1. West Midlands SHA
Good Practice and Innovations Identified in Learning
Disability Health Services –
The Self Assessment Framework 2009/10

2. West Midlands SHA
Good practice and innovation extracts from district returns
DISTRICT GOOD PRACTICE CONTACT AND INFORMATION
(Notes)
Top Target 2: LEAD: Sam.davies@benpct.nhs.uk
Birmingham  See-ability campaign – eye-to-eye campaign, working with local
(3x PCT) opticians to provide training and allow for reasonable adjustments. Website: http://www.tellusmore.org/
 Health Facilitation Team model, many examples of good practice in
service delivery, including: GP activity checklist for health checks, a
template for better metrics and training materials.
 Electronic templates in Primary Care, including guidance for primary
care staff on an extensive range of health issues, screening tool for
GPs to identify individuals with a learning disability.
 GP training around health checks, including accessible information for
health checks and an accessible invitation letter.
 Screening and procedure materials produced in accessible format for
a range of health issues, including coil fittings, canular etc.
Top Target 3:
 Dignity Champions in accessing acute care; trained all self-advocates
in safeguarding, develop “skills for care” and linked to overarching
workforce strategy.
 Complaints material produced in accessible formats, providing
information on how to make a complaint.
 Comprehensive and multiagency approach to Six Lives and
Healthcare for All in actions in implementation.
Top Target 4:
 The Growing Old with a Learning Disability and Dementia (GOLDD)
project – multiagency approach involving service users and carers to
help in the planning and developing of services for needs that arise
from the ageing process and dementia. (e.g. developing accessible
resources on ageing and dementia, e-learning training programme for
staff)
 Health Facilitation extended to Mental Health through: Policy for joint
working between adult mental health services and services for people
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3. with learning disabilities in Birmingham and Solihull.
 Comprehensive service specifications, i.e. for Forensic inpatients
step-down model, transition and challenging behaviour service
models.
Top Target 2: LEAD: Anima.Thawait@coventrypct.nhs.uk
Coventry  H Team Model; self-advocate peer health group who feed into the
Partnership Board and PCT to identify gaps in service provision and Website: http://coventry.ldpb.info
barriers to accessing health services. They also deliver staff training www.covwarkpt.nhs.uk
within health and social care.
 Screening tools; a range of accessible leaflets have been developed
to support service users and carers for a range of health conditions.
E.g. blood tests, breast screening, psychiatric, dentist, dietician, A&E
and dysphagia.
 Healthy Lifestyles Project to address health inequalities, pilot project
extended and commenced within BME communities.
 Health Buddies Project – local voluntary sector organisation
Grapevine provide training and support to service users to become
peer supporters for those who need help in accessing primary health
care services.
 Pacesetters Project; piloting electronic alert system/flagging system
to improve the access and experience of service users in acute care
settings.
 Excellent range of collaborative protocols between PCT, Health
Facilitation, Community Learning Disability Team and acute care in
supporting the care of patients with a learning disability when they
access acute hospital services.
 Named skilled “link person” in acute hospital to improve acute
services.
 Good service specifications on children with learning disabilities who
require continuing and long-term care.
 Good model for Community Dental Services, i.e. accessible
resources, training for dental staff, pre-visit questionnaire and
electronic patient records.
 NHS Coventry have applied flexible working style and developed
systems in relation to training and toolkits to improve on reasonable
adjustments in practice and wider services.
 NHS Coventry provide a comprehensive approach to meet the needs
of individuals with profound and complex learning disabilities;
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4. including representation on Partnership Board and comprehensive
needs assessment.
Top Target 3:
 Health Buddies Project (Grapevine Project); providing peer-advocates
support and training peer-advocates in safeguarding, access the
complaint system and support to make complaints.
 Six Lives Workbook and action plan implementation is detailed and
impressive.
Top Target 4:
 Transitions – good model of transition from child to adult services.
 Working in partnership with family carers i.e. involving in training,
participation and engagement, peer advocacy and developing a
range of information in innovative formats, e.g. DVD.
 Ageing and Learning Disabilities, included within Learning Disability
strategy, and commissioning plan e.g. integration with mainstream
services for early onset dementia team
 Autism - numerous examples of good practice, including process
models and developed core strategy team.
 Approaches to addressing Challenging Behaviour, Mental Health,
Workforce planning and Offender Health provide good practice
examples.
