Learning disability delivery and implementation plan 2022 to 2026

1.1 Publication of a new four-year learning disability strategic action plan 

Status: complete/ongoing

Actions

• We will work with the Learning Disability Ministerial Advisory Group (LDMAG) and partners to develop and publish an overarching, cross-government strategic action plan and delivery plan for learning disability policy. The plan will include appropriate, measurable, outcome focused actions, monitoring arrangements, reporting agreements and periodic review. Published by May 2022. We will work to develop a complementary delivery and implementation plan which will include the specific actions required to deliver the strategic priorities outlined within the action plan – October 2022.
• We will formally review progress against delivery of the actions within the action and delivery plans on an annual basis.
• We will undertake a comprehensive review of the strategic action plan after two years to ensure the plan’s priorities remain appropriate and relevant – spring 2024.

Progress to date

• The learning disability action plan 2022 to 2026 was published on 24 May 2022. The associated delivery and implementation plan was published in October 2022. Both plans were developed and co-produced with stakeholder partners including the LDMAG, third sector, public bodies, and people with lived experience.
• The first annual review commenced on 31 March 2023 with progress updates reported within this plan.
• The formal review of the action plan will commence in April 2024 following the 2023 to 2024 financial year.

1.2 Commit to an inclusive and fully accessible Learning Disability Ministerial Advisory Group for people with a learning disability

Status: ongoing

Actions

• We will hold at least four LDMAG meetings a year, and subgroups where required – ongoing. 
• We will regularly review processes with members to ensure meetings are inclusive and accessible for people with a Learning Disability (LD) – reviewed annually. 
• We will agree annual review and evaluation of terms of reference, membership and procedures – reviewed annually.
• We will work to review the impact, effectiveness and public perception of the LDMAG, maximising its exposure and reach to ensure partners and the public can fully engage with the LDMAG’s work – by March 2023 and reviewed annually.

Progress to date:

• LDMAG meetings continue to be held quarterly with sub-committee and Task and Finish (TF) groups held as required. Options for the return to physical, in-person meetings are currently being considered with a view to their reintroduction during 2023 to 2024.
• Accessibility is reviewed as a matter of course with a formal review discussed annually at LDMAG in the December meeting each year.
• Terms of reference and membership were reviewed and updated in December 2022.
• A review of the public perception of LDMAG was commenced in December 2022. A number of actions are being undertaken including changes to the website, awareness raising through improved communications, attendance at events, and so on.

1.3 Equality and inclusion

• To consider the impact and effectiveness of learning disability policies on people with learning disabilities, their families and carers in the Black, Asian and Minority Ethnic community.
• To ensure the needs of first language Welsh speakers are met in the design and delivery of services and support.

Status: ongoing/on track

Actions

• In year one Welsh Government (WG) and LDMAG will establish a TF group to review the impact and effectiveness of current policies to ensure that the needs of individuals with a learning disability in protected or disadvantaged communities are being met – by April 2023.
• Where gaps are identified, we will consider and implement actions that ensure WG policies fully meet the identified needs of people with a learning disability – by April 2024.
• Following completion of the initial phase of work in relation to race equality, we will explore the impact of current and developing policies on people with learning disabilities from groups who share protected characteristics – from April 2024.

Progress to date

• A LDMAG TF group helped develop a specification to review the impact of current LD policies on under-represented ethnic minority groups. This specification went out to public tender in March 2023. This work will continue during 2023 to 2024.
• The LDMAG will consider future priority activity in this area from April 2024, including which equality issues to cover next following completion of the ethnic activity work.

1.4 Scope the establishment of a national learning disability observatory for Wales

Status: not yet started

Actions:

We will undertake a feasibility study to identify the costs and benefits of establishing a learning disability observatory for Wales – by April 2024.

Progress to date:

• Current workload prioritisation, financial and personnel resourcing within WG and partner organisations means this work is now scheduled for commencement later in the government term.
• Preparatory work has commenced.
• Improvement Cymru have appointed an advanced improvement analyst with learning disability expertise. Whilst their role is to support the improvement work in respects to data collection and analysis, they will have a valuable contribution to this feasibility work. They came into post in March 2023. 
• Improvement Cymru have held positive conversations with key potential stakeholders within Public Health Wales.

