AQW 51770/11-16 Written question to the Minister of Health, Social Services and Public Safety
To ask the Minister of Health, Social Services and Public Safety for an update on the implementation of action plan recommendations as set out in the Bamford Review Equal Lives report on learning disability.
Asked by Claire Sugden MLA on 1 December 2015
- Answered
- Written
- After due date
- Tabled
- 1 December 2015
- Answer due by
- 16 December 2015
- Answered
- 17 December 201516 days after tabling
- Department
- Department of Health
- Priority question
- No
Answer
The Bamford Review, including the recommendations of the Equal Lives report, is being taken forward through the implementation of the current Bamford Action Plan 2012-15.
Progress of the Bamford Action Plan is monitored by the Bamford Inter Departmental Senior Officials Group biannually. The last monitoring round was in October 2015, and the position on the learning disability actions and joint mental health / learning disability actions is detailed at Annex A.
A comprehensive evaluation of the Action Plan is underway and will be completed by Spring 2016.
ANNEX A
PROGRESS AGAINST BAMFORD ACTION PLAN 2012-15 AT OCTOBER 2015:
LEARNING DISABILITY AND JOINT MENTAL HEALTH / LEARNING DISABILITY ACTIONS
| Action No. | Key Action | RAG rating | Progress at October 2015 | |
| 1 | Publish and implement a revised cross-sectoral promoting Mental Health Strategy (DHSSPS) | AMBER | The New Protect Life Strategy is being substantially re-drafted into two parts: 1 - frontline intervention/postvention; 2 – early intervention. Part 1 of the document recently issued to stakeholders for pre-public consultation comment. These amendments are currently being reflected in the document. Consultation will take place in early 2016. | |
| 2 | Develop final proposals for Early Years Strategy (DE) | GREEN | This action is completed. 'Learning to Learn - A Framework for Early Years Education and Learning' was published on 7 October 2013. The overall policy aim of Learning to Learn is that all children have equal opportunities to achieve their potential through high quality early years education and learning experiences. Full implementation to be achieved by 2015/16. The implementation of actions which require legislative change may be delayed. | |
| 3 | Implement a 10 year Strategy for Sport and Physical Recreation (DCAL) | GREEN | ‘Sport Matters’: The Northern Ireland Strategy for Sport and Physical Recreation, 2009-2019' was launched in 2010 and is live until 2019. In 2013, DCAL and Sport NI delivered a pilot programme, ‘Mental Health and Well-being in Sport’ to support the Public Health Agency (PHA) in raising awareness of mental health, break down barriers and perceived stigma within sport on the subject of mental well-being. Funding the Mental Health and Well Being through Sport pilot programme enabled engagement with 5 Governing Bodies of Sport (GBs) and as a result there have been two phases of the programme reaching 85 selected clubs from areas of high social need and within the existing five governing bodies. Additionally, PHA partnership investment enabled Sport NI to deliver 75 mental health awareness training sessions (delivered by Mindwise and Aware Defeat Depression). Reflecting the commitment by Sport NI to further developing mental health and well-being within sport, the following actions will be taken forward by Sport NI in the short to medium term:1. Appoint a lead Sport NI officer for Mental Health and Wellbeing In and Through Sport who is responsible for both the strategic direction and operational aspects. (Oct 15)2. Sport NI to ‘sign up’ to the Mental Health Charter for Sport created and launched by Sport and Recreation Alliance (SRA) in 2015. (Nov 15)3. Establishment of a Mental Health and Wellbeing In and Through Sport Strategic Steering Group involving all relevant statutory and voluntary partners. (Jan 16)4. Completion of a desk based review of relevant policies, strategies and interventions that have used ‘Sport’ as a tool for promoting Mental Health and Wellbeing In and Through Sport. (April 16)5. Development of a Mental Health and Wellbeing In and Through Sport Action Plan with an associated research monitoring and evaluation framework. (Oct 16) | |
| 4 | Promote an anti-bullying culture within the schools in partnership with the NI Anti-bullying Forum (DE) | GREEN | DE continues to work with NI Anti-Bullying Forum (NIABF) to promote an anti- bullying culture in schools. A wide ranging joint DE / NIABF work programme has been agreed. The Education Minister announced on 23 June 2014, his intention to introduce new Anti-Bullying Legislation in the current Assembly Mandate. The proposed legislation will provide a common definition of bullying; require all schools to centrally record incidents of bullying, their motivation and their outcomes; and require Boards of Governors to play an active role in the preparation and implementation of anti-bullying policies and measures within the school. A draft Bill has now been agreed and confirmation of legislative competence is being sought from the Departmental Solicitors Office and the Office of the Attorney General. The Minister is currently seeking Executive consent for its introduction to the Assembly. It remains the intention for the Bill to complete its legislative passage before the end of the current Assembly Mandate. | |
