Nottinghamshire Insight

Joint strategic needs assessment

Learning Disabilities (2019)

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Topic title Learning Disabilities (2019)
Topic owner Mental Health, Autistic Spectrum Disorders and Learning Disabilities Integrated Steering Group
Topic author(s) James Wheat
Topic quality reviewed January 2019
Topic endorsed by Mental Health, Autistic Spectrum Disorders and Learning Disabilities Integrated Steering Group
Topic approved by Health and Wellbeing Board March 2019
Current version March 2019
Linked JSNA topics

Executive summary

Introduction

A learning disability affects the way a person learns new things, understands information and how they communicate. Valuing People defined learning disability as:

  • a significantly reduced ability to understand new or complex information, to learn new skills (impaired intelligence), with;
  • a reduced ability to cope independently (impaired social functioning) which started before adulthood with a lasting effect on development

People with learning disabilities are among the most vulnerable in our society, generally having greater and more complex health needs than the general population, and often these needs are not identified or treated. Research shows life expectancy of people with learning disabilities is increasing, but is lower than the general population.

This chapter provides an insight into the prevalence of adults with learning disabilities living in Nottinghamshire. Using a variety of data sources it explores several interconnected areas including primary care health needs, accommodation status, assessed level of learning disability, mortality, employment and learning disability health checks. This chapter also gives an overview of current service provision and assets.

Diagnosis and prevalence

It is broadly estimated that approximately 2% of the adult population will have a learning disability, however a significant proportion of this group will not be known to health or social care services. Evidence shows estimates vary because many adults with mild learning disabilities do not use specialist learning disability services, and are unlikely to self-identify as having a learning disability.

Using POPPI and PANSI estimates, it is predicted the number of adults in Nottinghamshire with a learning disability is expected to increase from 15,227 in 2017 to 16,660 in 2035. The greatest increase in prevalence will occur within the 65+ age groups.

Unmet needs and service gaps

Transforming Care: The Transforming Care agenda remains a significant influence on the future provision and planning of services for people with learning disabilities. The development of community based services to enable people to be supported in or near their own communities remains an area for future development via the Transforming Care Partnership. It is important to note it is not necessarily about the creation of more services, but the development of different ones with enhanced skills and training.

Accommodation and Support: People with learning disabilities are less likely to be homeowners and more likely to live in places over which they have less secure tenure. Nottinghamshire County Council will continue to work with social, private and residential providers to support the availability of properties in areas where people feel safe and where they have access to support.

Continued work is also required to ensure that out of county inpatient or care home placements are necessary only in very exceptional circumstances.

Population Health: Breast cancer screening rates remain disproportionately low for people with learning disabilities. Type 2 diabetes rates remain higher for people with learning disabilities.

Employment: There is a need to ensure that people with learning disabilities have enhanced opportunities to gain skills and support, to get a job and remain employed.

Future service provision: There are known challenges with staff recruitment and retention within care and support services in Nottinghamshire. Provider training and resilience is being reviewed to support Nottinghamshire providers, ensuring there is adequate capabilities in the local workforce to support very complex needs.

The commissioning of an additional unplanned care bed is currently being reviewed.

Planning for transition services: Further work is required for people in transition when moving from Children’s to Adult services, to ensure the correct support and service are available to eligible adults.

Recommendations for consideration by commissioners

  Recommendation Lead(s)
1

Ensure that future strategies across a range of multi-disciplinary areas take into account the current and future needs of people with learning disabilities living in Nottinghamshire.

Local Authority, NHS Commissioner

2

Continue to monitor the overall picture of people in Nottinghamshire with learning disabilities through a range of methods, including Adult Social Care data, General Practice and comparators with regional and national benchmarks.

Local Authority, NHS Commissioners with oversight from the Health and Wellbeing Board

3

Identify a range of key stakeholders who will work towards maximising employment opportunities in Nottinghamshire for people with learning disabilities.

Adult Social Care Department, Local Authority working in partnership with voluntary and independent provider agencies

4

Through a joined up approach, ensure accessible health promotion and prevention initiatives are promoted and inclusive for people with learning disabilities living in Nottinghamshire.

Local Authority, NHS and Local Authority Commissioners

5

Further assessment is required on the needs of people with learning disabilities in the criminal justice system.

Nottinghamshire Police

6

Review the outcomes, learning and best practice identified within the Transforming Care Partnership and explore ways this learning can inform the planning of care and support for the wider learning disability population. This may include staffing models, effective training, effective environments and accommodation options.

Nottinghamshire Transforming Care Partnership

7

Continue to develop approaches to ensure health and care services are joined up to support people with learning disabilities, particularly during transitional periods between services.

Work in partnership to review health and social care funding arrangements to support early discharge from inpatient to care home settings.

Clinical Commissioning Groups, Local Authority

8

Further develop the LeDeR programme to increase the number of reviews undertaken.

LeDeR Steering Group

9

Ensure that future service development and provision embrace the views of people with learning disabilities and their carers through a range of methods, including the Learning Disability Partnership Board.

NHS and Local Authority Commissioners, in partnership with stakeholder groups including LDPB and Carers Forum

10

Where possible, ensure that future services are organised around intended outcomes that will be defined by evidence of need and local priorities – ensuring a range of stakeholders are involved in the co-design and co-production of provision.

NHS and Local Authority Commissioners, Voluntary and independent sectors

11

Explore methods to increase the uptake of learning disability health checks within the worst performing geographic areas in Nottinghamshire.

Clinical Commissioning Groups

Key contacts

James Wheat (Commissioning Officer, Adult Social Care and Health)

Mercy Lett-Charnock (Commissioning Manager, Adult Social Care and Health)

This is an online synopsis of the topic which shows the executive summary and key contacts sections. To view the full document, please download it.

Full report »