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 peoples 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