Agenda item

Purpose of the report: To review and scrutinise plans for the new Learning Disabilities and Autism Service.

Witnesses:

Karl Atreides, Chair, Independent Mental Health Network

Steve Hook, Assistant Director of Disabilities, Autism & Transition

Jonathan Lillistone, Assistant Director of Commissioning (Adult Social Care)

Nick Markwick, Co-Chair, Surrey Coalition of Disabled People

Sinead Mooney, Cabinet Member for Adults and Health

Kate Scribbins, Chief Executive Officer, Healthwatch Surrey

Simon White, Executive Director of Adult Social Care

Patrick Wolter, Chief Executive Officer, Mary Frances Trust

Fiona White left the meeting at 1:56pm.

Clare Curran left the meeting for discussion of this item.

Key points raised during the discussion:

1. The CEO of Healthwatch Surrey asked how effective the LD Partnership Board, Autism Partnership Boards and Valuing People Network groups were at engaging with residents and gathering a diverse cross section of views. The Assistant Director of Disabilities, Autism & Transition said that the Council was commissioning Voluntary Action Surrey to work with the Council on its communications and engagement plan. This piece of work would go out to the Valuing People Network groups; however, because of the pandemic it had moved more slowly than initially anticipated. There was also a reference group and delivery group with some providers, and the lead for that network was Maria Mills, the CEO of disabilities organisation Active Prospects.
2. The Assistant Director of Disabilities, Autism & Transition confirmed that the Valuing People Network included mental health representatives.
3. A Member highlighted that the proportion of people with LD receiving annual health checks was lower in Surrey than in many other parts of the country. She emphasised the value of these checks but said that publicity was poor, and suggested that the annual health check could be included as part of the Education, Health and Care Plans that people with LD already received in order to increase take-up of the checks. Members emphasised the importance of publicising these checks, both to encourage GPs to offer them and to encourage public take-up. The Assistant Director of Disabilities, Autism & Transition replied that the responsibility for annual health checks lay with GP practices, who were paid for offering extra services through the Direct Enhanced Service (DES) system. For example, GP practices were given higher DES payments for offering appointment slots longer than the usual 10 minutes to patients with LD. He acknowledged that the health checks could make a significant difference, and that there was room for improvement when it came to Surrey’s performance on providing the checks. Therefore, the Council had employed two health facilitation workers, who would work with GPs to encourage, upskill and train them in order to increase the number of people with LD and autism receiving health checks every year. It was important to target people living at home with their families or in supported living, for whom the rate of uptake for health checks was particularly low.
4. A Member commented that the report did not give a sense of dealing with the transition from children’s to adults’ LD and autism services. The Assistant Director of Disabilities, Autism & Transition responded that ASC was working with colleagues in Special Educational Needs and Disabilities (SEND) and children’s disability services. Transition was not mentioned in the report as the report dealt with the Select Committee’s remit of adults’ services, but the Council did want to smooth the pathway from children’s to adults’ services and would be setting up a pilot this year to start working with young people from the age of 16 onwards (not 18 onwards, as it had been).
5. The Assistant Director of Disabilities, Autism & Transition explained that the latest autism strategy was an all-age strategy with a steering group, and the recently released autism survey was a small part of the overall consultation programme. Members commented that the mental health-specific questions in the survey should be worded in a way that was clearer to people with LD and/or autism, and the Assistant Director of Disabilities, Autism & Transition agreed to look at that in more detail. He also acknowledged the need to improve Surrey’s performance on supporting people with LD to find employment.
6. A Member said that there had long been a separation of LD and mental health, even though they might be linked. Children’s and adults’ mental health services were often treated separately; there was a need for more joined-up working across mental health services. Moreover, there should be increased levels of staffing to support employability services for people with LD and autism, including those on the lower end of the LD and autism spectrum. The Assistant Director of Disabilities, Autism & Transition responded that since mental health locality teams had been brought back into the Council due to the end of the Section 75 agreement, there was an opportunity for greater collaboration between LD and mental health services; for example, staff could cross over between the two services. The Deputy Director of ASC echoed the Assistant Director’s comments and added that in order to prevent young people from falling between two stools in the transition from children’s to adults’ services, the Council had established a new process.

David Mansfield left the meeting at 2:34pm.

7. The CEO of Mary Frances Trust stated that the GPIMHS were helpful but were still only in pilot stage so were only available in certain areas. It was important that physical health needs for people with LD and autism were met, as well as mental health needs.

Recommendations:

The Select Committee:

1. Welcomes the progress made by the Learning Disability and Autism Service to date and supports its plans for the future;
2. Recommends that annual health assessments are more focused on unearthing mental health issues, which can have physical manifestations;
3. Recommends that greater emphasis is placed on the transition period and that the steps taken to address this are outlined in a follow-up report;
4. Recommends that officers explore the inclusion of KPIs on to the Select Committee’s performance dashboard to monitor future progress.