Commissioning for people with challenging behaviour Ben Dyson

Commissioning for people with challenging behaviour Ben Dyson Director of Primary Care Department of Health

Health and people with learning disabilities Closing the Gap (Disability Rights Commission) Death by Indifference (Mencap) Healthcare for All (Sir Jonathan Michael) Six Lives (Parliamentary and Health Service Ombudsman + Local Government Ombudsman)

Valuing People Now Learning Disability Programme Board Valuing People Now Healthcare Steering Group

Health and people with learning disabilities • Some progress made: – Annual health checks – Confidential Inquiry and Public Health Observatory – Better leadership at a local, regional and national level – Better engagement of people and families through processes like the health self assessment framework • But much work is still needed

Commissioning • Understanding people’s health needs • Deciding what services best meet needs • Creating a specification for services • Establishing and holding contracts • Monitoring quality of services provided

Commissioning • Currently, healthcare commissioning is carried out by PCTs • Weaknesses identified in White Paper: – Too remote from people, patients and communities – Divorced from clinical decisionmaking – Too driven by top down targets – Creates unnecessary layers of bureaucracy

NHS White Paper • Putting patients first: more information and greater choice and control over their care – ‘no decision about me without me’ • Improving healthcare outcomes: giving professionals freedom to focus on improving outcomes so that these are amongst the best in the world • Autonomy and accountability: involving giving power back to NHS professionals and healthcare providers, giving them more autonomy and, in return, making them more accountable to patients and the public • Cutting bureaucracy and improving efficiency by continuing to reinvest savings of up to £ 20 bn

NHS White Paper • GP commissioning consortia • NHS Commissioning Board • Abolition of PCTs and SHAs • Stronger role for local government • Health. Watch

Proposals for GP commissioning • All GP practices to become part of ‘Commissioning Consortia’ • Responsibility for commissioning the majority of NHS services • Would decide what functions to carry out themselves, what to do collaboratively, and what to do through external support

Proposed duties on consortia • Improving outcomes • Managing resources • Promoting equality • Public and patient involvement • Partnership with local government • Multi-professional involvement

Issues to consider • Leadership • Building on what works, changing what doesn’t • Partnerships and behaviours • Relationship with local government • Information for good commissioning

Next steps… • Consultation on NHS is open until October 11 th • Need your views on how to make sure the proposals will work for people with challenging behaviour www. dh. gov. uk/liberatingthenhs