Issue - meetings

To consider the report of Andy Styring, Director of Operations, Cheshire and Wirral Partnership NHS Foundation Trust

Andy Styring and John Courtney from the Cheshire and Wirral Partnership NHS Foundation Trust (CWP) briefed on proposed changes to learning disability inpatient and community services.  The Committee was informed that CWP provided various services including both inpatient and in the community; the organisation had 3300 staff providing services across 95 sites; the budget was over £155m.

Mr Courtney explained the background to the proposals – the Winterbourne View review and reports from the Department of Health had said that there was an overdependence on inpatient beds in learning disability services; too much use of out of area placements; and a need to enhance learning disability community services.  There was also a requirement to make savings in the NHS, with CWP required to save £13m over the next 3 years.  In reference to the question raised at public speaking time, Mr Courtney explained that the term community services had a broad definition and referred to any service that was not an in patient service.   

The Learning Disability Service Review had identified the need for the following improvements:

·        Care Pathways – establish an improved clinical model with better service user outcomes.  There should be a defined pathway for each area of need (Challenging Behaviour; Mental Health; Physical Health including profound intellectual multiple disability; Forensic Needs (offending behaviour), with individualised packages of care;

·        Community Learning Disability Teams – redesign to provide a core team in each area of need with emphasis on specific therapies such as speech and language therapy and occupational therapy;

·        Inpatient Services – reduce reliance on inpatient services – close one Assessment and Treatment Unit and reduce bed numbers in the longer term. 

The Review considered the option of making no changes to learning disability services.  However, based on the need to make savings as well as a desire to improve services based on the review, this was not considered a viable option.  It was proposed that changes to the learning disability service were introduced whereby a care pathway model was introduced which promoted supporting people in the community, with access to enhanced community services and access to inpatient services for those people who needed it. 

A public consultation on the proposals would be undertaken for three months starting from 14 January.  The consultation would include an easy read paper based document and questionnaire, online questionnaire and public meetings.

In discussing the proposals, Members raised the following issues:

·        Health issues were often a concern for people with learning difficulties.  In response, the Committee was advised that CWP staff undertook training and awareness raising sessions for GPs and medical staff in relation to treating patients with learning difficulties, who tended to have higher levels of illness.  The development of neighbourhood teams would improve links with GPs with each GP practice having a named contact at CWP to assist with any issues regarding patients with learning difficulties.  Ms Field of South Cheshire Clinical Commissioning Group explained that it was intended to integrate as many services as possible around the GP service  ...  view the full minutes text for item 86