1.5 Promote Positive Behavioural Support (PBS) and trauma informed care in health, social care and education

Reducing restrictive practices framework 

Ensure the WG’s 'Reducing restrictive practices framework' principles are promoted, understood, and embedded in training and services across health, social care, education and childcare. To include appropriate monitoring, recording, and reporting.

• Work with sectors to ensure they consider and agree actions to support effective implementation of the restraint reduction framework in childcare, education, health and social care – by summer 2023.

Status: ongoing/on track

Actions:

• We will work with stakeholders and service providers to ensure the WG’s 'Reducing restrictive practices framework' principles are promoted, understood and embedded in training and services across health, social care, education and childcare. This work will also include ensuring the inclusion of appropriate monitoring, recording and reporting – by April 2024.
• We will undertake a series of pilot or test schemes to identify the most appropriate methods of delivering this commitment across various areas of the public sector – during 2023 to 2024.
• We will launch animation (and accompanying communication plan) to raise awareness of the framework for commissioners and providers – summer 2022.
• We will launch the animation to raise awareness for people using settings and services and the people that matter to them – summer 2022.
• We will work with sectors to ensure they consider and agree actions to support effective implementation of the framework in childcare, education, health and social care.

Progress to date

As part of their broader work programme, Improvement Cymru have:

• Delivered a series of workshops across Wales with people with a learning disability and their families to raise awareness of restrictive practices and develop resources to aid regions to continue to raise awareness.
• Commenced planning for a national virtual event to raise awareness and create change ideas for the workforce supporting people with a learning disability. 
• Contributed to the restraint reduction network through the 'National Steering Group'.
• Developed a peer network for NHS restrictive practice trainers.
• Contributed to the development of national resources to support the framework.
• Coproduced a proposal for the formulation of an all-Wales expert reference group for reducing restrictive practice that will support implementation of WG framework.

1.6 Joint working, co-production and collaboration

Status: ongoing

Actions:

• We will work with third sector partners to seek views from people with learning disabilities on what Wales should look like for them in 2033, to ensure the programme successful – by April 2024.
• We will review and explore best practice in collaborative working and co-production – by April 2024.
• We will develop and promote guidance to maximise opportunities for collaboration and co-production – by April 2024. 
• We will develop and implement a communications and engagement strategy that clearly sets out how we will share information about the work we’re doing and receive input and feedback in an accessible way - by April 2024.

Progress to date

• LDMAG will be discussing the issue of coproduction at a meeting in June 2023 with a view to deciding on how best to progress this issue. 
• As part of their broader programme, Improvement Cymru are working with co-production Wales to consider how we embed co-production with greater governance within our improvement programme.

2.1 Social prescribing and loneliness and isolation - to promote and improve wellbeing amongst people with learning disabilities

Status: on track

Actions:

LDMAG will contribute to a national task and finish group to understand how social prescribing could aid Wales in its recovery from COVID-19 and introduce an all-Wales framework to roll out social prescribing to tackle isolation.

We will consider the outcomes of the consultation (closing date 20 October 2022), seeking feedback regarding sustainable funding, specifically what action can be taken at a national level to secure long-term funding arrangements. 

Progress to date

On 16 February 2023, the ministerial TF group chaired by the Deputy Minister for Mental Health and Wellbeing, met to discuss how the findings from the recent consultation exercise will shape the way forward in terms of the national framework. Officials are undertaking this work, meeting with policy leads across WG, including disability policy leads, with a view to publishing the final framework and supporting action plan in summer 2023.

2.2 Wellbeing

Status: not yet started

Actions:

• We will work with LDMAG and other partners to determine the priorities for action for a renewed strategic approach to well-being, in a new learning disability delivery plan.

Progress to date:

• Work has yet to commence in this area.
• Work in this area should use the NYTH/NEST framework for mental health and wellbeing for babies, children and young people.

2.3 Ensure that the COVID-19 recovery needs of people with learning disabilities, their families and carers are recognised and supported within the Welsh Government’s national COVID recovery programme

Status: ongoing

Actions:

We will work with LDMAG and other stakeholders to contribute to review, evaluate and to consider lessons learned about the impact on restrictions to people with learning disabilities, their families, and carers during the COVID-19 pandemic – ongoing.