| 5 | Ensure that persons with a learning disability have equal access to the full range of primary health care services (DHSSPS / HSCB) | GREEN | Learning Disability Directed Enhanced Services (DES) has been implemented with the aim of ensuring that all adults with a Learning Disability have annual physical and mental health checks and follow up by a health promotion nurse if required. The majority of GP practices are signed up but a few remain outside of the DES. An Evaluation report of the DES was completed in 2014 and 3 forums have been established to take forward key improvements. | |
| Action No. | Key Action | RAG Rating | Progress at October 2015 | |
| 12 | Publish a strategy for the implementation of recommendations arising from the PSI report on Disability. (OFMDFM) | GREEN | This action is complete. This strategy was launched in February 2013. The Strategy was due to run until 2015; however in May 2015, the Executive agreed to extend the life of the Strategy until March 2017. http://www.ofmdfmni.gov.uk/disability-strategy-2012-2015-revised-010313.pdf | |
| 13 | Resettle long stay patients from learning disability and mental health hospitals (DHSSPS / HSCB) | AMBER | The March 2015 target date was not met, but resettlement is progressing. A small number of supported living schemes are still to be opened. Progress to date: Mental Health – 2007 Primary Target List for resettlement – 472. Currently 19 people remain in hospital. Most of these are planned to be resettled, with a small number (7) remaining in hospital for treatment or are legal challenging resettlement. Learning Disability – 2007 Primary Target List for resettlement – 347. Currently 26 people remain in hospital. Most of these are planned to be resettled, with a small number (3) remaining in hospital for treatment or are legal challenging resettlement. | |
| 14 | Scope existing supported housing capacity / suitability to maximise resources (DSD) | GREEN | Completed. This action is linked to action 15 in relation to new build and 'off the shelf' purchase. As part of the Social Housing Development Programme (SHDP) the Department, in conjunction with the NIHE, routinely and regularly examines the suitability of existing supported housing capacity to meet identified need. | |
| 15 | Ensure new build supported housing programmes are ‘future proofed’ to ensure longevity/sustainability in terms of the tenants. (DSD) | GREEN | Completed. The DSD Housing Association Guide includes specific detailed design standards for Housing Associations who deliver new supported housing. The Guide is updated as required. This ensures all new social housing adheres to Building Regulations and Lifetime Homes standard. | |
| 16 | To support and develop the Employment Advisor Teams to deliver services to people with mental ill-health or a learning disability. (DEL) | GREEN | Disability Employment Service, in partnership with Regional Learning and Development, local disability organisations and staff from the Health Trusts continues to provide training, coaching and other development to help the Employment Service Advisers provide support to this client group. | |
| 17 | Maintain support arrangements and extended eligibility for participants with disabilities on the Training for Success programme. (DEL) | GREEN | Ongoing. DEL provides a guaranteed training place on its Training for Success (TfS) programme for all unemployed young people in the 16-17 age groups (including those with special educational needs). The programme also provides extended eligibility for those with a disability up to age 22. Disability support services, delivered based on identified needs, include: participant coaching/mentoring, interpreter services and disability awareness training. | |
| 18 | Widen Participation in Higher Education Strategy. (DEL) | GREEN | Significant progress continues to be made on a range of Key Actions in Access to Success. The "Reach Higher" HE awareness and aspiration raising campaign continued during September 2014 with the focus on digital advertising. It re-commenced in November 2014 through to early December with a focus on TV, Press, outdoor media and digital advertising. Following a break for Christmas outdoor media activity began again in mid January 2015 this coincided with radio and online advertising. There was a further burst of TV advertising in Feb and March 2015. Most HE providers have approved Widening Access & Participation Plans (WAPPs) in respect of the 2015/16 academic year in place. All providers identified students with a disability as a target group with interventions planned to improve enrolments, retention and success of these students. When the outstanding WAPPs are approved, institutions will be invited to submit for approval their WAPPs for 2016/17. Project teams have been set up to work on the identification of students with multiple barriers to participation in HE and the development of exceptional routes of HE application by students from disadvantaged backgrounds including students with disabilities. | |
