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How our CCG increased health checks for people with learning disabilities by 32%

How our CCG increased health checks for people with learning disabilities by 32%

Thurrock CCG saw an opportunity to improve access for people with learning disabilities, exceeding its target in one year. The CCG works with primary care teams and nurses to provide a better healthcare experience for people. It also works with commissioners to ensure that patient pathways are effective and work well in the area.
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Thurrock CCG saw an opportunity to improve access for people with learning disabilities, exceeding its target of 70% in one year.

The CCG works with primary care teams and nurses to provide a better healthcare experience for people. It also works with commissioners to ensure that patient pathways are effective and work well in the area.

The problem

In 2015/16, we realised that we were falling behind on performance targets to improve rates of healthcare checks for people with learning disabilities. Just 40% of people with learning disabilities (LDs) had received their health checks.

We knew that other areas were performing much better than us in achieving this target, using alternative methods to get the checks completed.

We needed a plan to improve access and capacity to carry out the checks, which were left to local GP surgeries to action.

Following a data review, we found that many people were incorrectly coded as having an LD on the list. We worked with GPs to update the list so we had an accurate picture of numbers of people with LDs who were yet to have a health check.

What we did

We worked with GP practices in partnership with primary care commissioners at NHS England and were able to collate a list of nurses who could carry out the health checks and find more than one practice that could do this work.

We also worked with GPs to identify and confirm patients on the register who had a learning disability.

GPs were asked to contact and invite them undertake a blood test prior to attending a dedicated health check appointments.

The CCG made the health checks a priority and encouraged GP practices and their nurses to do the same. It also had the benefit of health hubs who were able to offer health checks outside the normal working day and at weekends.

Challenges

The main challenge was that the primary care team didn't have access to the patient data. This meant constant contact with our 32 GP practices to obtain the lists.

It was clear that with an inaccurate register of patients with LDs, GPs were finding it difficult to make contact with these patients or receive any return engagement from them.

It was also difficult to bring the GPs on board because of the length of time the health checks take, given they were already over stretched with fulfilling their general list appointments.

Results

Feedback from people with LDs was that the experience was less stressful and they were more likely to come to their next check-up.

Uptake of appointments moved from 40% to 72%. We expect to increase this to over 80% in this financial year, bringing us well over the required standard.

The future

We learnt that we needed to work differently to make the system more efficient and able to cope with more people.

Our advice would be to take time to ensure your list is updated regularly and you use nurses who are trained to provide full health checks and ensure that patients receive a good service.

Jane Itangata is the lead commissioner for mental health at Thurrock CCG

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