Progress to date:

While lessons learned from the pandemic continue to be implemented during the development of post-COVID policies, strategic work in this area will not commence until the COVID inquiry completes its work.

3.1 Implement recommendations from the 2020 review of Adult Specialised Services ‘Improving Care-Improving Lives’.

Status: ongoing/on track

Actions:

• We will establish a multi-agency stakeholder national group to advise and oversee delivery of the national plan for adult learning disability services – January 2022.
• We will work with stakeholders to monitor and evaluate delivery of the report’s actions – ongoing.
• We will respond to the need for medium secure provision in Wales identified by the scoping review undertaken by the Welsh Health Specialised Services Committee (who commission all medium and high provision on behalf of health boards in Wales) – by April 2023.
• Learning disability specialist inpatient audit cycle – We will learn from the NHS Wales delivery unit’s quarterly specialist service inpatient and 'Deeper Dive' audit cycle to support sustainable development of community services and reduce any inappropriate and lengthy stays in a hospital facility. Reporting system and improvement plans in place by Dec 2022. 
• Right sizing learning disability community services – We will support the development of a piece of 'right sizing' work for learning disability services, in order to facilitate the implementation of 'care closer to home' and reduce any unnecessary hospital stays for people with a learning disability – by April 2024.
• Pathways of care delays – We will support the inclusion of learning disability inpatients in the national 'Pathways of care delays' (formerly 'delayed transfer of care') implementation, in order to understand the challenges faced by people with a learning disability who are ready to transition to the next phase of care – by March 2023

Progress to date

• The Learning Disability – National Implementation and Assurance Group (LD-NIAG) was launched in early 2022 to oversee delivery of an agreed action plan for specialist learning disability inpatient and community provision. This includes monitoring regional progress on delivery of the recommendations of the improving care-improving lives review. The group continues to meet quarterly and are finalising an update on progress during 2022 to 2023. 
• Task and finish groups established to undertake key actions for LD-NIAG focused on developing models for early intervention, prevention and crisis care and timely transition into and out of specialist hospital.
• Supported health boards to align transformation plans with the national action plan for delivery of improving care, improving lives recommendations.
• NHS delivery unit have been commissioned to undertake a quarterly audit of adult learning disability inpatients to assist in monitoring of progress in reducing the number of people with learning disability in hospital beds. 
• Year 1 data will be analysed in 2023 to 2024 and a deep dive exercise commenced to explore the reasons behind ongoing use of inpatient provision, discharge planning, delays in discharge, and so on.

3.2 Mortality review and Medical Examiner Service (MES)

Status: ongoing but delayed

Actions:

• We will develop processes that ensure that deaths of individuals with a learning disability are reviewed as part of the new mortality review system and that lessons are identified and shared appropriately. 
• We will contribute to the development of a 'learning from deaths framework,' ensuring learning disability issues are reflected appropriately – by April 2023
• We will work with partners to establish a proportionate and appropriate process for the systematic review of deaths of individuals with a learning disability – by April 2023

Progress to date

• Work progressing and discussions have commenced around this work although this has been impacted by unforeseen staffing issues within Welsh Government.
• As part of their broader work Improvement Cymru have supported a variety of discussions and provided expert learning disability knowledge to a number of meetings in respects to both mortality reviews and medical examiner services. This has included reviewing the learning development annex in the framework developed by Welsh Government and contributing a checklist as well as the Do Not Attempt Cardiopulmonary Resuscitation (DNA CPR) paper.
• This work will now be progressed further during 2023 to 2024.

3.3 Learning disability education framework for healthcare staff

Status: on track/ongoing

Actions:

• We will improve services and ensure reasonable adjustments are made that meet the needs of people with a learning disability accessing services. This will be achieved through the roll out, monitoring and evaluation of the three-tier learning disability education framework for healthcare staff. Tier 1 to be launched in spring 2022 with tiers 2 and 3 to follow from April 2023. 
• We will work with partners to develop the Tier 2 and Tier 3 training for NHS staff – scoping work to commence from October 2022.
• We will work with partners to review and evaluate the impact and effectiveness of the tier 1 training for healthcare staff following the first full year of the training - spring 2023.
• We will work with partners to explore options for adapting and widening out this training to social care and other services.