| 19 | Establish and progress effective Partnership Agreements and joint working arrangements with post-primary schools, further education, training and apprenticeship providers, HSC Trusts and organisations who act as advocates for young people with a variety of barriers, including disabilities. (DEL) | GREEN | On Target: Partnership Agreements and service delivery were evaluated and reviewed with all post primary schools during 2013/14. Review and agreement of 2014/15 PAs currently underway. Target to have 98% of partnership agreements with schools agreed by end of October 2014 was achieved. Partnership Agreements are also in place between the Careers Service and further education and training suppliers, HSC Trusts and organisations who act as advocates for young people with a variety of barriers, including disabilities. | |
| 20 | Lead on the implementation of a cross-departmental Strategy - "Pathways to Success" - for those young people Not in Education, Employment or Training (NEET). (DEL) | GREEN | Local Employment Intermediary Service has exceeded target with 1,080 NEETs case loaded (41.6%) and at the end of January 2015, 424 individuals (39.25%) moved into positive destinations. The Community Family Support Programme aims to support 720 disadvantaged families that include NEETs and potential NEETs between November 2013 and March 2015. To date 480 families have been supported in cycle 1&2 and the additional 240 families are due to commence the programme on 29 September 2014. The Collaboration and Innovation Fund had supported 3,910 young people by the end of August 2014 and moved 1296 (52%) of those leaving the programme into positive outcomes of employment, education and training. Programme on target. | |
| 21 | To develop Careers Service delivery to support the above mentioned "Pathways to Success" Strategy (for NEETs). (DEL) | GREEN | On Target: The Careers Service continues to support all 16 and 17 year olds who are not in education, employment or training (NEET). At the 2nd January 2015, 573 16 and 17 year olds were being actively case managed by Careers Advisers. | |
| 22 | Continue to work in partnership with DE to increase the level of information sharing in respect of relevant pupil data being shared with DEL's Careers Service including electronic sharing of pupil data via C2K. (DEL/DE) | GREEN | On Target: Data Sharing Agreements reviewed with DE during August 2014. Revised agreement now in place for 2014/15 academic year. Electronic transfer of pupil data for 2014/15 Year 10 cohort is currently being tested for transfer, with plans for the details of approximately 24,000 pupils to transfer directly from C2K to CMS. Careers Service is currently working with C2K to progress the electronic download for the 2015/16 academic year. | |
| 23 | Continue to provide specialist support, as appropriate, for young people considering participating in Training for Success (TfS). (DEL) | GREEN | Provision of appropriate targeted support is ongoing. DEL provides Pre-Entry Training Support referral for school-leavers with a disability. These young people are referred by Careers Advisers to receive specialist support by providers specialising in disability and learning support. This process aims to ensure that support needs in training are identified and put in place as soon as possible after commencement of training. | |
| 24 | Incorporate provision within the design of the new Work Connect Programme to meet the employment needs of those who are claiming Employment Support Allowance and who have mental ill- health and learning disability. (DEL) | GREEN | Since the launch of the Work Connect Programme 441 (44%) of the 999 starts have Mental ill-health disability. 63 (6%) people have a Learning disability and 31 (3%) have Autistic Spectrum Disorder. Of those who have started the programme 141 (11%) have found employment. 121 (86%) of these have Mental ill-health, 15 (11%) have Learning disability and 5 (3%) have ASD. | |
| 25 | To support the uptake of self-directed support and individual budgets in line with Transforming Your Care (DHSSPS) | AMBER | “Who Cares?” the first stage of the reform of adult care and support was published in September 2012. The document states the need for care and support to be personalised to individual need and focuses on the concept of personalisation. Future policy direction on self-directed support will flow from the Reform of Adult Social Care, but has been delayed due to difficulties in securing resources for the financial modelling work. It remains the intention to launch consultation on a stage 2 proposals paper in Spring 2017. However, the roll-out of self-directed support by the HSCB is ongoing and the number of people with self-directed support continues to increase. Mental Health has seen an increase of 34% from 2012/13 to 2014/15 and Learning Disability has seen an increase of 39% for the same period. | |
