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Learning Disabilities

What is a learning disability?

People with learning disabilities are among the most vulnerable and socially excluded in our society. It is estimated that there are approximately 20/1,000 people with mild learning disabilities and 3-4/1,000 with severe and profound learning disabilities in the UK.

Over the past three decades, almost all the long-stays in hospital for people with learning disabilities have closed and virtually all people with learning disabilities are now living in the community and depend on general practice for their primary care needs.

There is often much confusion between what is a learning disability or a learning difficulty.

Here is an explanation:

A learning disability is a reduced intellectual ability and difficulty with everyday activities – for example household tasks, socialising or managing money – which affects someone for their whole life

Someone must meet all 3 of these criteria for a learning disability diagnosis

  • Significant impairments in intellectual functioning (IQ below 70)
  • Significant impairment of social or adaptive reasoning. The person requires support to achieve their survival needs i.e. eating, drinking, planning, appropriate clothing for weather etc. and with social problem solving and reasoning
  • Impairment of onset before 14 years old.

What is not a learning disability?

  • It is not a mental illness
  • It is not Autism or ADHD in isolation. Autism is sometimes mistaken as a learning disability. Autism affects a person with their social interaction, communication, interests and behavior. Someone with Autism can have a learning disability but not always.
  • A person can have a learning difficulties on a scale might have a mild learning difficulty or a severe learning difficulty.
  • A person with an IQ score that falls slightly above 70 would be deemed to have a learning difficulty
  • The person may have a specific difficulty processing certain types of information i.e. numbers (dyscalculia), reading and writing (dyslexia), dyspraxia. These conditions are specific learning difficulties.
  • Blindness or deafness in isolation is not a learning disability. Although people with a learning disability can have, in addition to their learning disability diagnosis, have loss of hearing and/or sight)



Better working to support people with learning disabilities

Across Surrey we are working towards greater integration of health and social care for people with learning disabilities, in order to improve the service they receive.

This will mean creating a single team across Surrey County Council and the NHS, with staff receiving information and training on supporting people with a learning disability and/or autism and it will be a contractual requirement that services are able to accommodate their needs.

One of the key aims of our work is to ensure that more people can live in the community, with the right support, and closer to home.

To help achieve this, we have our county-wide Learning Disability Partnership Board, a county-wide Autism Partnership Board and the Learning Disability and Autism Programme Delivery Board.

We are also committed to service user and carer engagement and this is done through our local Valuing People groups.

 

Transforming Care

Surrey Heartlands CCG is working hard to make sure that fewer people with learning disabilities and/or autism will need to go into hospital for their care by improving services in the community.

We have plans in place for the discharge from all CCG beds for adults with learning disabilities and/or autism and, where people do need to stay in hospital, we will work to ensure their care is the best it can be so they can be discharged as soon as possible.

We have a small local Forensic community team (FIND) for people who have forensic support needs with a learning disability and/or autism and we are currently in discussion with our local providers with regards to providing settled accommodation and support for people with these needs.

We are also working in partnership with health, social care and our provider partners to:

  • Develop discharge pathways and community alternatives to hospital stays.
  • Carry out Care (Education) and Treatment Reviews (CTRS and CETRS) to ensure that all those involved in a person’s care and treatment are acting to ensure that the person can be discharged from hospital as soon as they are well enough to leave.
  • Conduct eight week visits for all adults and six week visits for all children and young people in out-of-area inpatient settings to ensure they benefit from increased focus on their care.
  • Maintain the quality of our learning disability and autism inpatient facilities. We will be working with Experts by Experience service users and carers to check the quality of our local services.

There is further information available on the following links:

https://www.england.nhs.uk/wp-content/uploads/2015/10/ld-serv-model-er.pdf

https://www.england.nhs.uk/wp-content/uploads/2017/02/easy-read-model-service-pec.pdf

https://www.england.nhs.uk/wp-content/uploads/2017/03/my-care-treatment-review-symbol-updated.pdf

 

Acute liaison and reasonable adjustments

When people are ill and need to go into hospital they may find it difficult to explain their symptoms. They may not be comfortable with the hospital environment and as a result may not receive the care they need.