Lead: Neill.Bucktin@dudley.nhs.uk
Dudley
http://www.dudleyld.org/
Top Target 2:
 Robust Special Needs Register database – capturing disease register ann.parkes@dudley.gov.uk
/ informatics team. john.povey@dudley.gov.uk
 Screening information made accessible, e.g. bowel, breast, testicular
cancer, working with radiography.
 A wide range of accessible information within Primary Care, including
psychology and dementia easy reads. amanda.irwin@dudley.nhs.uk
 Smile project – supporting people to access the community dental
services in the local area.
Tracey.Shilvock@dudley.nhs.uk
 Work with BME communities; specific group for Partnership Board,
monitoring of ethnicity within GP practices and the data collected is
used to inform strategic developments.
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5.  Good use of IM & T in developing easy read leaflets about National
Care Records Service, care plans for learning disability patients are
accessible via web based tool.
 A & E nurse champion for learning disabilities
Top Target 3:
 People with learning disabilities working as volunteers within hospital Karen.Jaunzems@dgoh.nhs.uk
 PALS service supporting the Learning Disability Support Line –
enabling people to make complaints Vanessa.Biddulph@dudley.nhs.uk
 Good model of engaging service users, carers and voluntary sector in
addressing the safeguarding, training and education agenda.
 Excellent multidisciplinary approach to addressing safeguarding,
complaints, DoLS and legislative compliance.
Top Target 4:
 Robust arrangements for monitoring Out of Area placements
 Supported living for people with learning disabilities
 Excellent examples of strategies, approaches and models of practice
within older peoples services, Transition, Autism and Workforce.
LEAD: skeetley@herefordshire.gov.uk
Hereford
Website: http://herefordshire.ldpb.info/
Top Target 2:
 Electronic Learning Disability Register – managed by Strategic Health
Facilitator jdavies2@herefordshire.gov.uk
 Model of Strategic Health Facilitator role in influencing service
delivery and commissioning.
 Good use of personal health budgets through personalized mahardy@herefordshire.gov.uk
commissioning approaches.
 Good model of commissioning through vertical integration working to
improve transitions, care pathways and strengthening partnerships,
i.e. with acute sector.
Top Target 3:
 People’s Union – which involves teaching and supporting individuals Caroline Wharby
to make a complaints by peer-advocates. advocacy@herefordshire.com
 Extending the “lessons learned” newsletter from all complaints made
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6. by service users to the PCT, which now include examples involving jdavies2@herefordshire.gov.uk
learning disability services, shared among the wider health economy.
Top Target 4:
 “Getting a Life” pilot - work in relation to transition from children to
adults service; prevention and individualised planning, linking to tkirby@herefordshire.gov.uk
health, further education, employment and vocation.
Top Target 2: LEAD:
Staffordshire (N&S) North christine.adams@staffordshire.gov.uk
 Good model of training of GPs in locality around learning disability
awareness and reasonable adjustments. Website: http://www.staffordshire-
 Robust commissioning strategy for learning disabilities, including ldpb.info/
approach to transition and older people for 2008-2012.
 SNAP – Special Needs Action Plan as an evidence base for
improving practice in acute care by establishing a flagging system
and allowing for reasonable adjustments.
South
 Acute Liaison Nurse in place; good practice in local acute trust.
 Linking into Health Trainers service for health promotion initiatives,
extended to people with learning disabilities.
 Training for doctors and midwives delivered by service users;
programme has been running for 6 years and links to local University
programmes.
 SNAP – Special Needs Action Plan as an evidence base for
commissioning for acute liaison nurse role.
 Robust commissioning strategy for learning disabilities for 2008-2012.
Top Target 3:
North
 Workforce – “My Next Patient had a Learning Disability” toolkit used
to train professionals.
 Easy read materials and resources around Mental Capacity Act.
 Easy read materials around Six Lives and Healthcare for All.
South
 A citizen’s pilot project to tackle bullying in local community;
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7. workshops, training and public engagement working to address
learning disability and the wider vulnerable children and adults’
agenda through a multiagency approach.
 Strong work around Six Lives and Healthcare for All.
Top Target 4:
North
 Joint work with Combined Healthcare Trust, for specialist epilepsy,
hearing and sight nurse in post.
 Accessible information available regarding Mental Health in Primary
Care.
 The bereavement project - which includes a range of components
and has been well monitored.
 Challenging behaviour nurse specialist in post.