| 26 | Take forward and implement Review of Special Educational Needs & Inclusion (DE) | GREEN | The Special Educational Needs Review proposals relate to all young people with special educational needs, as defined in the 1996 Order, regardless of the particular need. If a child, up to age 19, as a result of mental ill health or a learning disability has special educational needs, then the new framework will include them. The Minister’s policy proposals were accepted by the Executive in July 2012. The Education Committee completed its clause by clause scrutiny of the SEND Bill on 14 October and expects to finalise its report on the Bill in early November. Once the SEND Bill leaves Committee Stage the desire is to move to Consideration Stage as soon as possible thereafter. The new SEN framework will be delivered through a number of elements: the SEND Bill; new SEN regulations; and new Code of Practice. While progressing the SEN Bill in the current Assembly's mandate is the priority, it is intended to carry out engagement with key stakeholders in the coming months and then formal consultation early 2016 on the SEN regulations and Code of Practice. | |
| 27 | Implement "Developing Advocacy Services - A Policy Guide for Commissioners" (DHSSPS) | GREEN | An Independent Advocacy Code of Practice and Standards Framework was launched in June 2014. Members of the Advocacy Network NI have committed to the code of practice and are using it as part of their induction and training programmes for new staff and volunteers. An RQIA Review is underway and any recommendations will be considered for action. | |
| 28 | To support the employment of experts by experience in the commissioning and delivery of mental health and disability services. (DHSSPS) | GREEN | Current Bamford Structures, including the Programme Board and the Learning Disability sub group have parents and carers representation, who contribute to commissioning decisions. 18 Peer Support Workers are now employed across the 5 HSC Trusts. | |
| 29 | Investigate how information provision on transportation issues can be improved for people with learning disabilities. (DRD) | GREEN | The refreshed Travel Safe Guide was published in June 2014 and continues to be issued to voluntary groups, learning disability groups and schools. Translink have reviewed their access guide which is available on the Translink website http://www.translink.co.uk/accessibility/translink-access-guide/ and at Translink Stations. | |
| 30 | Examine options for improving the provision of travel training schemes. (DRD) | GREEN | The Transport Buddy pilot scheme has been evaluated and recommendations have been made for a future roll-out of the scheme. A decision in respect of the Transport Buddy Scheme evaluation is still under consideration. | |
| 31 | Review the training of staff to ensure that its content covers the needs of people with a learning disability. (DRD) | GREEN | Ongoing programme of Diversity Now training to DRD staff. Ongoing Programme of Disability Awareness Training is available to all NICS staff. Ongoing programme of MIDAS Training (Minibus Driver Awareness Scheme) to drivers which includes Disability Equality Training. Translink provides an ongoing training programme to staff to deal with passengers with learning disabilities, with input from the NOW Project and Mencap. Translink have provided training to 1720 drivers which covers hidden and learning disabilities and dementia. | |
| 37 | Enhance the arrangements to meet demand for respite including emergency respite and short break care (DHSSPS) | GREEN | Provision of respite is based on a carers assessment, the range and choice of respite has been extended and improved. Mental Health Short Break hours have increased from 110,003 to 146,737 from 2014 to 2015. Learning Disability short breaks have increased from 1,107,215 to 1,234,856 from 2014 to 2015 NB These figures exclude Day Care. | |
| 38 | To provide support to all carers in order that they may continue in their caring role. (DHSSPS) | AMBER | The HSCB is striving to ensure that all carers are offered a carers assessment. The number of carers assessments offered has increased by 27.5% from 2012/13 to 2013/14. There has been an increase of 19% in the numbers of carers offered assessment across both Mental Health and Learning Disability Programmes of Care between 2013/14 and 2014/15. However whilst the numbers of carers assessments are increasing, the target of all carers is unlikely to be achieved as some carers do not wish for an assessment to be completed. | |