Progress to date:

• Tier 1 training was launched on 1 April 2022. Uptake has been monitored throughout the year. A report reviewing uptake and analysing feedback has been drafted and is under consideration ahead of finalisation (end of April 2023).
• Developed a communication campaign to support the ongoing roll out of the Tier 1 training.
• Learning from the analysis of the first year, planning has commenced in respects to adapting the training for social care and other services. 
• Early discussions have commenced on the development of Tiers 2 and 3 with further conversations set to take place during 2023 to 2024.

3.4 Establish learning disability specific quality and safety standards for learning disability adult specialised services

Status: ongoing

Actions:

• We will work with partners to develop evidence-based quality and safety standards and measures for implementation across Wales. To be implemented by Dec 2023. 
• We will work with partners to measure and assure the achievement of these national standards across Wales - by Dec 2023.

Progress to date

• Early discussions have commenced with the majority of this work set to be undertaken during 2023 to 2024.

3.5 Increase access to health checks for people with a learning disability

Status: ongoing

Actions:

• We will evaluate the effectiveness of the pilot health check project that ran from October 2021 to March 2022 and explore options for further development, implementation and embedding of the health check framework – spring 2022.
• We will review health board approaches to delivering health checks, identify effective approaches and disseminate learning across Wales – by April 2023. 
• We will develop national standards for the delivery of health checks and improve the consistency of approach to delivering these checks across Wales – by April 2023.
• We will work with partners to measure and assure the achievement of these national standards across Wales – commencing April 2023.

Progress to date

• Work is ongoing but has progressed slower than initially anticipated. However, this work is now getting back on track.
• The early pilot from 2021 to 2022 was extended into 2022 to 2023 to maximise the evidence available for analysis.
• A summary report in respects to Annual Health Check (AHC) project work undertaken by health boards in the year 2022 to 2023 has been completed. 
• Partners at Improvement Cymru (IC) have undertaken improvement coaching with specific health boards in respects to improvement ideas for the delivery of AHCs. 
• IC have also delivered a social media campaign and communications strategy to promote AHC accessible resources to health board primary care services.
• Planned and facilitated primary care liaison nurse/cluster link face to face all day workshop.
• Utilising the learning from the pilot projects, work has commenced on the development of an AHC proposed policy paper which is set for discussion with Welsh Government policy colleagues in early 2023. This will consider all approaches to the future format and delivery of AHCs including their potential role within GP contracts, direct enhanced services or cluster-level delivery. It also recommends changes to the format and increased user accessibility through improvements to electronic completion and use by health professionals other than GPs.
• Work in respects to the development of standards has not commenced yet due to a number of factors not least the need to agree the above-mentioned policy paper, ongoing contract negotiations with GPs, personnel changes, and so on.

3.6 Undertake an options appraisal to establish a digital platform to support the comprehensive implementation of the Health Equalities Framework (HEF) across Wales

Status: on track

Actions:

• We will support and undertake user research to inform development of a specification for the digital HEF platform by spring 2023. 
• We will work with partners to establish and rollout a user-friendly digital platform to support comprehensive and consistent use of the HEF – from spring 2023.
• We will monitor and evaluate the digital HEF process to maximise its uptake and effectiveness – from spring 2023. 
• Following the implementation of the new HEF, we will explore the establishment of a national outcomes reporting system that measures the effectiveness of therapeutic interventions – from April 2024.

Progress to date

• Partners at IC have commissioned a supplier to undertake alpha testing with health board users to develop a digital prototype for beta testing by the 1st May 2023.
• Shared HEF training materials with all health boards and three universities, Bangor University, South Wales University and Swansea University. 
• Disseminated easy read materials disseminated across Wales. 
• Received draft report on the validation of the HEF learning disability accessible outcome tool.
• Continued support offered to all health boards in the use and implementation of the HEF.

