the progress made in the Transforming Care Programme (TCP).

From within the report, the officer gave the following synopsis:

·         The programme had reached its final year (from an NHS England perspective) and the March programme board had been dedicated to the wider issues facing people with learning disabilities and/or autism and seek to broaden the scope of our programme going forward. This required changes in the current organisation and governance arrangements. The intent behind changes was sustainability and improvement;

·         Bradford’s plan for people with Learning Disabilities across the three CCGs and the Local Authority, was wider than the national NHS England agenda of the TCP programme in that Bradford was working to develop a community provision for all people with learning disabilities and/or autism by ‘building the right support’ for people, not just those who found themselves in in-patient beds.  However, the national focus on the programme had meant a closer concentration on those who were in beds, both within area and out of area and in particular those who had been an in-patient for over five years;

·         The report highlighted other key pieces of work that could improve the quality of life and opportunities for people with a learning disability and autism in the district. In doing so, it highlighted the need for changes in service delivery across health and social care;

·         Bradford did not have a local forensic community service to support people returning to the area form secure services. National Health Service England (NHSE) Specialised Commissioning was developing a regional ‘Forensic Outreach Liaison Service’ (FOLS) to support local TCPs where local forensic community support was not available. The aim was to have this service ‘referral-ready’ by March 2018;

·         Work is underway to develop a single pathway for children and young people that will sit across Children’s, Adults, Education and Health. The transforming care programme was linking into this work; and,

·         In June 2016, a national 3 year campaign (STOMP) was started to ensure that people had medication reviews with a focus on reducing anti-psychotic medications when these were prescribed inappropriately. 

Following delivery of presentation, a clarification was sought on how could all elements be configured with one another as sharing hubs for all involved. In response, it was explained that a Liaison and Diversion process, funded by NHSE existed, the sole purpose to identify vulnerable people early in order to improve health. Also an Assessment and Treatment Unit was in process, involving a specialist assessment and treatment ward for adults over 18 with moderate to severe learning disabilities and mental health problems whose needs were not supported at home, in the community or in other adult mental health wards. The service was support to help individuals meet daily living needs and maintain independent skills. The process ensured that the care was personalised to meet the needs and that a person was involved during the development of their care plan.

During discussion, the following points were tabled:

·         This was an exceptionally well presented detailed report;

·         There were always risk issues in pursuit of providing the correct support for people with challenging issues;

·         The national Transforming Care Programme is expected to lead to additional unfunded cost pressures for both CBMDC and local CCGs. This situation is in line with experience in other parts of the country. Nevertheless it is important to note that the primary aim of the programme is to enable people to live good lives in their own homes and communities, and that all partners at the Health and Wellbeing Board fully support this goal and will work together to achieve it;

·         The wider partnership at the Health and Wellbeing Board can support creative and holistic solutions. For example it was noted that in some cases the availability of suitable accommodation was a factor limiting the return of individuals to the local community. It was noted that there may be opportunities to address this through including local social housing providers in the programme.

·         In addition it was noted that the local programme had secured capital investment from national bodies to enable creation of suitable accommodation for people with learning disabilities requiring additional support to live independently. This was commended by the Board.

It was also noted that Bradford had a range of services which specifically focus on helping vulnerable people access health and care. An example was given of Bevan Healthcare, an established organisation was a Social Enterprise which was a responsive organisation promoting high quality health and social care for the most vulnerable members of society. Bevan was committed to helping people get the health care that they need. The enterprise provided responsive NHS General Practice services designed to meet the needs of people who were homeless or in unstable accommodation; those who have come to Bradford as refugees or to seek asylum.

 Resolved –

(1)       That the progress already made in delivering the national            transforming care programme for people with learning disabilities       and autism and to be aware of the identified financial risks as they       are currently understood be noted.

(2)       That the Strategic Director of Public Health and Wellbeing and the        Chief Officer, CCGs in consultation with the Leader of Council be    requested to write to Members of Parliament representing the     District to update them with information related to the funding    implications for local organisations of the transfers of             responsibility anticipated under the national Transforming Care            Programme.

(3)       That the Strategic Director of Public Health and Wellbeing jointly           with the Group Chief Executive of Incommunities explore    opportunities to utilise existing housing stock to create             appropriate residential environments for people whose care is the        subject of the Transforming Care Programme.

LEAD:            Strategic Director Public Health and Wellbeing

                        Group Chief Executive - Incommunities

                        Chief Officer, CCGs