 Workforce – “My Next Patient had a Learning Disability” toolkit used
to train professionals.
 Offender Health – health needs assessment conducted at local young
offenders’ institute.
 Good model - Transition workers in place in Newcastle and
Staffordshire Moorlands.
South
 Active involvement of service users and family carers through a range
of workshops reflected positive approaches.
 Workforce – “My Next Patient had a Learning Disability” toolkit used
to train professionals.
 The model to engage Offender Health through hospital
communication training manual in health facilitation training in
learning disabilities.
* *
Sandwell
Top Target 2: LEAD:
Shropshire  Multiple initiatives in relation to sexual health and parenting, including ruth.houghton@shropshirepct.nhs.uk and
a sexual health clinic, awareness training in relation to learning jackie.taylor@shropshirepct.nhs.uk
disability for midwives and a parenting strategy that includes people
with a learning disability.
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8.  Health Access Nurse role – a much valued post and perceived
favorably by service users, carers and staff.
 Models of joint working and working to influence mainstream culture
on how services are traditionally delivered.
 Excellent Shropshire Learning Disability Strategy 2010-2013.
 Large numbers of accessible resources produced for a range of
health issues, e.g. sexual health, cancer screening.
 “Building Bridges” – is a training organisation led by service users and
carers, in partnership with the Joint Training Unit. Deliver learning
disability awareness training to midwives and other health
professionals.
 Pilot site for the Common Assessment Framework for adults
demonstrating joint partnership working and working to influence the
safeguarding of vulnerable adults agenda.
 Excellent models of specialist health care and clinical services are
based on a multiagency approach, i.e. Health Access Team,
Integrated Community Team for IAPT (Increasing Accessing to
Psychological Therapies), Shropshire Integrated Teams – Community
Therapy and Psychiatric services.
Top Target 3:
 Unannounced service visits by service users and carers have
enabled the monitoring of services and are feeding into
commissioning plans.
 Commission “Taking Part”, a self-advocacy organisation to work on
safety issues.
 Community Hospital have introduced the admission to hospital
guidelines for people with a learning disability.
 Use of Patient Passport “All About Me” has been promoted with the
involvement of Taking Part and is used widely.
 Comprehensive Six Lives report and action plan.
 Robust multiagency vulnerable adult safeguarding approaches, i.e.
training, strategy, referral processes, involvement of users and
carers.
 Accessible complaints process for people with learning disabilities
available online.
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9. Top Target 4:
 Robust processes in place for the following: End of life, Autism,
transitions, Challenging behaviour, workforce and offender health.
Top Target 2: LEAD: catherine.nolan@solihull-ct.nhs.uk
Solihull  Collaboration with Public Health to produce screening materials on
cervical screening. Establishing a collaborative service between Website: http://www.easy-read-
dieticians and speech therapists to assess and help individuals with online.co.uk/news/solihull-learning-
swallowing problems disability-services.aspx
 Work to support individuals with challenging behavior and complex
needs. This included the design of bespoke services, staff training
and support
Top Target 3:
 Support in understanding and reporting abuse, including easy read
materials.
 Six Lives workbook has been implemented; including specific training
for people with learning disabilities on “keeping people safe” and work
in underway with the acute hospital to strengthen their approach to
safeguarding.
Top Target 4:
 Strategic work and multiagency approach to improve transition from
young peoples to adult services.
 SLOT (Supported Living Outreach Team) covering out of area
placements.
 Care Trust funds an Autism project worker post, who addresses
Autism awareness issues for the general public as well as cross
sector providers.
 Funding of a support group for people with Aspergers Condition.
 Active Mental Health and Learning Disability group working on the
Green Light toolkit; with a shadowing programme between staff from
both services.
 Systems in place to monitor offender health.
Top Target 2: LEAD: Kevin.Day@stoke.gov.uk and
Stoke  Joint work with Crossroads (voluntary organisation) who hold the Mark.Tunstall@stoke.nhs.uk
contract for carers register and work jointly with PCT to review and
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10. identify gaps to feed into commissioning. Website:
 The SNAP (Special Needs Action Plan) project which identifies http://www.equalpeopleinstoke.org/
people with a learning disability when they go into hospital.
 The use of service user’s stories to influence service delivery
 Improved access to dental services for people with a learning
disability.
Top Target 3:
 The SNAP (Special Needs Action Plan) project which identifies
people with a learning disability when they go into hospital.