3.7 Physical health – undertake improvement projects to reduce health inequalities, premature and avoidable deaths

Status: ongoing

Actions:

• We will develop policies and/or guidance to address emerging health issues and improve how mainstream NHS services identify and respond to the needs of an individual with a LD: 
• Priority areas of focus will include:
  • identification, diagnosis, and treatment of constipation 
  • access to vaccinations and health screening services
  • secure widespread use of the health profile 
  • review use of the flagging system
  • review the care bundle – ongoing from April 2022

Progress to date:

• Improvement Cymru have led this work stream on behalf of Welsh Government. Progress is being made although this was slower than anticipated in the early stages.
• Bowel health - worked to gather together the evidence base to develop a programme of work around constipation in people with a learning disability across the lifespan, as well as engage with stakeholders in the validation of a suitable bowel profile tool for people with a learning disability. 
• Vaccines – Worked with the Public Health Wales Vaccines and Preventable Disease Programme (VPDP) in development of surveys, allocation of supplier of focus group work for co-production of accessible vaccines campaign for 2023 to 2024 vaccines season. 
• Health profile - completed a programme of health profile awareness raising with identified stakeholder groups. We also engaged with Digital Health and Care Wales (DHCW) to map the health profile across systems such as Welsh Nursing Care Record (WNCR) and the NHS Wales app. We also undertook an evidence-based communication campaign highlighting the health profile as patient safety tool. In addition to this we commissioned an evaluation of the usability of the health profile for delivery in May 2023. 
• Flagging - continued to engage with DHCW to map the health profile and subsequent need to ‘flag’ across systems such as WNCR and the NHS Wales app. We have been working with specialist learning disability health services who should be flagging those who access their services within local health board digital systems. 
• Care bundle – developed and awarded a tender, to commission an organisation to undertake the options appraisal, due for completion June 2023.

3.8 Loneliness and isolation

Ensure the ongoing work on tackling loneliness and social isolation continues to link with our LD improvement priorities.

Status: ongoing

Actions:

• We will work with partners to explore the causes of loneliness and isolation for people with a learning disability.
• We will contribute to policies that address these issues – ongoing from April 2022.

Progress to date

• A representative from All Wales People First has now joined the Loneliness and Isolation Advisory Group in order to ensure the causes of loneliness and isolation for people with a learning disability are understood and opportunities identified to address these.
• The Welsh Government launched its three-year £1.5m Loneliness and isolation fund in September 2021. The fund was aimed at supporting front-line organisations to tackle loneliness and isolation within local communities. Feedback from local authority and community voluntary council partnerships to date indicates that some of this funding has been used to provide a range of opportunities for people with a learning disability to connect and socialise with others.

3.9 New approaches to day services, respite care and short breaks

Status: ongoing and on track

Actions:

• We will work with partners to implement the actions in the delivery plan that support Priority 3 of the Strategy for unpaid carers: supporting a life alongside caring, including working towards a better understanding of how a break from caring can be accessed, funded, and delivered – ongoing.
• We will work with ADSSC/local authorities and partners to explore the safe reopening of local authority day services and ensure those services meet the needs of people with a LD, their families and carers – commencing October 2022 with ongoing review.

Progress to date:

• We have commissioned the Association of Directors of Social Services (ADSS-Cymru) to undertake a review and analysis of LA day service provision with a view to understanding the changing landscape and helping ensure changes to services meet the needs of people with learning disabilities. This work is ongoing with a report set to be delivered in the summer of 2023. Subsequent activity in this area will be dependent on the findings and recommendations from this report.
• A new short breaks fund has been co-produced with the Carers Ministerial Advisory Group. £9m of funding over three years (2022 to 2025) was announced in 2022 with Carers Trust Wales appointed as the managing body. The funding in each year is allocated across the 7 Regional Partnership Boards and through the Amser strand to bidding 3rd sector organisations. The fund will support development of more and new short breaks activity for all ages of unpaid carer, including young carers.

3.10 Enabling integrated care and support through direct payments and CHCs

Status: on track

Actions:

• We are working with partners to explore the interface between direct payments and Continuous Health Care (CHC) to maximise impact and effectiveness for people with a LD, their families and carers – from April 2022.