| 39 | Carry out a scoping exercise to ascertain future caring requirements for people with a learning disability living with elderly carers where there is a risk of a breakdown in caring arrangements and develop a rolling costed plan to support them. (DHSSPS/DSD) | GREEN | Research is currently underway into the future care needs of older people with a learning disability and their families and carers. A plan which will consider both housing and care elements will be developed in conjunction with DSD. A scoping exercise for those carers of people with learning disabilities who are 55 years old and above was completed. A second scoping exercise has been completed by the 5 HSC Trusts looking at carers of individuals who are 35 - 54 years. £2M recurrent funding (£1M part year funding in 2015/16) has been secured to develop services to meet this need. | |
| 40 | Monitor/review departmental capital budget (DHSSPS) | GREEN | Ongoing - Mental Health and Learning Disability policy leads regularly liaise with relevant branches within the Department on proposed and current capital schemes. | |
| 41 | Complete research into priorities highlighted by Bamford rapid reviews (DHSSPS) | GREEN | All the priority research projects are underway, led by the Public Health Agency, and involving universities, HSC organisations and PPI representatives. The results from the first project, “Parental Alcohol Use and Resilience in Young People in Northern Ireland: A study of Family, Peer & School Processes” has completed and the final report has now undergone peer review. Results will be disseminated at an event with key stakeholders in early 2016. http://www.publichealth.hscni.net/publications/bamford-rapid-reviews | |
| 42 | To ensure Personal and Public Involvement, (PPI), in planning, commissioning, delivery and evaluation of services in line with guidance. (DHSSPS) | GREEN | DHSSPS issued guidance on effective PPI implementation in Sep 2012. Implementation of this guidance is being led by the PHA through the Regional PPI Forum. | |
| 43 | To carry out a qualitative research study into our customers who have a disability to allow us to obtain an insight into the thoughts and behaviours of this specific group of customers. (DSD) | GREEN | The research has been completed and published by DSD in December 2013. http://www.dsdni.gov.uk/dla_and_aa_-the_impact_of_the_benefits_and_an_exploration_of_dla_and_work.pdf | |
| 44 | To develop and implement a strategy for increasing the uptake of benefits. (DSD) | GREEN | Maximising Incomes & Outcomes is a 3 year plan for improving the uptake of benefits (2013 - 2016). Year 2 has been completed and results will be published after Ministerial approval is given. Year 3 is well underway and plans are in place to devise a new strategy for Benefit Uptake commencing April 2016. | |
| 45 | To work in Partnership with organisations and government departments which are impacted by Universal Credit. (DSD) | GREEN | Various governance structures have been established to include all organisations impacted by Universal Credit in the development of customer journeys, planning and communications. There is also ongoing consultation between relevant Departments to define eligibility for other benefits that are available to those in receipt of Social Security benefit, for example, free school meals. These are known as ‘passported’ benefits. Work is on-going but has been delayed due to uncertainty around the Welfare Reform Bill. | |
| 46 | To improve access to advice and information on services and support available. (DHSSPS) | GREEN | Mental Health web portal was launched by NI Direct in April 2015. Amendments to the Family Support Network have been completed for CAMHS. The Mental Health web portal went live 01/04/2015. A Learning Disability web portal is next to be developed. http://www.familysupportni.gov.uk/ | |
| 47 | Improve services for children with challenging behaviours and their carers. (DHSSPS/DE) | AMBER | The HSCB in 2012-13 committed £1m regionally to support development of services within Trusts for Children with Disability who display challenging behaviours. This initial allocation was to support developments of services at level 3 of the NI family support model and was in addition to additional funds provided to the regional unit at Iveagh to enhance the tier 4 service. In 2015-16, the HSCB has committed an additional £1.2m to enhance supports at level 2-3 for with a clear emphasis on early intervention and reducing the number of Children requiring placements outside of NI. | |
| 48 | Develop and implement a Service Framework for learning disability services. (DHSSPS) | GREEN | A Service Framework for learning disability services was launched in September 2012. Year I benchmarking against standard completed. Framework revised and reissued January 2015. | |
| 49 | Maintain direction of HSC funding towards community based services (DHSSPS) | GREEN | The percentage of the total learning disability expenditure directed towards community-based services continues to increase. 83% of HSC spend on learning disability services in 2012/13 was in community services and 85% in 2013/14. The percentage of the total learning disability expenditure being spent on community based services continues to increase. In 2014/15 expenditures was 12% Hospital, 88% Community services. | |
