1. Public Health and Learning Disabilities: A fitting partnership Lesley Russ NHS Bristol May 2010

2. Objectives of Presentation To give an overview of the context of UK Learning Disability service provision. To explain the rationale behind the need to develop partnerships between public health and learning disabilities. To describe the role of public health specialist in learning disabilities. To outline some of the achievements of the NHS Bristol role

3. Context of Learning Disability Services History of service provision outside of the mainstream. Responsibility for learning disabilities sits in specialist services, providing “hands on” Specialist services and people with LD needs become detached and hidden. Mainstream services lack evidence of need, knowledge, staff skills or ownership

4. What should happen for all ? Commissioning PCT’s (PH Dept’s) collect evidence on all local population needs. Commissioning PCT’s write contracts and commission services based on needs. The quality of local services is closely monitored and adjusted accordingly Local residents are consulted and “have a say” on local services

5. What should happen ? Valuing People ( DoH 2001) LD Rights, Independence, Choice, Inclusion. PCT’s should highlight and prioritise populations experiencing inequalities. PCT’s should identify and collect evidence on populations for JSNA. Health services must make ‘Reasonable Adjustments’ to enable equal access.

6. What often happens in Learning Disabilities There is a lack of evidence on the needs of the local LD population. Commissioning contracts are based on history and don’t meet identified needs. Mainstream services (GPs Hospitals) often fail to provide good quality health care. General staff have poor knowledge, skills and negative attitudes.

7. What often happens in Learning Disabilities LD is not visible, high priority or owned by the mainstream LD staff are constantly ‘knocking on the door’ of mainstream, highlighting issues People with LD miss out on screening health promotion, disease management. People with LD have worse health outcomes and die younger. Carers and people with LD are not heard.

8. Why Learning Disabilities and Public Health? Public Health is about improving and protecting the health of populations - groups of people - rather than about treating individual patients Improving health Protecting health Improving health & social care services

9. Why Learning Disabilities and Public Health? PH is strongly linked into the mainstream. Is responsible for highlighting and assessing populations experiencing health inequalities. Has skills, knowledge and resources for collecting statistics and demographic evidence. Is responsible for promoting and monitoring equality schemes, health needs assessments and health equity audits. Works to the ‘World Class Commissioning’. Used to working with innovation and difference. Has access to different financial processes

10. What is the role of Public Health Specialist in Public Health? To place learning disabilities strategically and firmly within the work of NHS Bristol. To collect evidence (quantitative and qualitative) on the needs of local people with learning disabilities. To inform and work with commissioners to ensure LD needs are considered. To commission new work, as required.

11. Examples of work achieved or ongoing. Health needs assessment of 1098 adults with learning disabilities linked to JSNA. Smoking cessation post for people with LD Survey on the needs of Older Adults. Sexual health needs assessment. Scoping report on parents with learning disabilities. Maternity Services Review Health Inequalities work stream.

12. Examples of work.2 CQUIN established with acute hospital Equality scheme includes LD actions Team of LD Health trainers and admin team member with LD employed. Accessible communication resource available for all staff. 30 staff trained. 80 staff trained by people with LD. Commissioner consultations.