Developing ICT skills and networks of support.
Last week the Department of Health introduced their largest ever piece of health legislation with the arrival of the Health and Social Care bill. At over 200 pages long, the bill sets out the government’s ambition to transform the way in which the NHS in England buys health services (called commissioning) and is held to account by local people. So what are the main changes and what might they mean for people with a learning disability?
At the national level, the Secretary of State for Health, Andrew Lansley MP, is looking to reduce direct political involvement in the day to day running of the NHS. Many of the big decisions will be taken by the new independent NHS Commissioning Board. The board will also be responsible for commissioning primary care (ie General Practice) and more specialist services – typically for conditions that are more rare.
At the local level, Primary Care Trusts and Strategic Health Authorities are being abolished, with the vast majority of services now being commissioned by groups of General Practitioners (called GP consortia). Each part of England will have its own consortia. GP consortia will also have a responsibility to work closely with local authorities, to ensure that health and social care are properly joined up.
Given that many of the issues around health are relevant to all people with a disability, Mencap is working with a coalition of 15 disability charities and Royal Colleges to ensure that the needs of all disabled people are met in this new bill.
Particularly in an era where budgets are tight, Mencap is looking for reassurance that both the board and consortia will continue to deliver good health services to those with the most complex needs, such as those whose behaviour is challenging or who have profound and multiple learning disabilities. This is important as GPs often haven’t understood how to deliver excellent health to people with a learning disability.
A June 2010 survey of 1,000 healthcare professionals, commissioned by Mencap found that GPs did not understand how to make reasonable adjustments to their work when dealing with patients with a learning disability. Mencap will be looking for reassurance that this will be addressed.
Another key factor is how to enable patients with a learning disability, their families and carers to make meaningful choices about which services to use. The only way for a patient to be able to compare Service A vs Service B, is by collecting data on the health outcomes delivered by each service. To be meaningful to people with a disability, Mencap are also arguing for the data to be broken down by each disability.
Finally, the new bill sets out how local people will be able to hold the new NHS structures to account. A new body will be established called Local Healthwatch, in each local area. The body aims to act as a Consumer Champion and Mencap is pushing to ensure that each of the new bodies have a duty to consult disabled people, given their specific needs and the proven health inequalities that exist.
Let us know what you think of the planned changes to the NHS.