Agenda item

Future Model for the provision of health services for people with Learning Disability/Autism

Report of Heather Burns, Deputy Director of Mental Health, Learning Disability, Autism and Dementia Transformation, NHS South Yorkshire Integrated Care Board.



The Sub-Committee received a report giving an update on the work that had progressed on developing a future model for the delivery of community and inpatient health services for people with a learning disability/autism, following changes in patterns of demand over the period of delivery of the national Transforming Care programme and to update the Sub-Committee on engagement and co-production to date in Phase 1 of the programme and the move to the phase 2 of this work.




Present for this item were Richard Kennedy, Engagement Manager, and Heather Burns, Deputy Director of Mental Health, Learning Disability, Autism and Dementia Transformation, NHS South Yorkshire Integrated Care Board).




Heather Burns said that the purpose of the report was to update Members on work that had progressed since their previous report in December, 2022 and this item overlapped from the previous item relating to Firshill Rise.  She said that due to the success of the Transforming Care Programme, the demand and need for inpatient beds has greatly reduced.  She referred to page 32 of the report which summarised the outcome from Phase 1 Engagement on the key issues and challenges.  She said the NHS South Yorkshire Integrated Care Board (NHS SYICB) had engaged with service users, families, carers and stakeholders in a person-centred way. Theyhad provided grants to two community organisations (Sheffield Voices and Sheffield Mencap and Gateway) to develop a set of open questions to promote meaningful dialogue on the issues faced.  She referred to the feedback received and said that full engagement reports could be shared by request.  The key themes arising from a series of events run by Sheffield Voices and Healthwatch Sheffield were that more work needed to be done to prevent people from reaching a point where they need to go to hospital and more support is needed from generic services. Some patients had a fear of being locked up or being sent away from their homes and their families.  Heather Burns said that information had been gathered through speaking with a large number of people and options had been developed.




Richard Kennedy referred to feedback received from 178 individuals overall, with 109 responses being from those with a learning disability and/or autism, which he felt showed strength and expertise.  He said the next stage was to inform NHS England of their progress.  He said taking account of the feedback received, all viable options would be considered and if it was deemed necessary, a further report would be brought back to the Sub-Committee to decide the next steps in the process.




Members made various comments and asked a number of questions, to which responses were provided as follows:-




·                Following the Panorama documentary showing an undercover operation which had been carried out at a secure unit run by Greater Manchester Mental Health Trust, highlighting a toxic culture and deficits in the system. The Transforming Change Programme is to improve health and care for everyone and have the robust scrutiny in place to check people’s placements. In response, Sheffield Health and Social Care Foundation NHS Trust recognised the role of leaders to prevent these cultures developing and to ensure good standards of care were maintained. 




·                There was a need to invest in Community Services, particularly with regard to providing better out of hours teams.  Work was being carried out to develop a step-down facility in order to prevent admission into care. If wraparound support was available, breakdowns would be prevented.




Councillor Ruth Milsom said that a public question had been received from Geoff South as follows:-




Firshill has always had good reports prior to this last one, it always had long waiting lists for admissions from many areas outside Sheffield. Our son Andrew had three stays with excellent outcomes. It has never been intended to be a Long-stay hospital, any cases of more than six months duration would be the result of a lack of suitable placements from care providers outside the hospital's remit, exacerbated by Covid restrictions and related staff shortages.


 We strongly believe that this hospital should be kept open to give people with learning disabilities who also suffer from severe mental health problems a compassionate and safe environment not available anywhere else.




In response, Heather Burns said that she thought that Mr South’s question probably related to an experience a number of years ago, as with regard to out of are waiting lists, this hasn’t been an issue for some time. Circumstances have changed dramatically and they are now looking at options with regard to community provision, the step up, step down facility mentioned earlier, and the availability of specialist clinicians.  Prevention work is key.




Andrew Weawood, Assistant Director of Adult Social Care referred to a recent case where someone with extreme mental health problems said been supported in an establishment out of the city, his family had been assisted with travel costs and now that he was back in Sheffield and had been supported by an Enhanced Framework Provider and to live and work in the city and had one to one all support and has a high quality of life.  These challenges can and do work and were available in Sheffield.




He said that there had been strong challenge on money from the NHS, particularly where there were people with lower care needs but these people still have life ambition and look for support and the local authority was getting to where it needed to be. With regard to carers, the local authority has pulled together small numbers of staff and was hoping to run some clinics over the next few months for carers with children in their 40s and 50s and support them through the life developments of their children and would be working through a supported plan of action be addressed in the next financial year.




Members made various comments and asked a number of questions, to which responses were provided as follows:-




·                There was a need for wraparound support to families, particularly for those whose children were older and had other children within the family and to offer some kind of enhanced community service to them.




·                Any options that come out of the process will have Equality Impact Assessment attached to those options and would expect that to be a fundamental part of it and be properly mitigated for, where possible.




Councillor Ruth Milsom said that a written summary would be sent to Mr. South in response to his question.




RESOLVED: That the Sub-Committee:




(a)      thanked Heather Burns, Andrew Weawood and Richard Kennedy for their attendance at the meeting;




(b)      notes the contents of the report; and




(c)      would receive a further update on the future options to the next meeting of this Sub-Committee.


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