This report will be provided by Rebekah Bailie, Essex County Council

A report and accompanying documentation is included within Member’s papers to support this item

This item was introduced by Rebekah Bailie, LD Health Commissioner, Essex County Council.  Key points included:

·         People with learning disability across Southend Essex and Thurrock die on average 20 years younger than other people in the population and experience health inequalities which impact on their quality of life.

·         Between the beginning of the programme in SET and the end of the 19-20 year there were 272 deaths of people with Learning Disability. At the end of March 137 reviews had been completed with 318 recommendations identified. (These are summarised by organisation and cross-system issues in the LeDeR Themes document)

·         Pneumonia is the leading direct cause of death (on part 1a of a death certificate) often as part of a pattern of early frailty and deterioration (45 years onwards). Aspiration pneumonia (caused by swallowing difficulty) was the second cause and cancer the third. Underlying cardiac issues were prevalent and need further investigation.

·         More people with learning disability die in hospital than in the rest of the population and there needs to be earlier and better end of life planning.

·         We have a small number of people from BAME backgrounds and need to have better understanding and representation of issues which impact. All but one of the BAME deaths were of children.

·         Most care was good or satisfactory. There are some examples of excellent care, but a similar level of very poor care which impacted on the death. We need more established processes to alert quality and safeguarding issues to councils and CCGs.

·         318 recommendations have been made and it is important to understand all of the recommendations.  Four themes have been identified comprising Annual health checks frailty dynamic support and case management 

During discussions the following points were made:

·         Learning disabled – substantial backlogs in NHS regarding cancer treatment.  Members agreed that there is a need to ensure that the learning disabled are not over burdened by delays in accessing care due to COVID-19.  It was agreed that consideration should be given to how implications of health decisions are explained to people. 

·         LeDeR has been very positive on raising awareness and highlighting challenges experienced by people with a Learning Difficulty.  There were improvements being made regarding health action plans.  It was recommended that HWB considers a more comprehensive overview about our strategic thinking regarding learning disabilities at the meeting scheduled for January 2021.  

·         Members welcomed the significant work undertaken on LeDeR and acknowledged that the reduction in sepsis may be a result of training programme provided to carers

·         Reasonable adjustments and communications.  It was agreed that Patricia would engage the patient group to consider how people with learning disabilities can be effectively communicated with and engaged.

Action Patricia Dorsey

·         Annual health checks were recognised as important.  LD health checks are now being prioritised following Simon Stephens phase 3 letter.

·         During the first wave of COVID a patient list was compiled whereby some people have poorly managed health conditions – GP’s were effectively supporting people who did not wish to attend hospital.