Agenda item

This report provides an update to the Board regarding progress against the Transforming Care priorities within Brent’s Health and Care Plan both at a local and sector level. The Board are asked to note and comment on progress and identify any areas where the Board would require further development.

Helen Duncan-Turnbull (Head of Adults Service, Complex Care, Brent Council) introduced the report which provided the Board with a progress update on the transforming care priorities within Brent’s Health and Care Plan. She explained that, in light of the Winterbourne View Hospital scandal in 2011, there had been a national programme to transform care for people with learning disabilities based on individuals at risk of hospital admission being identified and services being transformed within the community. She gave an overview of the four work streams under the Brent Transforming Care Program (TCP) and outlined that there were now only seven in-patients in Brent who had a learning disability. She updated the Board on recent key areas of progress at the local level such as: the early intervention blue light protocol being implemented; a wrap-around discharge service being formulated; the planned establishment of a Brent Autism Board; and integrated team operating in shadow form from September 2018 and expected to be fully operational by April 2019. She also noted some of the challenges which related to: specialist commissioning; funding; and delays which related to the development of certain elements of the market management strategy.

Helen Duncan-Turnbull continued and highlighted some of the key priorities being pursued in this area at North West London (NWL) level (included in paragraph 3.4 of the report). She drew Members’ attention to the Learning Disability and Autism Strategy 2017-2020 (attached as appendix 1 to the report) which had been agreed and signed off on the Council’s side. She also ran through the four key ‘enablers’ which had been identified as essential elements to the strategy being successful. Duncan Ambrose (Assistant Director, Brent CCG) added that the progress of the work at NWL level had been beneficial and outlined that different provisions to meet the needs of adults with learning disabilities in a community setting at the Kingswood Centre was an example of this. He also said it would be useful to link with the Association of Directors of Adult Social Services (ADASS) on their learning disability work stream. He concluded by stating that, on the CCG’s side, the Autism Strategy 2017-2020 was presently working its way through the CCG’s own governance process before it could be signed off.

A question was asked on the plans for an integrated learning disability team and whether the time gap between the team operating in a shadow form (from September 2018) to being fully operational (April 2019) could be reduced. Duncan Ambrose responded and stated that there remained a need to understand the costs and benefits to a fully integrated team and that the shadow arrangements gave both the CCG and Council a suitable timetable to be able to consider the different operational options.

The Chair referenced the statistics contained within page 12, appendix 1, of the agenda pack (on the prevalence of learning disability nationally, and the statistics within Brent) and questioned whether the figures were precise or if they had been approximated. Dr Melanie Smith stated that the first set of figures were a direct application of what the percentage of national population known to have a learning disability would equate to in relation to Brent’s population size. She also stated that the second set of figures, on the number of adults known to have learning disability in Brent, was an indication of the precise number of people known to the borough’s health and social care services. Helen Duncan-Turnbull said that there were also people across the borough who accessed non-statutory support services and therefore were not in direct contact with either the Council or CCG. She explained that this meant that the numbers of adults with a learning disability in Brent could actually be higher than presently recorded. 

Discussions continued on the need to ensure that Brent’s data for individuals with learning disabilities was as accurate and up-to-date as possible. A point was made that General Practices (GPs) kept a register of people with learning disabilities in accordance with data collected as part of the Quality and Outcomes Framework (QOF). The Board agreed that this data should be analysed against the figures included in the report: on both the adults registered by Brent CCG and those known to Brent Council as users of statutory funded services. 

It was RESOLVED that:

(i)         The progress report be noted;

(ii)        The direction on travel of the Transforming Care Programme be agreed; and

(iii)       That relevant Officers from both the CCG and the Council arrange to jointly assess the data on adults with learning disabilities known across health across social care settings in Brent, including a comparison of the register held by GP practices.