1. The 2006 LD Census Interim Feedback 5 th May 2006 …repeated 22 nd June 2006

2. Warning! You are spending circa £16 Million and you do not know what you are getting!

3. Why interim? This presentation will explain, –What we did, –What we got, and… –Why we want more!

4. Cumbria and Lancashire, 1 SHA 13 PCTs 4 LAs 2 UAs Where?

5. What we did and why Listened to Martin Routledge who said, –If there is one thing the SHA could do to improve learning disability services it would be to understand where people are placed and why

6. Census Objectives To provide an accurate picture of, –Who was where? –What was their status? –Why were they placed there? –How long have they been there? –How long are they expected to stay there? –How much does it cost?

7. Scope Adults, With a LD who have been placed –Out of area –Out of sector/pathway –Or both Originating from Cumbria and Lancashire SHA footprint. The project must be useful not merely academic

8. Definitions Out of area, –Placements where individuals are placed outside of the PCT/Local Authority catchment area Out of sector/pathway, –Placements where individuals are placed outside of the Agencys mainstream learning disability provision.

9. Data Returns No naming names! (well not much!) 10 out of the 13 PCTs 2605 total placements 257 out of area and/or pathway (10%) Financial data on 149

10. The Who 66.5% (139) male 32.5% (68) female 1% (2) where gender not recorded 96% white British –1% white other, Asian British, Black British, and not known respectively.

11. Age Groups

12. Diagnosis - ASD One area 0% one area 65%! Is this is a clinical, operational, financial or a definitional issue?

13. Dual Diagnosis 43% combined MH, Forensic and challenging behaviour

14. Reason for Placement Not known, Multiple reasons and breakdown in care accounts for 62% - We need a better understanding of this

15. Reason for Continuation Over half of placements meet current needs – yet over half have no record of their last review!

16. Reason for Provider What does other mean in this context?

17. Type of Provider 60% Residential Care – who pays for this health or social care?

18. Plurality of Providers 114 providers for 209 placements – caution, some providers may have multiple names, i.e., hospital, unit, ward) Only 8 providers hosted more than four placements (39%) 61% of placements are provided by a highly fragmented market

19. Legal Status Caution – re: Bournewood!...but, 76% not subject to MHA 11% Section 3 3% Section 37 2% Section 37/41 2% Section 47/49 2% Other 2% not known 1% 117 Variation between locations 52-95% not subject to MHA Why?

20. Reviews Caution – CPA/PCP… but, 24% subject to CPA (76% not) No caption needed!

21. Care Co-ordinator 17% None 40% Not known or recorded 43% Yes

22. Future Plans 50% either no plans or plans not known Why?

23. Costs 149 financial returns £1246 average (mean) per week Ranged between £100 - £6,128 Actual cost for 149 = £185,642 pw or £9.65 million per year If replicated to 209 = £260,000 pw Or £13.53 million For all 13 PCTs = …? For NW =…??, nationally =…??

24. Next steps – our proposals Extend submission date till June 06 NOT to change data – but to make it richer, as it was on the 16 th Feb Report July 06 Roll out across the NW summer 06 Roll out across whole of North of England – Autumn 06 Repeat census February 07

25. Thank you! For further details please contact, andrew.keefe@mentalhealthstrategies.co.uk or tony.ingham@mentalhealthstrategies.co.uk