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Learning Disability and Autism
Learning Disability and Autism
Move from NHS England to Provider Collaboratives
From April 2021, 15 NHS-Led Provider Collaboratives became financially and clinically responsible for delivering adult medium and low secure mental health and learning disability and autism services to their respective populations. IMPACT is the Provider Collaborative covering the East Midlands region (Derbyshire, Leicestershire, Lincolnshire, Northamptonshire and Nottinghamshire).
IMPACT Provider Collaborative has nine providers.
- Nottinghamshire HealthCare (the lead provider)
- Cygnet Healthcare
- Derbyshire Healthcare NHS Foundation Trust
- Elysium Healthcare, Leicestershire Partnerships NHS Trust
- Leicestershire Partnership NHS Trust
- Lincolnshire Partnerships NHS Foundation Trust
- Northamptonshire NHS Foundation Trust
- Priory Healthcare
- St Andrews Healthcare
NHS England holds a contract with the Lead Provider. Lead Providers will hold subcontracts with other members of the Provider Collaborative, supplemented by a partnership agreement.
Provider Collaboratives work closely with ICSs and alongside service users, carers and families to support improved commissioning of services for people within their population footprint. This approach aims to improve clinical oversight of people’s care, with a view to delivering care closer to home and to enable money released from specialised inpatient care to be invested in community services. IMPACT and its wider partners are working collaboratively to reduce inappropriate admissions and length of stay for people who do require hospital care.
Funding Sources
Funding for adults with learning disability and or autism in secure care was passed from NHS England to Provider Collaboratives. This marked the end of the Funding Transfer Arrangements (FTAs) and the creation of the new Pathway Funds. The ambition for provider collaboratives is to generate new ways of working and flexibility to make savings which can be reinvested in community and step-down services to improve the whole pathway and reduce reliance on the most specialised and restrictive services.
There is still additional funding from NHSE passed to our local systems via the National Programme for Learning Disability and Autism. This funding is prioritised on:
- Community services in line with the Building the Right Support Service Model Building the Right Support Action Plan - GOV.UK (www.gov.uk)
- Key workers for children and young people in the most complex needs
- Health screening services in residential schools
- Care (Education) and Treatment Review (C(E)TR) delivery and full implementation of Dynamic Support System (DSRs). PR1486-Dynamic-support-register-and-Care-Education-and-Treatment-Review-policy-and-guide.pdf (england.nhs.uk)
- Continued support to and development of the Learning from Deaths (LeDeR) programme
ICBs and Local Authorities still retain the decision making and funding streams for people eligible for Continuing HealthCare (CHC) and Mental Health Aftercare (S117 funding) in community settings. Both continue to meet the costs of general and specialised health and statutory social care needs. This may include an aligned or pooled budgets (Section 75 agreements).
Local authorities (x5 counties in the East Midlands) each have a Community Discharge Fund which is dedicated funding to accelerate the discharge of patients with a learning disability, autism or both from mental health hospitals.
Pathway Forum
Together with IMPACT the Integrated Care Boards (ICBs) for the five East Midlands counties represent the wider Integrated Care Systems (ICS’s) on the Pathway Forum. The Association of Directors of Social Services (ADASS), service users and carers and NHSE are also represented on the current Pathway Forum.
The Pathway Forum’s governance structure that enables this wider partnership to agree their common priorities for the future care of their collective population and create co-commissioning opportunities.
The Pathway Forum aligns and complements the existing Transforming Care Partnerships (TCPs) in each county.
Pathway Strategy
Each Pathway Forum is expected to develop a Pathway Strategy which sets out how the specialised inpatient target for adult services is to be achieved and the scope for releasing resources for reinvestment in alternatives to inpatient care. Panels can decide locally if they wish to extend the scope of the Fund. Presently in the East Midlands only the budget that comes to IMPACT from NHSE is included. It is for future consideration to include funding streams in ICBs and Local Authorities.
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