Top Target 4:
 The SNAP project demonstrated effectiveness of flags being used at
admission for A&E.
 Specialist healthcare services for people with learning disabilities are
based within Combined Healthcare.
 Parents and carers have been involved throughout AHDC programme
from making commissioning decisions, helping with capital building
developments, supporting on task and finish groups on core areas of
work.
Top Target 2: LEAD: kit.roberts@telfordpct.nhs.uk
Telford and Wrekin  Comprehensive strategy and working to affect cultural change in the
PCT on the learning disability agenda. Website: ??
 Comprehensive training packages been developed and delivered to
GP practices to tackle the health inequalities among people with
learning disabilities.
 Creative and personalized responses to health promotion including:
Fit for Men, Green Gym and Women in Motion exercises for all.
 Work to meet the needs of people with a learning disability from BME
communities with the appointment of a BME worker.
 Innovative ways of promoting overall health and wellbeing via social
events at Pussycats nightclub.
 Encouraging greater involvement and engagement of people with
profound and multiple learning disabilities and their family carers.
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11. Top Target 3:
 Robust approach and process in place around Six Lives and
Healthcare for All.
 Comprehensive complaints procedure, with easy read materials,
support from Taking Part and independent advocacy involvement.
 Whole approach to improving safety in health services for people with
learning disabilities offers many good practice examples on accessing
and monitoring complaints, legislative compliance, and safeguarding
issues.
Top Target 4:
 Creative commissioning (Autism, Challenging Behavior, older people
and transitions)
 Reducing “out of area” placements and improving placement
monitoring, through stronger links across children’s and adult’s
services and utilizing reviewing officers
 Carers Partnership Board with support from Taking Part (Self-
advocacy organisation)
 Excellent joint approaches and models to ensuring LD agenda is
addressed in mainstream Older peoples and Dementia Strategy;
Transitions, Out of area placements; Challenging Behaviour through
the review of Mansell 2; and New Horizons.
 A range of approaches to address workforce issues and
improvements around offender health.
LEAD: Andy.Rust@walsall.nhs.uk
Walsall
Website: www.walsalltogether.net
Top Target 2:
 An E-learning package for staff in Primary Care StaplesL@walsall.gov.uk
 Provision of mandatory induction training for all staff at Manor Richards.Lesley@walsallhospitals.nhs.uk
Hospital in supporting and understanding people with a learning
disability
 Cancer screening programme provided under the auspices of Julia.Kelly@walsall.nhs.uk
Pacesetters
 The running of a number of different health promotion groups, e.g. Julia.kelly@walsall.nhs.uk
epilepsy, cervical screening, diabetes, breast screening, well-persons
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12. group and dentistry.
 A range of easy read materials, DVD’s, podcasts and website
documenting numerous health conditions and issues.
 The appointment of a health and social care facilitator specifically for
people with a learning disability from BME backgrounds ZamanN@walsall.gov.uk
 Acute liaison nurse model.
 The use of “Elephant kiosks” as a means of involving service user in Richards.Lesley@walsallhospitals.nhs.uk
decision making in planning service development
Louise.Mabley@walsall.nhs.uk

Top Target 3:
 The Healthy Lives Advisory group based in acute; service users and
carers are invited to attend this to subsequently feed into the
Partnership Board. Service users have a direct impact on health
initiatives in Walsall. daviessam@walsall.gov.uk
 Website is fully accessible and interactive and includes a www.walsalltogether.net
safeguarding contact, details of a new hate crime advisory group and
downloadable accessible reporting documents.
 Whole approach to safety; Six Lives, legislation compliance, DoLS,
complaints and safeguarding are robust and reliable.
Top Target 4:
 New CPA (Care Pathway Approach) policy for learning disabilities in
Walsall Community Health is providing a seamless process through
discharge and rehabilitation.
 Specialist nurse for dementia and long-term conditions employed
within the robust Community Learning Disability Team’s
infrastructure.
 Robust pathway for transitions and a dedicated team working with
young people and their families who are approaching and
experiencing transition.
 Good practice on profound and multiple learning disabilities,
challenging behaviour, mental health, autism, workforce and offender
health.
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13. Top Target 2: LEAD: trish.wood@warwickshire.nhs.uk
Warwickshire  Integrated role of acute facilitator and health facilitator working to and rebeccahale@warwickshire.gov.uk
provide seamless services and care pathways within GP practices.
