Health checks for people with learning disabilities Primary Care Development Presentation for Locality Meetings January 2017 Martin

Introduction Population Health status and outcomes Lambeth: over 1200 people with learning disabilities identified from GP practice records – about 1000 of these aged 19+ Age: 518 people aged 20-39 and 450 people aged 40-59; 123 aged 60+ Gender: 68% male 32% female Ethnicity: one third ‘White British’; one third ‘Black African’, ‘Black Caribbean’ or ‘Black Other’; smaller numbers in other groups, though around 14% of people on the learning disability register do not have ethnicity recorded Health status and outcomes In the UK, people with learning disabilities die 25 years earlier In Lambeth people with learning disabilities are more likely to have a long-term condition such as epilepsy, COPD (lung disease), diabetes, heart disease (including high blood pressure) and serious mental illness Martin to talk Shorter life expectancy – some genetic causes (eg Downs) however, the difference is still stark.

Primary Care Equality Objectives 95% of people with a learning disability to have a health check annually Health checks can help prevent and identify early signs of illness 50% of people with a learning disability to have a care plan Care plans can support people to work in partnership with health and care professionals to stay well, manage their health and access appropriate care if needed Martin Objective is to ensure people with LD get a health check and if they need a care plan that a suitable plan is in place

How we’ve done so far Poorly to begin with…. At end of May 2016, 16% had a health check and 15% had a care plan in place End of December 2016, 57% had a health check and 16% had a care plan Understanding why the poor and slow uptake But now in right direction Martin Understanding why:  low priority within primary care, despite CCG priority;  low levels of confidence and knowledge within primary care staff - awareness/knowledge training gap;  communication - people invited by letter, low levels of literacy among pwld; busy family carers; anxiety leading to avoidance; underdeveloped communication skills within general practice    wariness (sometimes fear) of medical profession in ld community and lack of proactive engagement by pwld and carers - related to historical abuse and institutionalised care models 

What are we doing about it? Set up a Taskforce Group to look at the issues that is impacting non achievement of the targets. Currently meeting fortnightly Developed an action plan Developed a Communications plan aimed at raising the profile of health checks with clinicians and enhance skills and confidence of practice staff Produced materials to promote the importance of carrying out a health check, video. Produce, launch and promote clinician training video Use locality meetings, All Practice Event(s) and GP bulletin. Raise awareness of health checks with people with learning disabilities and their carers Produce, launch and promote explanatory video for patients and carers Hold pilot information and health check booking event at Lambeth Walk GP Practice Promote at Big Health Day, through social care and voluntary sector learning disability networks. Martin

What we want Practices to do… View the two animated films Check coding 69DB Use the Cardiff Template (SE Federation developed a version for EMIS) Raise the profile of health checks with clinicians and enhance skills and confidence of practice staff Produce, launch and promote clinician training video Use locality meetings, All Practice Event(s) and GP bulletin. Raise awareness of health checks with people with learning disabilities and their carers Produce, launch and promote explanatory video for patients and carers Hold pilot information and health check booking event at Lambeth Walk GP Practice Promote at Big Health Day, through social care and voluntary sector learning disability networks. Martin

Working together to achieve the aims What we are doing? Set up a Taskforce Group to address issues Action/Communications Plan Produced resources available on website Monitoring reporting progress at practice and Locality meetings Tell us your concerns What we want you to do? Identify an LD Lead (?safeguarding lead) Use the LD Resource website Use the EMIS Cardiff template Use EMIS code 69DB Claim for NHSE LD DES payments. All signed up Continue/kick off your health checks/