For some years the Western Health Board (WHB) has recognised the value of working closely with service providers and recipients of the service. The strategy document Enhancing the partnership, in an attempt to establish a structured approach to coordinated planning, identified a dual model of consultation—the Mental Handicap Services Consultative Committee and the Mental Handicap Services Development Committee. For some this was seen as progress, but these proposals were seen as a retrograde step within the WHB, where parent representatives on the Regional Coordinating Committee had enjoyed a direct input into the decision-making process of resource allocation and planning for services. Until the matter is resolved at national level, the WHB will continue with its existing single committee, with parent representatives having an equal contribution to make with all the key players in the determination of funding allocation.
Investment in learning disability services across the country has resulted in many developments, including more respite places, residential and day-care places. Yet there are significant areas where services are inadequate, and these gaps result in great stress for service users, their families and service providers.
Up to now, each service provider has made detailed plans identifying the key pressures they seek to address on behalf of their clients. The way funding arrangements were organised has sometimes led to competition between agencies rather than to collaboration. I believe that the way forward must begin with a strategic plan drawn up by all those involved in voluntary and statutory agencies. All of us need to spend more time talking to each other and, more importantly, listening. No strategic plan will be complete without input from all parties, in the same way that no service will be complete without clients, families and service providers working together to the same end—the provision of a high-quality, client-focused service which will allow each individual with a learning disability to reach his/her full potential and to participate as fully as possible in his/her local community.
The recent appointment of a Regional Coordinator in the WHB will further help to bring together the many people involved in service provision and those in receipt of services. As part of its annual service planning, the WHB is required to stipulate in advance what it hopes to achieve with the funds available. This year, in discussion with the Coordinating Committee, I have made a commitment to advance a strategic plan that will set out our goals in very specific terms, identifying what services we feel we need across our three counties, where we feel we need them, and prioritising these needs.
Service providers from all agencies are starting this process with service users, taking stock of current gaps in service, and considering each client’s assessed needs as perceived by the clients themselves and their carers. The strategic plan will seek to outline what developments should take place over the next five years, so that all parties will have a shared view of what is needed and the plans to meet those needs.
In this region, as in many parts of the country, there are many challenges still to be addressed. Because we have focused on the needs of those with more severe disabilities, services for mild disabilities have not been as well developed. We often need to re-evaluate our plans as a result of clients presenting in emergencies, where carers have died or become incapacitated. We need to develop strategies to help improve users’ access to information on service provision and entitlement, and to establish standardised policies and procedures to ensure equitable distribution of and access to resources. We must continue the development of strong partnerships with voluntary agencies providing disability services. We must seek to provide additional respite facilities and home-support schemes, and more locally based day-care programmes. Specialist services which will include integrated packages of care for specific service needs (such as autism) are also required. We need to take account of the needs of older service users and clients with challenging behaviours, which can mean a reinvestment in staffing and facilities in our current care centres.
Our aim is to make the direction of our planning clearer for everyone to see. There is a five-year plan in existence which frames much of our resource allocation from the Department of Health and Children, but we also need to take a fresh look at whether we are remaining on the right course. We want our plans to be easier to follow from all perspectives. This presents a real challenge, with many partisan views around the table, from county perspectives to more localised ambitions. We cannot hope to achieve all our aims immediately, but we can work together so that we have shared views of what is needed and how we will go about meeting these needs.