Role of Learning Disabilities Nursing in Clinical Commissioning Groups Dr Ben Thomas Director of Mental Health & L

1. Role of Learning Disabilities Nursing in Clinical Commissioning Groups Dr Ben ThomasDirector of Mental Health & Learning Disability Nursing

2. Government, national policy and learning disabilities • Norman Lamb MP –MS (CS) • Local Government HWB • Adult Social care • Safeguarding • Mental health • Physical & learning disabilities • Third sector • Prison Health Services

3. National nursing leadership Viv Bennett Director of Nursing and Government Principal Advisor on Public Health Nursing Department of Health Jane Cummings Chief Nursing Officer NHS Commissioning Board NHS Outcomes Leadership Implementation & delivery Public health Adult social care

4. The Commissioning model

5. Why is it important to involve nurses throughout the commissioning cycle? • Improve the health of people with learning disabilities • Improve services for people with learning disabilities • Listening, consulting and engaging • Look for opportunities and create solutions • Strong, effective clinical leadership • Monitor and improve patient care • Navigate their way through NHS and social care systems • Suitable measures to use in CQUINS • Contribution to clinical outcomes • Co-ordinating care • Make things happen !!!

6. How and why to involve learning disability nurses on the board

7. Our Vision - developing the culture of compassionate care Compassion Care is our business Competence Commitment Communication Courage

8. Our values and behaviours are at the heart of the vision and all we do Care Compassion Competence Delivering high quality care is what we do. People receiving care expect it to be right for them consistently throughout every stage of their life. Compassion is how care is given, through relationships based on empathy, kindness, respect and dignity. Competence means we have the knowledge and skills to do the job and the capability to deliver the highest standards of care based on research and evidence.

9. Our values and behaviours are at the heart of the vision and all we do Communication Courage Commitment Good communication involves better listening and shared decision making - ‘no decision about me without me’. Courage enables us to do the right thing for the people we care for, be bold when we have good ideas, and to speak up when things are wrong. Commitment will make our vision for the person receiving care, our professions and our teams happen. We commit to take action to achieve this.

10. Six Areas for Action Helping people to stay independent, maximising well-being and improving health outcomes Working with people to provide a positive experience of care Delivering high quality care and measuring impact Measure Impact • Deliver evidence-based care & extend evidence through research • Explicitly demonstrate our impact on outcomes • Make ‘every contact count’ to promote health and wellbeing • Support people to remain • independent • Maximise the contribution to • specialist community public health nursing • Design our services so people, and their carers and family are active participants in their care • Prioritise patients and the people who receive care in every decision we make • Collect, listen to and act on • feedback and complaints • Promote personal responsibility for health and wellbeing • • Follow evidence-based best • practice to deliver high quality • outcomes to those that use health and care services • Measure what we do and our • contribution to quality • • Be transparent and publish the outcomes • • Promote careers in research to strengthen the focus on evidence based practice Leadership at every level

11. Six Areas for Action Building and strengthening leadership Ensuring we have the right staff, with the right skills in the right place Supporting positive staff experience et Staffing Right Measure Impact • Ensure all registered nurses & midwives understand their leadership role with the wider care-giving team • Free our leaders to have time to lead e.g. supervisory status, better use of technology • Empower nurses, midwives & registered managers to make local changes to improve care. • Use evidence based staffing levels • Commit to and support life long learning for the whole care-giving team • Recruit staff with the right culture & values • Create worthwhile & rewarding jobs • Create equality of opportunity • Support each other & new entrants to the professions • Be professionally accountable • Embrace new technology • Be productive and efficient Leadership at every level

12. Jane Cummings, CNO6 Cs of Nursing NHS Change Model Leading change Compassion Courage Competency Communication Care Commitment a shared purpose to the vision Making sense of it all to bring

13. NHS OUTCOMES FRAMEWORK 2012/13 Domain 1 Preventing people from dying prematurely Domain 2 Enhancing quality of life for people with long-term conditions Domain 3 Helping people recover from episodes of ill health or injury Domain 4 Ensuring that people have a positive experience of care Domain 5 Care in a safe environment and protecting them from avoidable harm

14. Learning Disabilities Nursing • 1995 – 12,504 in NHS • 2011 – 5,189 in NHS • 54% reduction (1,000 per year) • Increasing vacancy factor 1,7% in 2009) • 600 student commissions per year • 4/500 register with NMC

15. Learning Disabilities Nursing Review • Strengthening capability • Strengthening the quality • Strengthening the profession • Strengthening capacity

16. Recommendations: • Ensure the knowledge and skills of learning disabilities nurses are provided to the right people, in the right places at the right time • Knowledge and expertise available across the lifespan • Work collaboratively with general health services including health improvement, prevention and public health approaches • Specialist services employ sufficient numbers of learning disabilities nurses

17. Maximising the learning disabilities nursing input into commissioning • Assess and monitor the quality of services • Ensure the needs of people with learning disabilities are considered in all commissioning plans • Raise awareness of social factors • Joined up person centred services • Effective commissioning, QIPP • Strong clinical leadership • Improve access to services • Challenge discriminatory attitudes • Implement reasonable adjustments • Accessible information

18. Determinants of Health (In)equalities as outcome measures Determinant 1 Social factors e.g. poverty, poor housing, unemployment, social isolation Determinant2 Genetic & biological conditions Determinant3 Personal health risks & behaviours e.g. self-harm, poor diet, lack of exercise Determinant 4 Communication difficulties & reduced health literacy Determinant5 Access to healthcare provision

19. Summary • Safe, high quality local care • More responsive • More person centred • Reduction in variation • Increased range and choice • Improved health outcomes and satisfaction • More preventative care • More complex, long term care in the community • More joined up care • More cost effective care

20. Thank You Contact details: Dr Ben Thomas ben.thomas@dh.gsi.gov.uk