Surrey Heartlands CCG is working in partnership with all our local hospital trusts in order to develop services which provide reasonable adjustments to help people with learning disabilities receive high-quality care.

Examples include making sure that every acute hospital has both adult and paediatric learning disability liaison nurses.

Please check with your local trust to see what services we have put in place to help you and your family receive the best care.

Royal Surrey County Hospital 

Frimley Park NHS Foundation Trust

East Surrey Hospital             

Ashford St Peters

Epsom St Helier                      

Surrey and Borders NHS Foundation Trust

 

Annual Health Checks

People with a learning disability often have poorer physical and mental health than other people. An annual health check can improve people’s health by spotting problems earlier.

All people with a learning disability are entitled to be registered on the GP learning disability register. From age 14 + they will be offered an enhanced annual health check.

Our new Primary Care Networks will be working hard to:

  • Increase the numbers of people with learning Disabilities having an annual flu vaccination.
  • Increase the numbers of people having the enhanced health check.
  • Reduce the use of unnecessary medication ( STOMP)

 

LeDer

Surrey Heartlands CCG is part of the national Learning Disability Mortality Review (LeDeR) Programme. The LeDeR programme is commissioned by the Healthcare Quality Improvement Partnership (HQIP) and funded by NHS England. 

The aim of the programme is to support local areas to review the deaths of people with learning disabilities (aged four years and above), identify learning from those deaths, and ensure services are developed in order to address any learning from the review. The University of Bristol is contracted to establish and develop the review process and evaluate the findings. 

For more information on the programme please click HERE.  

Anyone can report the death of a person with a learning disability to the LeDeR programme.  All deaths of people with learning disabilities who are aged four years and above should be reported.  Deaths can be reported via:

Eileen Clark, Deputy Director for Quality and Nursing and Kathryn Fisher, Head of Integrated Learning Disability Commissioning are the Local Area Contacts (LACs) for the Surrey Heartlands CCG programme.

They can be contacted at This email address is being protected from spambots. You need JavaScript enabled to view it. and This email address is being protected from spambots. You need JavaScript enabled to view it..

 

You can read the latest LeDeR Annual Report to get an overview of the LeDeR programme and how this has been implemented in our local area. It provides an overview of the number of deaths that have been reported to LeDeR for these areas and summaries the learning that has come from the completed reviews.

 

Carer support

Providing care for someone with a learning disability can be very demanding and it is important to ensure that you make time to look after your own health and well-being, not least because in many cases carers support their loved one for the rest of their life. Across Surrey, support is available to help the person you care for reach their full potential, and to support you and your family.

Speaking to people who are facing similar challenges to you can help you make sense of things. Having a network of people who you can turn to for advice and support can be very helpful. Key to all this is understanding the rights you have as a carer enshrined in the Care Act 2014 and the Children & Families Act 2014. There are many things you will want to consider including planning for the future.

Please click here for more advice on services and support available to you.

 

Model Publication Scheme Class: Not part of the MPS

Pharmacies

 

Community Pharmacy

Community pharmacists like GPs, nurses, dentists and other healthcare professionals, are part of the NHS family. Every day about 1.6 million people visit a pharmacy in England.

Community pharmacies range from large chain stores, often on the high street or in supermarkets to smaller independently owned pharmacies often serving smaller or more rural communities. Many Pharmacies are open long hours offering healthcare advice, without the need for an appointment, when other health care professionals are unavailable.

The traditional role of the community pharmacist as the healthcare professional who dispenses prescriptions written by doctors has changed. In recent years community pharmacists have been developing clinical services in addition to the traditional dispensing role to allow better integration and team working with the rest of the NHS.

 

Out of Hours Medicines and Prescriptions

If you run out of medicine or your prescription outside of your GP surgery's normal opening hours and need some urgently even if you're away from home go to the Out of Hours Medicines page of the nhs.uk website.

 

Why should you seek the help of a Pharmacist?

As qualified healthcare professionals, Pharmacists can offer clinical advice and over-the-counter medicines for a range of minor illnesses, such as coughs, colds, sore throats, tummy trouble, earache, cystitis, skin rashes, baby teething, red eye and aches and pains. They are also trained to provide health and wellbeing advice.

