The Black Country Transforming Care Partnership (BCTCP) has been working with people with learning disabilities, their families and carers to develop and deliver a new community model of care that maintains their rights, respect, and dignity. This work has been informed by feedback from previous engagement undertaken by BCTCP between April 2016 and July 2018.

The new proposed model of care means the investment is in a community model and, as a result, fewer assessment and treatment beds will be needed. Clinicians and other experts have analysed the existing assessment and treatment units and believe the unit that best meets the requirements for a safe and effective service is Penrose House in Sandwell.

A nine-week engagement exercise was undertaken by the Black Country CCGs from Thursday 21st March to Thursday 23 May 2019.

The purpose of the engagement process undertaken was to seek the views of stakeholders, service users, carers and family members on the following:

  • The introduction of a new community model for people with learning disabilities that provides enhanced support in the community.
  • The permanent closure of specialist inpatient beds at Ridge Hill Hospital, Dudley and Orchard Hills/Daisy Bank, Walsall. (These are beds that are reserved for assessing and treating people with learning disabilities and are not connected to general hospital services).

 

Engagement Process

  • Dudley Voices for Choices (DVC) are an advocacy group for people who have a learning disability or autism and are a member of the TCP programme board. Their membership is to ensure that people with learning disabilities are represented at programme level.
  • An engagement document to promote understanding of the TCP programme and the proposed new model and questionnaire was produced to allow feedback and to advise on the format of the stakeholder events, capturing feedback at those events.
  • As DVC support people with learning disabilities and autism to speak up for themselves, they were also commissioned to undertake outreach engagement in the community and produce an easy read version of the engagement document and questionnaire.
  • Several thousand stakeholders were contacted by the CCGs and invited to get involved by attending one of the four stakeholder events and/or completing the online questionnaire.
  • Four stakeholder events (one in each of the Black Country and West Birmingham CCG areas) took place to explain the TCP programme and hear views on the proposed service model. All feedback from the stakeholder events has been collated in this report.
  • Outreach engagement with service users, their carers and families were undertaken by DVC; 174 conversations took place. DVC undertook interviews across Sandwell, Wolverhampton, Walsall and Dudley.
  • A press release and social media also informed people how to get involved by attending one of the four stakeholder events and/or completing the questionnaire.
  • information was published on the CCG websites.

 

Who did we hear from?

The largest group of respondents completing the survey (44.90%) were service users followed by carers of a service user (30.61%). Of the (4.08%) selecting ‘other’ were said to be from a charity and special school professional.

 

Outreach Engagement

The charity Dudley Voices for Choices was commissioned by the CCGs to undertake face to face targeted engagement with potential service users, service users, family members and carers across the Black Country and West Birmingham as part of the Transforming Care Programme engagement process. During the outreach engagement, people were encouraged to complete the easy read version of the questionnaire.

  • 174 conversations took place.
  • Interviews were undertaken across Sandwell, Wolverhampton, Walsall and Dudley.
  • 11 community groups were engaged with and 184 easy read questionnaires distributed across the Black Country and West Birmingham.
  • Wherever possible, the easy read version of the questionnaire was completed face-to-face.
  • 39 Easy read questionnaires were completed, some fully, some to a limited extent. Please see the findings from the questionnaire feedback in section 5.
  • Carers and family members were also invited to complete the questionnaire.

 

What people told us

In summary, the following key themes were identified from the views and experiences we captured:

  • There was an overall positivity about the community focus offered by the new model.
  • The importance of relationship building and maintaining a good relationship between, patients, family members, carers and professionals was identified.
  • Transport and access to the Penrose site for visitors were raised.
  • There needs to be a consideration for those with autism and those in transition (age 16 to 18yrs).
  • Concerns were raised about the response to crisis, not having enough staff and the number of beds in the new model.

 

Engagement Report

Following the nine-week engagement period, the feedback was analysed and an engagement report produced. The report outlines how the views and experiences of people with learning disabilities, their families and carers were used to inform the community model of care.

CCG decision-making

In September 2019, a report was presented to Walsall CCG’s Governing Body on the new community model for learning disabilities in the Black Country including the bed closure proposal. The Black Country Transforming Care Board asked Walsall CCG Governing Body to:

  • Note the feedback from the engagement process recorded in the engagement report and appendices;
  • Approve the recommendation from the Transforming Care Board to close the inpatient beds at Daisy Bank in Walsall, as these beds are no longer required with the new focus on maintaining patients in the community where possible;
  • Note the implementation of the new Black Country Intensive Support Team and Forensic Service across the Black Country in line with Building the Right Support and the national service specification.

The Governing Body accepted the recommendations with the following caveats:

  • The clinical model needs to be redesigned to take account of supporting patients with Autism.
  • There needs to be dialogue with the Trust to understand why patients are being placed out of area. The clinical model needs to be adjusted to mitigate this arrangement.
  • There is an urgent need to make modifications to the Penrose facility to ensure that it is suitable for autistic people. Need to see the Trusts plans for this.

To view the report which was presented to Walsall CCG’s Governing Body, including the discussion that took place, click the links below.