Transforming care for people with learning disabilities The Arden, Herefordshire and Worcestershire Fast Track Experience Becky Hale, Strategic Commissioning Service Manager All Age Disability, Warwickshire County Council Deputy SRO December 2015 Key messages: Locally we have been advanced in our thinking and planning on our new model of care. The footprint for the Fast Track has been a real challenge as there is no natural synergies apart from Coventry and Warwickshire. Patient flows largely cover Birmingham not Herefordshire and Worcestershire.

The Local Context Population of approximately 30,000 people with a learning disability and/or autism (1.9%). 4,000 in receipt of support from local authorities. 47 people in inpatient care at time Fast Track bid submitted. Learning Disability Strategies, Joint Plans and Transforming Care structures in place pre Fast Track bid.

The Local Plan Reduction in inpatient beds to 14 by 2020: 19 non secure beds to 3 21 secure beds to 11 Reduction of 7 LD CAMHS beds Transfer of funds from inpatient to community services. Exploring strategic alliance across West Midlands based on patient flows. Key Messages: Ambition has been developed and jointly signed off as part of our joint plan in response to Winterbourne and is also key to our new LD Statement of Intent. New model of care predicated on personalised local services, hospital being the last resort.

Implementing our new Model of Care Enhanced Community Support Teams being implemented. LD and MH Liason Nurse. Admission avoidance agreements, funds and accommodation Long term accommodation with support developments. Community Forensic Service 2016/17. CAMHS Re-design. Model of care DVD and workforce development Continued customer and carer engagement. Key messages: Poor take up of screening and primary healthcare - perpetuates inequalities, health problems going unnoticed. Need a better understanding of our children’s population – especially those transitioning into adult services. People out of area due to a lack of appropriate accommodation with care locally. Short term assessment and treatment beds – used because they are there. Recognise the need to support people in specialised commissioning to return to their local area – more active involvement early on to support effective discharge.

Being a Fast Track – The Challenges Working across an unfamiliar commissioning footprint. Different starting points….. Population versus Beds Changing brief The Bid: External bid support Understanding our target population Governance within timescales Diverted attention (focus on writing) Finances! Key messages: Poor take up of screening and primary healthcare - perpetuates inequalities, health problems going unnoticed. Need a better understanding of our children’s population – especially those transitioning into adult services. People out of area due to a lack of appropriate accommodation with care locally. Short term assessment and treatment beds – used because they are there. Recognise the need to support people in specialised commissioning to return to their local area – more active involvement early on to support effective discharge.

Being a Fast Track – The Benefits Early agreement and clarity of purpose (to implement national plan) Transitional funding – 825K. Escalating pre existing plans. LD higher on the priority list locally. Focus on pooled budgets and joint working. Clinical review activity with Specialised Commissioning. Overwhelming support for model of care. Starting to see results. Key messages: Poor take up of screening and primary healthcare - perpetuates inequalities, health problems going unnoticed. Need a better understanding of our children’s population – especially those transitioning into adult services. People out of area due to a lack of appropriate accommodation with care locally. Short term assessment and treatment beds – used because they are there. Recognise the need to support people in specialised commissioning to return to their local area – more active involvement early on to support effective discharge.

Top Tips Build your model of care from the bottom up = buy in. Focus on enhancing work already happening locally. Learn from others (Solihull model). Accessible model of care (DVD). Dedicated resources for ongoing customer and carer engagement. Think about potential need for public consultation early. Transparency and collaborative working with service providers. Key messages: Poor take up of screening and primary healthcare - perpetuates inequalities, health problems going unnoticed. Need a better understanding of our children’s population – especially those transitioning into adult services. People out of area due to a lack of appropriate accommodation with care locally. Short term assessment and treatment beds – used because they are there. Recognise the need to support people in specialised commissioning to return to their local area – more active involvement early on to support effective discharge.

Questions? Key messages: Poor take up of screening and primary healthcare - perpetuates inequalities, health problems going unnoticed. Need a better understanding of our children’s population – especially those transitioning into adult services. People out of area due to a lack of appropriate accommodation with care locally. Short term assessment and treatment beds – used because they are there. Recognise the need to support people in specialised commissioning to return to their local area – more active involvement early on to support effective discharge.