Pharmacists undertake a four year Masters in Pharmacy degree course followed by a one year placement working in a pharmacy under the supervision of an experienced pharmacist. At the end of this year they take a professional examination and those who successfully complete the examination are able to register as a pharmacist.

Pharmacists have the right training to make sure you get the help you need if your symptoms suggest something more serious, for example, they will tell you if you need to see a GP, nurse or other healthcare professional.

Most pharmacies have a private consultation room where you can discuss issues with pharmacy staff without being overheard.

 

What help and services do Pharmacies provide?

Community Pharmacies provide a range of services and help ranging from:

  • A Repeat Dispensing Service. This service allows you to collect your regular repeat prescription medicines direct from your local pharmacy for an agreed period of time, without having to go back to your GP. You will need to give your permission to your GP for him/her to share information with your chosen pharmacist. When you need your prescription, instead of requesting it from your GP, you will be able to get your medicines directly from your local pharmacy.
  • Medicines Use Reviews* (MURs). An MUR is a consultation between the pharmacist and a patient that lasts approximately 10-20 minutes. It provides an opportunity for the patient to discuss how they use their medicines and to find out more about them; and the service is designed to supplement (and not replace) the more in depth clinical reviews that are conducted at GP practices. * This service is being replaced Apr 21 with the roll out of the Community Pharmacist Consultation Service
  • New Medicine Service (NMS). The service is for people who have received their first prescription for a medicine to treat any of the following conditions:
    • asthma
    • lung conditions such as chronic bronchitis and emphysema
    • type 2 diabetes
    • high blood pressure
    • conditions where you take a medicine to control the way your blood clots.
  • Disposal of Unwanted Medicines. If you have any medicines that you no longer use, you can take them to your local pharmacy for safe disposal.
  • Other services. that may be available at your local pharmacy:
    • you may be referred to a pharmacy for advice after calling NHS 111
    • emergency contraception
    • asthma inhaler use and advice
    • chlamydia screening and treatment
    • stop smoking service
    • blood pressure, cholesterol and blood sugar testing
    • substance misuse service, including needle and syringe exchange schemes
    • weight management service
    • flu vaccination

 

Useful links

 

 

Review Date: 2021-02-26
Review Due: 2022-02-26
Model Publication Scheme Class: Class 9: Services Commissioned

Eye Health and Ophthalmology

 

Page content to follow.

Model Publication Scheme Class: Class 9: Services Commissioned

Medicines

 

Medicines Optimisation

 

On this page

  • Role of Medicines Optimisation
  • Ask your Pharmacist
  • Branded verses Generic prescribing of medicines
  • Help with health costs
  • Surrey Heartlands CG Medicines Optimisation Team
  • Antibiotic Resistance

 

Role of Medicines Optimisation

The use of medicines is the most common therapeutic intervention. It is estimated that that 15-20% of a CCG’s money is spent on medicines. Medicines Optimisation is simply looking at all aspects of the safe supply, use and disposal of medicines.

Effective Medicines Optimisation will help contribute towards:

  • Improving health
  • Improving patient care and satisfaction
  • Reducing medication wastage

Prescribing is a key component of Medicines Optimisation. Doctors or other healthcare staff accredited as prescribers can prescribe medicines for patients under their care using a written order or prescription. Whilst prescribers can decide on whatever medication they think is appropriate for the patient, they are expected to take into account the evidence for the clinical and cost effectiveness of the medicines they prescribe.

 

Ask Your Pharmacist

  • Pharmacists across provide a range of services.
  • 96% of people can get to a pharmacy within 20 minutes by walking or using public transport.
  • Community pharmacists provide rapid access, without appointment, to a healthcare professional and now offer a range of clinical and public health services.
  • Ask Your Pharmacist, it may save you making an unnecessary trip to your GP or A&E.

 

Help with Health Costs

You can find more information on prescription charges, prescription exemptions and health costs by clicking here. Please discuss the prepayment certificate with your pharmacist if you pay for your prescriptions and have to have regular prescriptions since you may be able to save money.

