Agenda item

Written report by Anne-Marie Dean

The Board received a report from the Chairman of Havering Healthwatch that provided an update on a series of workshops held in the borough during February and March 2014. It was noted that the report had recently been presented at the National Commissioning Conference with Healthwatch England and at the last Board meeting at Queens Hospital where it was agreed to accept all the recommendations.

The purpose of the report was to investigate what services were available in Havering for people with dementia or a learning disability and what was needed to be done to secure improvements. Attendees to the workshop sessions included service users, carers, representatives from the voluntary sector, NHS organisations and local authority departments. The framework at each meeting and themes discussed were:

What is missing?

What would make a difference?

What have you experienced that is good?

The following conclusions were drawn from all the attendees sharing their knowledge and experience on both dementia and learning disabilities:

·                     Overall, services for people who have a learning disability or dementia appear adequate and there have been some good, innovative developments.

·                     Service planning over the years has taken account of the needs of people who have dementia; but much remains to be done, especially in early diagnosis

·                     Services for people who have a learning disability appear to be less advanced. The challenges are across all the age groups, but many parents felt very strongly about the support and access to basics such as aids and equipment.

·                     A more contemporary and intuitive care model for learning disability and dementia, which addresses the inequity of service and access across the Borough, is needed.

·                     The feedback indicates that people who use services and carers need better means of communicating their views and a better understanding of how to seek the support and help that they need.

·                     That is not necessarily a criticism of the services – there was no suggestion that staff do not listen, or seek views, or try to tailor services to individual need. However, the statutory provisions under which services are provided tend to be aimed at common needs rather than individual circumstances.

·                     Personalised budgets will undoubtedly help people choose what they want rather than what is on offer. However, it may take time both to give people the confidence to make their own choices and for “the market” to develop service packages that are tailored to individual choice.

·                     People will need help and support in taking on this responsibility.

·                     Service users and carers appeared to be confused regarding the services on offer, the role of various voluntary sector organisations and who to contact and when.

·                     Service delivery problems are not confined to one sector: and there is evidence of joint planning and working across the agencies. However, from the comments given by users and carers, there is no doubting professional staff commitment and passion to achieve the best possible care standards for the residents in the Borough.

In response, Healthwatch had highlighted areas of concern and made a number of recommendations in each of which the main points were:

·                     Health checks – to review provision and monitoring of annual health checks and to consider a centralised service with expertise in dementia and learning disability.

·                     General Practice awareness – to ensure GPs had the necessary training and expertise and to eradicate delays in diagnosis and treatment.

·                     Communication and awareness – to develop a Borough Information Pack for Learning Disability and Dementia

·                     Staffing – to clarify the position in respect of Admiral nurses and their future role in the borough.

·                     One Stop Shop – to provide all community services in one location so as to benefit service users and carers.

·                     JSNA – to improve the level of local detail about learning disabilities and dementia thus providing a better opportunity to plan and design care for the longer term.

·                     Reachability – to introduce “Reachability” as the new criteria for measuring access to services

In conclusion, concerns were expressed about the regularity of annual health checks for people with a learning disability and also the delays in GPs diagnosing dementia. 

The Chairman of the CCG advised the Board that diagnosing dementia often took some considerable time as the Memory Clinic would only accept referrals on blood tests taken after three months.

The Healthwatch Chairman advised Board members that the organisation was planning to develop and train staff in Learning Disabilities.

The Board welcomed the report and agreed the following actions:

A.   The Chief Officer of the CCG would respond to a number of key points raised by the report and to investigate what services were being offered by current providers.  A briefing would be available to the Health and Wellbeing Board in September 2014.

B.   There should be a review of voluntary and community services relating to Learning Disabilities and Dementia and that a mapping exercise should be carried out. 

C.   It was agreed that there should be a single source of up to date information which can be posted on a website. Information should also be simplified and easy to read and that leaflets for dementia and Learning Disabilities should be merged. Advice and support on dementia and Learning Disabilities was especially important when communicating with different cultures and ethnic groups.

D.   There should be a review of Learning Disability services in the borough.

The Board noted the report and it was further agreed that the Chairman of Healthwatch provide a report specifically on Learning Disabilities at a later meeting.