Debra Moore debra@debramooreassociates.com

www.debramooreassociates.com07950 333884

Health action planning and health facilitation

Problems, progress and priorities

Context “The NHS is there

when we need it most. It provides round the clock, compassionate care and comfort”

Lord Ara Darzi

“Witnesses described some appalling examples of discrimination, abuse and neglect across the range of health services”

Sir Johnathon Michaels

Am I bovvered? You are here! Main agencies and organisations

have this in their ‘sights’ and are here

Lots of mainstream examples of good practice e.g. Sheffield

Acknowledge competing demands and financial climate

Recognise inevitable ‘higher priorities’ and ‘play our hand’ accordingly

Yes!

Health action planning & health facilitation Finding out…..

We met with a range of people at several events and canvassed view

We heard about the issues emerging from research in this area

We looked at good practice and ‘what helped and what hindered’

We looked at VP targets in this area and issues relating to Learning Disability Partnership Boards

Considered changes in the policy landscape and new mechanisms to support change e.g. JSNA

Health Action Planning and Health Facilitation - what we heard……

VP Targets for health action planning and health facilitation not hit in many areas

Many areas lack an up to date ‘Action for Health Framework’ and lack local evidence, data or outcome measures

Health has not enough ‘air time’ at many Learning Disability Partnership Boards

Some LDPB’s don’t have a health subgroup or its poorly attended or not right people there

Some LDPB’s failed to make the relationships with commissioners and providers of mainstream and specialist health services

Ultimately – undermines not just achievement of VP targets but ability to address DRC, Mencap, Michaels, Healthcare Commission audit etc etc etc

So has it been a missed opportunity?

Yeah, but no, but!

What helped locally?

Taking an honest but constructive approach Leadership - a critical factor ‘Ownership’ by the mainstream Emphasising the wider benefits to all groups Involving people and families who have

appropriate skills and knowledge in training Performance management – SHA’S, PCT’s

and Healthcare Commission Incentivising the system – LES & DES Seeing HF and HAP as part of a wider health

agenda – ‘tools’ or means to an end rather than the end game

Lots of good practice examples – so it can be done!

What did people say?Good 1:1 health

facilitators

Know and trusted by the person Puts the person at the centre of

plan Works closely with those who

know and love them Know a lot about the persons

health needs and wishes and rights

Know how to access opticians, dentists, GP etc

Good communicator Knows how to format a plan

that is useful to the individual

Good strategic health facilitators

Good leaders Know about the health needs of

people with learning disabilities Understand how health services are

commissioned and delivered Can monitor and audit intiatives to

reduce inequalities Can work across a locality and

different agencies and services Understand mainstream and

specialist health policy

What did people say – Health Action Plans

Don’t have just one approach/format – need to be useful to the person

Need to have some ‘documentation’ that looks similar that health professionals recognise e.g. ‘grab sheets’ etc

Provide training and resources for people and families as well as health and social care professionals

Make good use of universal services Need to make sure health action planning it is a part of person

centred planning (and CPA where appropriate)

“Style and format less important that explaining the plan clearly and ensuring actions take place”

Primary Care Trusts some key messages from the field

‘Commission to improve outcomes’ - data and evidence and LD population needs and wishes should be seen within commissioning strategies and priorities

Provide leadership within the PCT, at the Learning Disability Partnership Board and beyond

Harness the expertise of specialist health provision and maximise contribution e.g. CTLD’s

Lead the delivery of the local Action for Health Framework and related strategies e.g. ‘Green Light’

key messages- continued Invest in posts that assist the PCT to deliver the

changes required e.g. Strategic Health Facilitation and deliver provider support e.g. Acute Liaison Nurses

Employ coherent data systems to monitor GP registration, the uptake of health checks and health action plans

Make sure that local health policies and practices are assessed (Equality Impact Assessments).

Undertake reasonable adjustments - including mental health and offender health services

Utilise Primary Care Service Framework and associated tools

Learning Disability Partnership Boards need to vaccinate against the ‘Dibleys’

Have the right people at the Board and the health subgroup – expertise and authority – earn their place!

Make sure they have a firm grip of the health agenda – be business like!

Have good evidence of what works and what’s not working nationally and locally

Have clear outcomes and develop locally relevant metrics that include social care and universal supports e.g. uptake in sport

Harness the skills of people and families (especially those with more ‘complex needs’)

Be decisive and get on with it - do what you can, where you can and do it now!

Action for Health Frameworks

‘Gearing up the different parts to work together’

‘Better health’ sits within a ‘broader context’We need to make sure everyone understandsthe implications for people’s lives and theachievement of their hopes and dreams

This IS a matter of ‘LIFE AND DEATH’