  • Help with Health Costs - NHS.uk site with information on help with health costs including prescription prepayment certificates.

 

Surrey Heartlands CCG Medicines Optimisation Team

Your Medicines Optimisation team is a dedicated group of pharmacists and pharmacy technicians working towards the common goal of improving the use of medicines across Surrey Heartlands. Within Surrey Heartlands there are four teams located within each Integrated Care Partnership (ICP). Our aim is to ensure that patients within Surrey Heartlands get the medicines they need to achieve the greatest health outcomes for both the individual and the local community within the resources available.

We use our experience and knowledge of medicines to ensure medicines use is as safe as possible. We constantly review new evidence and guidelines so that everyone can obtain the best outcomes from the medicines that they take.

By working closely with all members of local GP practices, our aims are to:

  • promote effective prescribing to prevent, as well as treat, disease to keep our local population healthy in future years.
  • help patients with long-term conditions, such as diabetes and heart disease, to use their medicines effectively to reduce disease progression and keep them healthier and independent for longer.
  • review new drugs that come on to the market and ensure that drugs that have been appraised by NICE are made available to those who will benefit most from them.
  • tackle the issue of wasted medicines which has been estimated to cost the NHS £300 million each year, of which £150 million is avoidable.

We also work closely with other local organisations including community pharmacies, Acute Trusts, borough councils and community health services to proactively deliver a quality service and help patients make the best use of their medicines. Read more about how we are collaborating together through Integrating Pharmacy and Medicines Optimisation (IPMO) across Surrey Heartlands.

 

Did you know?

  • If you have any unused medicines at home, you should take them to your local community pharmacy for disposal
  • If you have any queries or difficulties with your medicines you should first talk to your community pharmacist
  • Local prescribing decisions are available to view on the Prescribing Advisory Database.

 

Antibiotic resistance

Antibiotic resistance is one of the biggest threats facing us today.

  • Why it is relevant to you
     
    Without effective antibiotics many routine treatments will become increasingly dangerous. Setting broken bones, basic operations, even chemotherapy and animal health all rely on access to antibiotics that work.
     
  • What we want you to do
     
    To slow resistance we need to cut the unnecessary use of antibiotics. We invite the public, students and educators, farmers, the veterinary and medical communities and professional organisations, to become Antibiotic Guardians.
     
    Choose one simple pledge about how you’ll make better use of antibiotics and help save these vital medicines from becoming obsolete.
     
  • Visit www.antibioticguardian.com to make your pledge.

 

You can help to keep antibiotics effective.

 

 

Review Date: 2021-02-26
Review Due: 2022-02-26
Model Publication Scheme Class: Class 9: Services Commissioned

NHS 111, Walk in and Out-of-Hours


When you need help quickly but it’s not a life threatening emergency there are a range of services that can help. The services outlined below can give advice and treatment if your GP practice is closed or if you are injured or ill and you are not sure what to do. People in Surrey who need urgent NHS care are being asked to call NHS 111 before they decide to walk into the local Emergency Department (ED), or as many people know it, A&E.



NHS 111

NHS 111 can help if you have an urgent medical problem and need advice.

 

Get help online or on the phone

To get help from NHS 111, you can:

  • go to 111.nhs.uk (for people aged five and over)
  • call 111

 

NHS 111 is available 24 hours a day, 7 days a week, 365 days a year. Calls are free from landlines and mobiles.

If you have difficulties communicating or hearing, you can:

  • call 18001 111 on a textphone
  • use the NHS 111 British Sign Language (BSL) interpreter service if you’re deaf and want to use the phone service

 

How NHS 111 works

You answer questions about your symptoms on the website, or by speaking to a fully trained adviser on the phone. You can also ask for a translator if you need one.

Depending on the situation you will:

  • find out what local service can help
  • be connected to a nurse, emergency dentist, pharmacist or GP
  • get a face-to-face appointment if you need one
  • be told how to get any medicine you need
  • get self-care advice.

 

Easy read information on the NHS 111 service can be downloaded from the NHS 111 assets website.

