The ‘Commissioning for Quality Learning Disability Health Self Assessment Framework’ is a single delivery system for PCT/ clusters, in partnership with the Local Authorities, to assure Strategic Health Authorities and Department of Health on the following:
1. Key priorities in the Operating Framework 2012/13 apply to people with learning disabilities:
- Improve quality of basic care for older and vulnerable patients
- Maintain strong grip on performance including finance and key quality measures
- Meet the ongoing quality and productivity challenge
- Make the transition into the new health and social care system
2. Key levers for the improvement of health services for people with learning disabilities mandated through the Operating Framework are the:
- Equality Delivery System
- Safeguarding Adults at Risks requirements
- NHS outcome framework
3. Progress Report on Six Lives and the provision of public services for people with learning disabilities.
4. Responding to the National Review following the abuse uncovered in Winterbourne View and the subsequent CQC inspection of Assessment and Treatment Units.
The Self Assessment Framework and subsequent improvement plans will ensure a targeted approach to improving health inequalities. A simple public health model (Lalonde’s health field 1994) highlights that people with learning disabilities are disadvantaged in all four domains and experiencing poorer health than the non-disabled population, because of:
1. Greater risk of exposure to social determinants of poorer health such as poverty, poor housing, unemployment and social disconnectedness.
2. Increased risk of health problems associated with specific genetic, biological and environmental causes of learning disabilities.
3. Communication difficulties and reduced health literacy.
4. Personal health risks and behaviours such as poor diet and lack of exercise.
5. Deficiencies relating to access to healthcare provision.
People with learning disabilities are 58 times more likely to die before the age of 50 than the general population (Hollins et al 1999)
There a numerous reports on the Improving Health and Lives (IHAL) website about the health and well being of people with learning disabilities.