1. Health Improvement Strategy for People with a Learning Disability Julie Burza Health Improvement Officer NHS Fife

2. Why Have the Strategy? There isn’t one in Fife! There isn’t one in Fife! Response to the findings of the 2009 NHS Quality Improvement Scotland Review Funding for the strategy was made available by the Scottish Government through the Equally Well Learning Disability Change Fund programme 2009- 2011.

3. NHS Fife Population Fife, 361,890 people ( 2008) 2% of the Scottish population have a learning disability 6000 - 7000 adults with a learning disability in Fife

4. Key Aims Strategy Identify the health needs of adults with learning disabilities in Fife Identify the health needs of adults with learning disabilities in Fife Identify gaps in current service provision Identify gaps in current service provision Compile an action plan to address the significant health inequalities which can be experienced by this group of service users Compile an action plan to address the significant health inequalities which can be experienced by this group of service users

5. The Process Identify key partners Identify key partners Literature review Literature review Consultation process Consultation process Focus groups Consultation events On line questionnaire Service Review

6. 1. What is the leading cause of death for people with learning disabilities? a) Cancer b) Respiratory Disease c) Cardiovascular Disease Health Needs Quiz

7. 2. What Lifestyle/Public Health Issues are issues for people with learning disabilities? a) Obesity & Poor Diet b) Alcohol c) Smoking d) Lack of exercise

8. Health Needs Quiz 3. What system in the body has the highest cancer trend for people with learning disabilities? a) Cancer b) Respiratory Disease c) Cardiovascular Disease

9. Health Needs (Literature) People with a learning disability have greater health needs but often these are unmet and unrecognised People with a learning disability have greater health needs but often these are unmet and unrecognised Poorer uptake of universal screening and health promotion activities : Poorer uptake of universal screening and health promotion activities : Less than 25% have had a cervical smear & smoking cessation, Keep Well, immunisation programmes have lower uptake Less than 25% have had a cervical smear & smoking cessation, Keep Well, immunisation programmes have lower uptake Risks to health have increased - exposure to social and environmental risk factors - poverty, social isolation, low educational attainment Risks to health have increased - exposure to social and environmental risk factors - poverty, social isolation, low educational attainment

10. Consultation process Focus groups Consultation events On line questionnaire

15. Analysis

17. Key Issues Identified Relationships/friends Relationships/friends – limited social relationships including sexual relationships Health Needs Health Needs – – lower cancer screening / prevention uptake, sensory impairment, obesity, osteoporosis, Access to health care providers/premises Access to health care providers/premises - - physical barriers and communication

18. Key Issues Identified Educational needs & Employment – Educational needs & Employment – Gaps were identified in education, employment and social and leisure opportunities for the client group. Carers Carers – Often felt excluded and lacked information & support on key issues Transitions Transitions - Further opportunities and coordinated approach is required.

19. Key Issues Identified Transportation – for educational and social opportunities Transportation – for educational and social opportunities Communication – around services & treatments predominantly from statutory agencies Communication – around services & treatments predominantly from statutory agencies Training – No universal core staff training for those staff not seen as specialist - also profile & priority of this training Training – No universal core staff training for those staff not seen as specialist - also profile & priority of this training

20. A Health Improvement Strategy has been created: A Health Improvement Strategy has been created: Identifies the health needs of adults with learning disabilities in Fife Identifies the health needs of adults with learning disabilities in Fife Gaps in service provision Gaps in service provision 15 Recommendations and a draft action plan 15 Recommendations and a draft action plan Outcomes

21. Strategy’s Key Strength This strategy is needs-assessment-based i.e.: This strategy is needs-assessment-based i.e.: takes account of the views of people with a learning disability and their carers; takes account of the views of people with a learning disability and their carers; incorporates views of service providers incorporates views of service providers reflects what the research evidence tells us is effective in promoting the health of people with a learning disability; reflects what the research evidence tells us is effective in promoting the health of people with a learning disability; draws on similar strategies produced by other NHS boards. draws on similar strategies produced by other NHS boards.

22. Ambition and Challenge This strategy is rightly ambitious in its scope. This strategy is rightly ambitious in its scope. BUT BUT The challenge is to make the best use of the resources available The challenge is to make the best use of the resources available

23. “I enjoyed talking about doctors, dentists and services” service user “Very good event- felt my opinion matters- good opportunity to hear other views as well.” Service Users Comments

24. “ As a carer and a person involved in the Learning Disability Service I have found this very useful. Clearly there is a lot of work to do but care must be taken that the work is not done in isolation” Carer Carer Feedback Carer Feedback

25. Feedback Susan Manion, General Manager introducing the Health Improvement Strategy to delegates.

26. What Now? A multi- agency implementation group formed to take forward the recommendations from the strategy A multi- agency implementation group formed to take forward the recommendations from the strategy A copy of the strategy and updates on work streams can be obtained from A copy of the strategy and updates on work streams can be obtained from http://www.dwfchp.scot.nhs.uk/content.asp?Artic leCode=2847&par=215 http://www.dwfchp.scot.nhs.uk/content.asp?Artic leCode=2847&par=215

27. Further Information & Copies of the Strategy Improving Health Team, Dunfermline and West Fife Community Health Partnership, NHS Fife on 01383 565497. Improving Health Team, Dunfermline and West Fife Community Health Partnership, NHS Fife on 01383 565497. julieburza@nhs.net julieburza@nhs.net julieburza@nhs.net