NHS 111 does not replace 999 or A&E for medical emergencies - when someone is seriously ill or injured and their life is at risk. NHS 111 does not replace 999 or A&E for medical emergencies - when someone is seriously ill or injured and their life is at risk. However, people who need urgent NHS care are being asked to call NHS 111 before they decide to walk into their local A&E. This is to ensure that patients can access the clinical service they need, first time. It will help the NHS to maintain social distancing, reduce the risk of spreading Covid-19 and keep patients and staff as safe as possible.

You will be spoken to by a trained professional and a clinician if needed. If it is decided you need to go to the emergency department then you will be given a suitable time to attend and staff at the hospital will be expecting you. That means less waiting around and faster treatment.

Patients and a wide range of healthcare professionals helped to redesign the NHS 111 service for Surrey. Launched in 2019, the redesigned service aims to meet most healthcare needs on the first call – including a consultation with a doctor, nurse, dentist, pharmacist or mental health specialist if needed and appointments booked with many local services.

Care UK deliver NHS 111 and GP out-of-hours services in Surrey Heartlands. Find out more here

 

GP out-of-hours services

If you feel that you need to see a doctor outside of GP practice opening hours (known as ‘out-of-hours’) and it is not an emergency please call 111. The Surrey Heartlands GP out-of-hours service does not offer walk-in appointments, and can only be accessed by calling NHS 111.

The out-of-hours service is for urgent cases only. If your problem isn’t urgent, please contact your GP surgery when it is next open.

The GP out-of-hours service is open Monday to Friday from 6.30pm to 8.00am, and for 24 hours at weekends and during bank holidays.

NHS 111 will tell you if you need a face-to-face appointment and this could be either at a local healthcare centre or a home visit.

Find out more by visiting the Surrey NHS 111 service website.

 

Walk-in Centres

Nurse-led NHS walk-in centres can help if you have an urgent but non-life threatening injury or illness. No appointment is needed. They can provide a quicker and more appropriate route to treatment than hospital A&E departments.

Ashford Walk-in Centre  Ashford Health Centre, London Road, Ashford TW15 3FE

Open Monday – Sunday (365 days a year), 8am – 8pm.
Tel: 01784 884 000. For adults or children aged 2 years and over. Find out more.

Woking Walk-in Centre Woking Community Hospital Heathside Road Woking GU22 7HS

Open Monday – Sunday (365 days a year), 8am – 8pm.
Tel: 01483 846 209. For adults or children aged 2 years and over. Find out more.

 

Minor Injury Units

Nurse-led minor injury units can also provide a quicker and more appropriate treatment than going to A&E. Treatment is available for minor injuries such as:

  • Bites / stings
  • Cuts / grazes
  • Minor burns / scalds
  • Minor eye / ear injuries, including removal of foreign bodies from the ears or nose
  • Minor head injuries
  • Removal of splinters
  • Sprains / strains / limb injuries
  • Suspected fractures / broken bones
  • Neck pain

 

No appointment is needed.

Here are the details for our minor injuries units:

Haslemere Minor Injury Unit Haslemere Hospital, Church Lane, Haslemere, Surrey, GU27 2BJ

Open Monday – Friday, 9am – 5pm. Tel: 01483 782 334. For adults or children aged 2 years and over. Find out more.

Caterham Dene Minor Injury Unit Caterham Dene Community Hospital, Church Road, Caterham, CR3 5RA 

Open Monday – Sunday (365 days a year), 8am – 8pm. Tel: 01883 837512. For adults aged 18 years and over. Find out more.

 

 

Urgent Treatment Centres

Urgent Treatment Centres (UTC) treat minor illnesses and injuries that are urgent but not life-threatening. They treat adults and children of any age and can deal with the most common ailments people attend A&E for. They are GP-led but are not an alternative to your GP practice, which should usually be contacted first. You can walk-in to the service or an appointment can be booked through NHS 111. 

St Peter’s Hospital, Urgent Treatment Centre St Peter’s Hospital, Guildford Road, Chertsey, Surrey, KT16 0PZ Open Monday – Sunday (365 days a year), 8am – midnight. Find out more. 

  

  

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