Keys to life: implementation framework and priorities 2019-2021

How we got here

We worked with SCLD and policy advisers with the support of the Royal Society of the Arts’ Action and Research Centre. We explored how best to deliver the vision of The keys to life and A Fairer Scotland for Disabled People into sustained improvement in the lives of people with learning disabilities.

Our key themes – wellbeing, living, working and learning - started to emerge from this work.

This approach was developed by engagement with people with learning disabilities and their supporters:

• The whole system approach was discussed with The Scottish Government’s The keys to life expert group of people with learning disabilities who provided valuable early feedback.
• A range of third sector experts were invited by the Minister for Mental Health to take part in a Policy Reference Group to provide advice on the next phase of delivery.
• A series of stakeholder events were held in Glasgow, Inverness, Dumfries and Edinburgh. The events attracted policy professionals, service providers, family carers and people with learning disabilities, and gave everyone an opportunity to share their thoughts about what the next implementation priorities should be.
• A series of events were held with young people with learning disabilities who told us about their aspirations and expectations for the future.
• We heard from people with learning disabilities through ARC Scotland’s National Involvement Network, People First (Scotland), PAMIS family carers, ENABLE Scotland, Down’s Syndrome Scotland and the Thistle Foundation.

We have used the feedback from this engagement alongside learning from a range of other activities.

We heard often that attitudes to people with learning disabilities need to change and that this means focusing on capabilities not challenges. In particular, we were also reminded of the need to shape what we do to meet the legitimate aspirations of a new generation who expect a different future.

People with learning disabilities want to be part of the change by acting as leaders, supporting their peers and promoting understanding as positive role models.

As part of our work moving forward, we will work with people with learning disabilities, SCLD and stakeholders to promote awareness, through investing in targeted activities about the contributions that people with learning disabilities can and do make.

Priorities 2018 – 2021
Living

What we have heard

• People with learning disabilities lack meaningful choice and control about where to live.
• People with learning disabilities feel they are placed in houses far away from their family and friends.
• Parents with learning disabilities are not provided with adequate support.
• Transport links, particularly bus services, are hugely important if people with learning disabilities are to live active and independent lives.
• People with learning disabilities should be able to have safe and healthy relationships.
• Women with learning disabilities should have their sexual health and reproductive rights ensured and should have access to appropriate services if they experience gender based violence.

What we will do next

• Ensure that the needs of people with learning disabilities are reflected in decision making about housing provision, and that there is greater transparency and accountability in how these decisions are made. This will include reflecting these needs in the refresh of local housing strategies, new Scottish Government Housing Allocations Guidance by working with the Association of Chief Housing Officers, housing associations, local authorities and other providers.
• Support people with learning disabilities to become more connected to their local communities through public transport, by ensuring their needs are considered by providers, particularly bus services.
• Protect the rights of people with learning disabilities to become parents, addressing the need to provide effective, early and on-going support to   keep families together, including producing an easy read version of NHS Health Scotland’s Parenting Guide ‘Ready Steady Baby’, commissioning the Scottish Learning Disabilities Observatory to produce better data on women who become mothers and their children who become adopted or looked after, and working collaboratively with health and social care partnerships to address stigma and discrimination associated with the rights of people with a learning disability to have children.
• Recognise the rights of people with learning disabilities to enjoy and maintain healthy relationships, including sexual relationships. Address the discrimination around the reproductive rights of women and girls with a learning disability to be given appropriate relationship, sexual health and parenting education, to be empowered around their own reproductive health and to have access to advice and services. This will include working collaboratively with health and social care partnerships to address stigma and discrimination and including advice and guidance on learning disability in the redraft of the sexual health framework in 2019.
• Recognise and promote the rights of people with learning disabilities to be protected against gender based violence by working with the NHS Health Scotland Advisory Group on their Gender Based Violence programme including the publication of guidelines for frontline staff in 2019.

Learning

What we have heard

• Teachers have a pivotal role in securing positive experiences for people with learning disabilities.
• Many teachers do not have the skills and resources they need to support pupils with learning disabilities.
• Testing and attainment structures do not reflect the potential of children with learning disabilities and how they can succeed.
• Transition periods are particularly challenging for people with learning disabilities.
• There are a lack of appropriate choices for people with learning disabilities at school and college.

