Development of a multidisciplinary support pathway for people with learning disabilities with complex needs and/or whose behaviour challenges services

Abstract

This paper describes the process undertaken by local partner organisations across a health and social care economy, to develop and agree a multidisciplinary support pathway for the local inpatient assessment and treatment unit, for people with learning disabilities whose behaviour challenges current services. The paper provides a brief overview of how the social care and health system defines 'challenging behaviour' and how this affects the way in which services are being developed for this group of people. The paper attempts to highlight the place in a system-wide pathway for 'assessment and treatment services', within the context of an underpinning philosophy of enabling each individual to live an ordinary life within their local community, irrespective of the level of behaviour that presents a challenge. The paper also emphasises the need to set the development of local support pathways in the context of the 'whole system' working effectively together. This requires effective partnership working and leadership behaviour across all parts of the local system, including commissioning, provider development, and mainstream and specialist services. It also requires a gradual and supported transfer of skills and competence from 'specialist services' to mainstream services, such that local capacity and capability can be developed to enable people to remain in their own homes and communities. Early results from discussions with the local partners involved in this initiative highlight the usefulness of the process, leading to the development of an integrated care pathway approach from a number of different perspectives. This paper highlights some of the critical challenges for both commissioners and providers as they develop system-wide capacity and capabilities, and reminds them that developing this pathway is only one small part of the jigsaw.