Agenda item

(To receive a report by Justin Hackney, Adult Assistant Director Specialist Adult Services, which provides the Committee with details of the current Specialist Adult Services Commissioning Strategy 2018 – 2021)

Consideration was given to a report which provided the Committee with details of the current Specialist Adult Services Commissioning Strategy 2018-2021.  It was noted that the Council was a Commissioning Council and was organised in line with 17 Commissioning Strategies, which were in different stages of implementation and review.

It was highlighted that there was a joint commissioning approach in terms of this strategy, involving several partners, but particularly the NHS.  It was also noted that there were joint strategies in place. In relation to the Specialist Adult Services Commissioning Strategy, it was noted that the Council was the lead for this, and also that officers worked very closely with the Learning Disabilities Partnership.  Members were advised that a technical version and an easy read version of the document had been produced.  It was noted that the work programme for the next couple of years for the Strategy was set out in Appendix One of the document (p.36-37 of the agenda pack).

Lorraine Abbott was introduced to the Committee, and provided a brief summary of some of the work that she had been involved in.  She was an Expert by Experience and had been working with the CCG for two years, and had been a member of the Learning Disabilities Partnership for 10 years, as well as also chairing the Board.  She mainly worked with people with mental health issues. 

Officers advised that Lorraine had made a significant contribution over the years in terms of how the authority worked to make services better for people with learning disabilities.  Work had been undertaken to break things down into understandable sections and develop different ways of talking about things such as direct payments.

Lorraine informed the Committee she had been involved in the annual health care strategy, as people with learning disabilities often missed annual health checks as the GP's lists tended not to record whether individuals had a learning disability, and they may not push themselves forward to say they are entitled to a health check.

Members were provided with the opportunity to ask questions to the officers present in relation to the information contained within the report and some of the points raised during discussion included the following:

·         It was confirmed that many people with learning disabilities would be registered with GP's, but they may not be coded to say that the person had learning disabilities.  It was also possible that the GP surgeries were not signed up to the annual health check scheme.  CCG's were being asked to assert pressure on GP's to sign up for the annual health check scheme.  It was noted that this was continually raised by the Learning Disabilities Partnership as an issue.

·         It was commented that it was good to hear that the Experts by Experience were making a real difference and were highly involved in service development.

·         It was noted that the commissioning strategy read very well.  It was noted that Appendix 1 mapped out a direction of travel.  It was suggested that a summary should be included which set out what had been achieved during the year.

·         In terms of promoting the take up of direct payments, it was commented that there was a limitation of what could be achieved as it would not be a suitable way for some people to manage their finances.  There was agreement that there people should be given a choice on whether they wanted to switch to direct payments.

·         One of the Key Commissioning Actions highlighted in Appendix One was to 'agree and implement a new operating model for In-House Day Services'.  It was commented that the day care model and community hubs would be a good approach to take.

·         It was commented that some residential homes were boring for adults with learning disabilities (for example those adults who had to spend some time in a residential placement for medical reasons) as there were few activities or opportunities to mix with people in their own age group.   It was noted that the activities offered could be strengthened through the contract management process.

·         It was queried whether the voluntary sector had a part to play, and it was confirmed that it was a possibility and it was something that the commissioning teams were exploring.

·         Links with the Managed Care Network was something that officers were keen to expand, particularly for working age adults in residential placements.

·         There was a need for residential homes to be more of a part of the local community.

·         It was queried whether there was a need for contracts to be more specific about the activities which would be provided, however, it was commented that the more detail which was specified made it more likely that costs would rise. 

·         It was thought that it would be beneficial to highlight some examples of good practice, as activities did vary from provider to provider.

RESOLVED

            That the Committee note the content of the current Specialist Adult Services Commissioning Strategy and provided the following feedback for the Executive:

·         The importance of annual NHS/GP health checks for people with learning disabilities

·         A request for a brief annual report or position statement on this strategy (as well as other commissioning strategies)

·         Consideration to be given to the new operating model for in house day services

·         Support for strengthening the specification of residential care as part of the contract re-provision, possibly to address issues such as boredom for patients

·         A recommendation for wider community engagement on changes to provision.