Introduction of Health Equalities Framework Integrate HEF into

Introduction of Health Equalities Framework & Integrate HEF into NHS A&A Electronic System Steve Wright CLDT Team Leader

PWLD & Health Inequality • People with learning disabilities have a range of health differences in comparison with the general population. • PWLD can die earlier than is necessary and when experiencing poor health suffer a greater impoverishment of quality of life than their non -disabled peers. • These differences in outcome compared to the general population are, to an extent, preventable and unjust; as such they represent an example of health inequity.

HEF Development • The HEF was initially developed by the UK LD Nurse Consultant Network in response to a request from the Department of Health • Winterbourne, Death by Indifference, Confidential Inquiry into premature deaths: overwhelming evidence of inequalities • Increase focus on outcomes within policy • Increase focus on equalities in legislation and public health • Changing commissioning structures

What is the HEF Health Inequality Indicators: Consider the impact of exposure across 29 indicators to the 5 determinants Focuses on 5 known determinants of health inequalities: Social, Genetic & biological, Behaviour, Communication & health literacy, Service access/quality (Emerson & Baines 2010) • Evidence based outcome measure framework that can be completed electronically to record any work learning disability clinicians undertake to improve or stabilise the health and well being of pwld • Measures the contribution of learning disability services by reducing exposure to known determinants of health inequality: clinicians complete a before and after measure in relation to any service. • It is intended to compliment exiting interventions and context specific assessment and outcome tools

What Does the HEF Do? • The HEF will show the difference support is making to the health and wellbeing of people with learning disabilities • It helps us to make decisions about when and where we need to focus care and support/care planning • Allows us to look at individuals and populations • Provides information which can inform caseload management, strategic planning, skill mix and training & development • Informs commissioning decisions • Informs public health strategy • Demonstrates the efficiency and efficacy of learning disability nursing and other practitioners (provides performance data)

Stage 1 • Raise awareness of HEF within the Learning Disability Services: 3 Community Teams and an Assessment & Treatment Unit • Trial the use of HEF initially on Excel tool provided

Stage 2 • Consult with FACE/Care Partner Team to get HEF coded onto electronic health records • Pilot use of HEF on Care Partner: Every nurse completed a HEF on two clients and then after a few months or on discharge complete a second • Assess reporting software to ascertain if the results meets expectations

Current Stage • Everything on schedule until. . .

Future Plan • Meet with FACE/Care Partner Team and discuss how to progress. • If moving forward with HEF on FACE/Care Partner is not an option then reverting to Excel (free tool) may be the option.

Any Questions?