What we will do next

• Support the early years development of children with learning disabilities, including ensuring the needs of young children with learning disabilities are reflected in the implementation of The Scottish Government’s Play Strategy.
• Work with local government to improve the consistency of additional support for learning across Scotland, through improved guidance, building further capacity to deliver effective additional support and improving career pathways and professional development (including new free training resources for schools on inclusive practices).
• Work in partnership with Education Scotland, the Association of Directors of Education, local authorities, and other leaders on awareness raising to stimulate cultural change within our schools to improve the experiences of pupils with learning disabilities.
• Work with students, colleges, Colleges Scotland, College Development Network and the Scottish Funding Council to identify examples of best practice within the further education sector, with a particular focus on activity that supports progression to employment and promote the adoption of these across Scotland.
• Help to promote the Independent Living Fund (ILF) Scotland’s Transition Fund, to ensure that young people with learning disabilities are aware of and encouraged to access support to enhance their independent living, including access to further education and employment.

Working

What we have heard

• It is important to raise awareness and challenge attitudes amongst employers of what people with learning disabilities can do within the workplace.
• Job coaches provide valuable support for people with learning disabilities and their work should be better recognised and supported.
• Recruitment processes are not accessible for people with learning disabilities and the support provided is often unhelpful.
• Support the provision of supported employment services and ensure the needs of people with learning disabilities are considered when the effectiveness of these services are being evaluated.

What we will do next

• Challenge attitudes amongst parents, schools, colleges and employers about supported employment services and the potential of people with learning disabilities to succeed in the workplace with targeted awareness raising activity.
• Gather data more effectively and invest funding where people with learning disabilities in Scotland can secure both employment and support to develop in their job. This should include ensuring that people with learning disabilities are visible in data collected by employment programmes in Scotland.
• Ensure that the needs of people with learning disabilities are reflected within the new models of support being delivered by the Disability Employment Action Plan, including support to employers through the new Public Social Partnership and in awareness raising to promote the positive business case for employing disabled people.
• Undertake a review in 2019 of Supported Employment provision across Scotland, and consider the need to build on the existing service offer through local authorities and Fair Start Scotland, the devolved employment service.
• Building on the Seven Principles of Good Transitions, and broader recommendations received from sector experts, disabled young people and their families and carers, work across government to improve transitions into education, learning and work for young people with learning disabilities.

Wellbeing

What you told us

• People with learning disabilities have problems accessing and using primary care services.
• Healthcare information is not accessible and understandable for people with learning disabilities.
• Experiences of self-directed support are uneven and people with learning disabilities are not being supported in making the right choices.

What we will do next

• Develop effective interventions to improve the life expectancy of people with learning disabilities by improving access to support for general healthcare needs through primary care, annual health checks and screening services. This will include: working with Healthcare Improvement Scotland to gather case studies for best practice for treating patients with learning disabilities to be uploaded onto the Improving Together Interactive. This will allow GP clusters to carry out quality improvement work on this area to find and share examples of best practice.

• Monitor and evaluate the effectiveness of screening interventions which have been funded through the cancer strategy, to improve access to screening services for people with learning disabilities. This will be taken forward by the Screening Inequalities Network which is currently being established.
• Invest in the development of positive behavioural support through the creation of a University post and provide direct support to Health and Social Care Partnerships to consider the findings of the ‘Coming home: complex care needs and out of area placements’ report, including the need for different models of care to bring home people identified as priority to return.
• Work in partnership to ensure that people with learning disabilities are able to gain greater choice and control over their lives through self-directed support, including through The Scottish Government’s development of a new Implementation Plan for self-directed support for 2019-2021 and the associated funding of organisations offering advice, advocacy and support.
• Ensure the rights based approach of the new social security system in Scotland reflects the needs of those with learning disabilities with a focus on the design and testing phase of the new system.
• Develop guidance to support Health and Social Care Partnerships in building local learning disability strategies, to drive the delivery of The keys to life strategic outcomes and embed a human rights approach.