Health Action Planning Kathryn Joseph & Sharon Wood Strategic Health Facilitators Telephone:

Health Action Plans In 2001 the government brought out a report called ‘Valuing People: A new strategy for learning disabilities for the 21 st century’. The report made recommendations to improve the lives of people with learning disabilities in the following areas: Education, social services, housing, health, housing, employment & supporting carers

Health Action Plans In the report ‘Valuing People’ the government said each person with a learning disability should be offered a Health Action Plan by June 2005

Where are we now? ‘Valuing People Now’ (2008) - People with learning disabilities continue to have poorer health than the general population - The targets and objectives for Health Action Planning were not achieved Northants Evaluation of Health Action Planning - People were not involved in the planning of their own health - Plans were not being used or kept updated - Doctors surgeries were not aware of the Plans

Functions of Health Action Plans Health Action Plan Belongs to the person Person centred Accessible Identifies health needs Lists actions needed Identifies support needed Provides links to a range of other services Provides links to GP, primary care & other health services Coordinates services Influences services Educates & informs Integral part of PCP & other plans Most important are in shaded boxes

Health Action Plans Along with Person Centred Planning, Health Action Plans are particularly important at key stages in people’s lives: Transition from child to adult services Leaving home Moving from one provider to another Changes in health status On retirement When planning transition for those living with older carers

What should be in a HAP Identified health needs or issues What actions are needed to maintain health What actions are needed to improve health Who will help ensure these actions take place (especially if this is someone other than the health facilitator) Timescales for various actions and when there will be a follow up or a review.

Integrating PCP and HAP Health Action Planning should be part of the Person Centred Planning process If people do not have good health then their rights, choices, independence and inclusion will be compromised A Person Centred Plan must address any important health & safety issues

Integrating PCP and HAP Things you might need to ask when facilitating people’s Person Centred Plans: What's important to the person to keep them healthy and safe? What’s important for the person to keep them healthy and safe? What do other people need to know or do if the person is to keep healthy and safe?

The health needs of people with learning disabilities More likely than the general population: To die of respiratory disease To die from gastrointestinal cancer To develop dementia To develop schizophrenia To develop coronary heart disease

The health needs of people with learning disabilities More likely to be obese or under weight 80% of people engage in levels of activity below the recommended levels Higher incidence of physical & sensory disabilities Less likely to undergo a cervical screening test Less likely to undergo breast screening

Health checks Well person checks at the doctors surgery Screening (breast, cervical and bowel) Long term conditions such as diabetes, people should be having checks at their surgery Mental health - annual health check by the surgery Annual health checks for people with moderate to severe learning disabilities introduced October 08 ‘The Health Check and Health Action Plan Booklet’

Barriers to accessing healthcare & achieving good health Communication Low expectation Poor physical access Lack of accessible information Fear of health professionals Lack of time Physical environment Poor information from carers Poor support Lack of education Lack of preparation Additional needs e.g. Autism

Health Facilitation Strategic level Specialist level Individual level Varying levels of support to the person Everyone's role is to: Put person at the centre Ensure health & wellbeing Ensure equal access

Strategic level Specialist level Individual level - Service development work - Informing planning & commissioning A health professional who provides advice, guidance, support or treatment usually on a short term basis in partnership with patient & their Health Facilitator. May support or contribute to the HAP Focus on individual work and health outcomes. A support worker, advocate, friend, or family carer could fulfil the role at this level. The person should choose who they want as their Health Facilitator

The individual level Role and responsibilities: Support the person to understand HAP Supporting the person to develop a HAP Helping to identify and record health needs on the HAP Supporting the person to access services

The individual level Role and responsibilities: Ensure that the HAP is an integral part of the person’s PCP and other plans Helping to identify and meet health education needs Supporting the person to review the HAP and make sure the actions happened Supporting the person to raise concerns

Useful references and links Click on ‘resources’, click on ‘health’ and then click on ‘Health Action Planning’ at the top of the page Department of Health, (2002). Action for Health: Health Action Plans and Health Facilitation - Detailed Good Practice Guidance on Implementation for Learning Disability Partnership Boards. London: Department of Health Department of Health, (2002). Health Action Plans – What are they? Where do you get one? (A booklet for people with learning disabilities) London: Department of Health