Creating an all-age integrated disability service

By Richard Pantlin, NHS Integration Programme Manager (Interim) - in a personal capacity

A project in a London Borough has expanded from integrating NHS and social care adult learning disability teams into an all-age co-located service with education teams.

The London Borough has a very diverse population of a quarter of a million. Between the council and the local NHS, £29m per annum is spent specifically supporting local adults with a learning disability. In June 2018, the DASS initiated a project to integrate and co-locate the adult social work and health community teams, convinced that closer working would lead to better outcomes and hence reduce long-term care costs.

The first challenge was to define the scope and agree the governance with the local CCG and the NHS health provider trust. That was settled by January 2019 with a monthly tri-partite project board overseeing the work and rotating the chair between the three organisations.

The next challenge was to find suitable accommodation to co-locate 43 social care and NHS staff from four teams: Children and Young Adults with Disabilities (CYAD), Transitions, Specialist Over 25’s LD Team and the NHS Community LD Team. It also needed to include three rooms for the therapists to see their patients.

Luckily, the council had vacant premises on the civic centre site. These are large enough to accommodate five Education Services teams: Children’s Sensory, SEN, Educational Psychology, Portage and Autistic Spectrum Teachers. This has the added benefit that they can continue to be co-located with the CYAD team with whom they already work closely in an expensive NHS PFI building which will now be vacated.

With the enthusiastic support of the director for People Services, the project doubled in size to relocate 110 staff in a bespoke refurbished building creating a unique all-age disability service from the one central location.

A key part has been the culture change for adults LD staff, which started with two full day “Common Purpose Mapping” workshops in May for all staff. A further experiential team-building event was held in October including a review of a new draft integrated pathway. There has also been co-production with service users and clients facilitated by the local Mencap.

The council Head of Service for the new Community LD Team is confident that an integrated team will enable a more responsive and flexible approach when individuals and their families are approaching a crisis and that this will lead to improved outcomes. Given the high costs for secure accommodation and 24/7 supported living, it would take only 4 individuals to either remain at home or in lower level supported living to avoid additional costs of £500,000 per annum. 

More information will be available when the new service is publicly launched in January. 

NCASC 2019 >>>