Progress to date:

• There is a Programme for Government commitment to take forward this work. A working group has been set up which includes disabled people’s organisations, health boards, local authorities and WG officials. Potential legislative options to introduce DPs for CHC in Wales were consulted on between August and Nov 2022 and the responses will be published shortly. 
• In the meantime, an option to set up a third party model Independent User Trust (IUT) to enable local health boards to pay the trust and for trustees to arrange and purchase care for an individual in receipt of CHC is being explored. This arrangement will allow increased voice and control for disabled people who receive CHC, their families and carers. Such an IUT option is possible under the current legislative framework, and guidance is currently being co-produced with the working group.

3.11 Supporting parents with a learning disability

Status: on track

Actions:

• We will ensure increased understanding and awareness of the needs of parents with a learning disability across services, ensuring parents with a learning disability receive improved support with a subsequent reduction in children being taken into care. This will be achieved through the development, publication and launch of bilingual national guidance for children’s social care services on best practice about how parents or soon to be parents with a learning disability can be best supported so families stay together and children thrive. We will develop and publish accompanying guidance for parents with a learning disability. The 'guidance for social workers for families where the parent has a learning disability' was published on 11 May, stakeholders informed and a tweet used to publicise it.
• There are plans to further promote the guidance during Learning Disability Week 19 to 25 June.

Progress to date:

• Fully co-produced guidance has been developed and is set to be published in spring 2023.

3.12 Review of the Social Services and Well-being Wales Act 2014

Status: red

Actions:

• We will complete work on the review and evaluation of the Social Services and Wellbeing (Wales) Act 2014 – ongoing.
• We will ensure the views and experiences of people with learning disabilities are reflected in the outcomes of the review to address identified gaps in provision – ongoing.

Progress to date

No update received.

3.13 Social care workforce

Status: red

Actions:

• We will work with partners to support workforce planning to ensure the recruitment and development of a resilient, appropriately trained workforce.

Progress to date:

• No update received.

3.14 Learning disability nurse workforce

Status: ongoing but recruitment remains challenging

Actions:

• Workforce modelling. We will work with key stakeholders across settings to identify workforce models to meet the holistic needs of people with a learning disability. To further understand where learning disability nurses are needed and why - ongoing.
• We will explore with partners options to widening access to registered nurse learning disability education – ongoing and review of recruitment at commencement of every academic year (October 2023, 2024).
• We will work with partners to review existing career pathways for learning disability nurses, identifying current structures and consider approaches to improve the career pathways for existing learning disability nurses – ongoing.

Progress to date

• The ‘NMC register Wales 1 April 2022 – 31 March 2023’ annual report published 24 May, 2023 states that the number of learning disability nurses has increased marginally.
• Welsh Government's ‘National Workforce Implementation Plan: Addressing NHS Wales Workforce Challenges’ published by Health Education and Improvement Wales January 2023 recognises current challenges. 
• Work ongoing within HEIW in relation to workforce modelling and increasing applications to learning disability nursing courses. Media campaign launched on international nurses day 12 May 2023 that links to ongoing improvement to the Careersville pages. 
• The universities that offer learning disability nursing courses are working together and individually to widen access to education. First year nursing students (adult, child, mental health) are given an option to transfer to learning disability nursing following placement experience. Recruitment of nursing for September 2023 remains difficult. However will work towards increasing visibility of learning disability nursing during learning disability week 19-25 June, 2023. 
• The All Wales Learning Disability Nursing Group are considering options for supporting current career pathways for learning disability nurses. For example presentation from Foundation of Nursing Studies regarding creating caring cultures fellowship for aspiring leaders and early career frontline registered learning disability nurses, December 2022.  
• As part of their broader work, partners at IC have supported All Wales senior learning disability nurses group meetings, as well as the primary care liaison nurse and acute liaison nurse work. IC have supported initial conversations in respects to an improvement academy offer to the learning disability nurse workforce.

3.15 Carers and carers policy

Status: ongoing

Actions: 

• We will work with partners and internal/external stakeholders in the development of policies that ensure the needs of carers of people with learning disabilities, including family and sibling carers and carers with learning disabilities are understood and accessible support is available – ongoing.

Progress to date

• The strategy for unpaid carers and its associated delivery plan recognise the importance of addressing the needs of all groups of unpaid carers including access to information, advice and assistance, including help from statutory support services where appropriate. The first annual progress report was published in March 2023.