| 50 | Enhance provision of person – centred day opportunities (including employment provision) for people with a learning disability that facilitate integration into the community (DHSSPS) | AMBER | Implementation of the HSCB Day Opportunities Model has commenced. A Regional Implementation Team and Local Implementation teams in each Trust are in place. Full implementation is dependent on additional resources. | |
| 51 | Complete and maintain a map of learning disability services across Northern Ireland (DHSSPS) | AMBER | The HSCB will commence development of a web based map of learning disability services following completion of the mental health service mapping exercise (action 61 refers). Following the launch of a Mental Health online information service in April 2015, a Learning Disability equivalent will be developed. Date for commencement April 2016. | |
| 52 | Improve transitions planning for all children with statement of special educational needs. (DE) | GREEN | DE continues to engage with the Education Authority's (EA) Education Transition Service to take forward recommendations in the ETI Transitions Report. The EA has reported that it is already taking actions to improve the education transitions process on foot of the ETI's recommendations. DE is making good progress, in consultation with the EA and other relevant Departments, on revisions to the SEN Code of Practice that aim to strengthen the transition planning process. DE is also working with the EA to progress the Education actions in the Post-19 Transitions Focus Group Action Plan and will liaise with other Departments as necessary. | |
| 53 | Development of UK wide framework for learning disability nurses. (DHSSPS) | GREEN | Complete. The NI action plan for “Strengthening the Commitment” was launched in July 2014. The action plan will be implemented and monitored by a regional implementation group who will report to the office of the Chief Nursing Officer on an annual basis. http://www.dhsspsni.gov.uk/learning-disability-action-plan.pdf | |
| 54 | Develop a plan for community forensic learning disability services taking account of service to be provided with available resources and which makes full use of other forensic arrangements in place. (DHSSPS) | GREEN | Completed. A model for community forensic learning disability services has been developed and £550K invested in 2015/16 to take this forward. | |
| 55 | Community Dental Service to undertake an annual oral health assessment for each L.D. client and produce an individual oral health plan, referring as appropriate for care. (DHSSPS) | GREEN | This is ongoing, assessment is undertaken annually. Oral Health Issues are being addressed and preventative measures employed. | |
| 56 | Community Dental Service to provide training/ training materials for staff in day care facilities re significance of oral health issues. (DHSSPS) | GREEN | Ongoing - Regular training is being provided for staff as required. | |
| 57 | Improve the experience of people with LD using acute general hospitals based on the GAIN Guidelines "Caring for people with a learning disability in general hospital settings" (DHSSPS) | GREEN | Following an RQIA review of the care of people with a learning disability in acute hospitals, the HSCB and PHA are implementing the findings. A forum has been established to prioritise and take forward this work. Key activities undertaken to date include a scoping exercise across HSC Trusts to establish progress against the recommendations within the GAIN Guidelines and the development of a draft Regional Hospital Passport. | |
| 58 | Implement a regional Bed Management Protocol for those with a learning disability. (DHSSPS) | AMBER | A draft Bed Management Protocol for those with a Learning Disability has been drawn up and is awaiting agreement by Trusts. | |
| 74 | Ensure relevant Inter-Departmental and cross sectoral structures are maintained (DHSSPS) | GREEN | The Bamford Inter Departmental Senior Officials Group meets every 6 months, with the last meeting held on 3 November. The Evaluation of the 2012 - 2015 Action Plan is currently underway and expected by Spring 2016. | |
| 75 | Sponsor work on cross-cutting issues, involving the relevant agencies at local level along with service users and their carers. (DHSSPS) | GREEN | DHSSPS, with the assistance of PCC and BMG, have undertaken a number of focus groups with service users, carers and involving community/voluntary sector. A questionnaire has been developed for carers of people with a LD as part of the Bamford Evaluation, which covers health, education, post-school provision, transport. | |
| 76 | New mental capacity legislation | AMBER | Consultation summary report was published in February 2015. Final draft of Bill completed on 9 March 2015. Bill introduced on 8 June 2015. Bill timetable still allows for Royal Assent by the end of the current mandate. Commencement date to be confirmed, subject to progress on implementation arrangements, | |