 Use of electronic health templates to record and cross-code Website: http://warwickshire.ldpb.info/
information. www.covwarkpt.nhs.uk
 Excellent training for GP’s and primary care staff delivered by peer
health group who utilise a role play approach to training.
Top Target 3:
 Health inequalities lead commissioned and in post; with lead for
safeguarding.
 Work around Six Lives workbook detailed and robust, with key
recommendations for acute trust.
Top Target 4:
 Well functioning reconfiguration health subgroup that feeds into the
Partnership Board.
 Engagement and partnership work with service users and carers.
 Carer demonstrator site.
Top Target 2: LEAD: kathy.roper@wolverhampton.gov.uk
Wolverhampton  Good practice learning from LES data initiatives.
 Identified GP champion to support learning disabilities.
 New project commissioned with local housing association to develop
Health Action Plans.
 Healthy Lifestyles Project – running in day centres to promote health
and wellbeing and tackle obesity by increasing exercise and
awareness of healthy choice among people with a learning disability.
 Use of technology to improve service delivery, including the provision
of Wii Fits within day centres.
 Oral health and learning disabilities project; collaboration between
PCT dental services and learning disability team to improve the oral
health of people with learning disabilities. Include production of easy
read service information, accessible oral health checklists and action
plans, training of “Oral Health Action Plans”.
 Collaborative work with Public Health; post filled to conduct health
screening for cardiovascular disease.
 End of Life care pathway training delivered to specialist health and
social care staff.
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14. Top Target 3:
 Audits conducted at acute trust and following an action plan has been
developed to respond to Healthcare for All.
 Accessible information produced with service users about making a
complaint. Regular meetings with acute trust to ensure complaints are
followed up and lessons are learnt.
 Excellent and varied approaches to addressing complaints,
safeguarding, Six Lives and Healthcare for All.
 Joint recognition by PCT and commissioning of the resources needed
to complete safeguarding investigations requiring nursing expertise,
for dedicated nurse practitioner time.
Top Target 4:
 Out of area placement work – links to Person Centered Planning and
transition planning.
 Autistic Spectrum Condition - Supported Living scheme.
 Proactive involvement of service users and family carers in the
planning, tendering and supporting delivery of services.
 Systems within acute trust to flag patients with a learning disability.
 Work around dementia, autism, challenging behaviour, mental health
and offender health offer good practice examples to service delivery.
Top Target 2: LEAD: rkrivosic@worcestershire.gov.uk
Worcester  Acute Liaison nurse role supports service delivery across the two
local acute hospitals, as well as hospital champions for learning Website: http://worcestershire.ldpb.info/
disabilities.
 A Healthy lifestyle course run for six-week healthy living programme
providing service users with practical information on how to make
healthy lifestyle choice – run by Speak Easy now.
 Associate Pacesetters site for cervical screening and testicular
cancer.
 Link nurses - providing a variety of support to primary care including;
maintaining a GP register of people with a learning disability, staff
training and advice regarding capacity and best interest
 Reducing health inequalities by joint working, improving
communication between local authority, NHS and acute services
through the production of…Draft health pathway, “My Hospital Book”
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15. and regular reporting against the 35 health standards.
Top Target 3:
 “Us and Our Health” project – produced a training DVD to be used as
a training resources designed to raise awareness and promote
discussions about health inequalities.
 “Learning from Complaints Process” is in operation with independent
advocacy support on behalf of people with learning disabilities.
 “Health checkers” – which involves people with a learning disability
auditing other people’s experiences of health services.
 Approach and model to safeguarding is comprehensive, covering
commissioning and contractual arrangements, training strategy and
hate crime.
Top Target 4:
 Care pathway approach for epilepsy management and challenging
behaviour.
 Work around transitions is comprehensive and links to their health
care pathway.
 Involvement of carers and “expert members” in recruitment and
selection of staff, health subgroup plan (“58 times more likely”),
assessment & treatment service redesign and the awarding of the
Learning Disability Development Fund (LDDF) in 2009/10.
 County-wide Challenging Behaviour Service and the Psychiatry and
Psychology services provide training and mentoring to Community
Service Providers to improve support to people who challenge. A
forensic care pathway has also been developed.
 Good practice examples in dementia, autism, mental health and
workforce planning are also demonstrated.
* Not validated, however areas of good practice were documented in SAF return.
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