Unpaid carers delivery plan annual report

4.1 To promote voice choice and control for people with learning disabilities and their carers. To include advocacy and self-advocacy and digital inclusion

Status: ongoing and on track

Actions:

• We will work with stakeholders to explore and review best practice and different models of advocacy support, in order to develop advocacy services for adults in line with commissioning guidance – commencing October 2022.

Progress to date

• Commencement of this work was delayed slightly while initial discussions around its scope and reach were undertaken. In January 2023 Welsh Government commissioned the Association of Directors of Social Services (ADSS-Cymru) to undertake a review and evaluation of advocacy and self-advocacy services across Wales with a view to the development of a framework for use across the public sector. Work has commenced and is set to report early in 2024.
• Subsequent work in this area will depend on the outcomes and recommendations from the initial phase of activity.

4.2 Digital inclusion and use of technology

Status: not yet commenced

Actions:

• We will work with partners and stakeholders to review the appropriate use of technology and digital options to maximise engagement and build and improve connections for people with learning disabilities – from April 2023.
• We will explore ways to improve contact and linkages for people who struggle to get information or have their voices heard – ongoing.

Progress to date:

• No update available.

4.3 Friendships and relationships

Status: not yet started

Actions:

• We will work with LDMAG, partners and stakeholders to explore the potential for the provision of guidance and advice in respect of friendships and sexual relationships for people with learning disability, families/carers and service providers – from April 2023.
• We will ensure people with learning disabilities receive appropriate advice that allows them to engage in healthy relationships – by April 2024.

Progress to date:

• This work has not yet commenced. If it is agreed within the LDMAG as one of the priority work streams it will be taken forward by the group.

5.1 Children and young people’s learning disability services

Status: amber

Actions:

• We will work with stakeholders and service providers to improve collaborative working in the provision of children’s services, including transition services, for people with learning disabilities across health, social care and education – from April 2022.
• We will work with partners to consider the scope of this work and develop appropriate plans exploring best practice, gaps in provision, potential service improvements, and a plan for delivery and implementation of integrated learning disability services for children and young people – from April 2022 to April 2025.
• We will work with partners to measure and assure the achievement of these plans.

Progress to date:

• Commencement of this work stream was significantly delayed due to staffing and resourcing issues so it did not begin until late 2022. 
• IC have commissioned a literature review, scoping the evidence base for different service models / principles of delivery, specific to children and young people with learning disabilities (delivery May 2023).
• Commenced a scoping and engagement exercise with stakeholders for the life of the project to harness knowledge from expertise and lived experience in order to shape the programme. 
• Started work to identify leads from across each health board / local authority area with responsibility and accountability for Children and Young People (CYP) with learning disabilities such as via regional partnership boards.
• Work has continued to progress the CYP community of practice by drawing on the experience of all stakeholders: for discussion and collaboration; to share information and knowledge of best practice; to identify current issues and promote innovative solutions. 
• Commenced commissioning process and awarded tenders to targeted improvement projects grants across Wales in order to test models of service delivery relevant to this population. 

5.2 Additional learning needs – implementation

Status: ongoing

Actions:

• We will establish a national additional learning needs steering group in September 2022 to provide strategic direction information, and advice to support ongoing implementation of reforms. Ongoing – group has been established and work has commenced.
• Estyn will conduct a thematic review of the additional learning needs system with scoping proposed to take place in summer 2022 and field work in the autumn term with a view to publication in spring 2023. Ongoing – thematic underway.
• We will implement phased legislative commencement and movement of children to the new system over three years from September 2021. 
• We will appoint implementation leads in March 2023 to provide ongoing strategic support to the sector.  
• We will publish practitioner, technical, parent and child, and post-16 guidance on additional learning needs implementation in September 2022.
• We will develop and promote the national additional learning needs professional learning pathway. 
• We will establish a children and young people participation group in spring 2023 to strengthen learner participation, improve understanding and awareness of ongoing implementation and ensure the voice of learners and parents is accounted for - ongoing.

Progress to date:

• Implementation is underway, the implementation phase has been extended to August 2025, reflecting evidence of additional time required to effectively plan for and meet learner needs - ongoing.
• National and further education implementation leads are in place - complete.
• Practitioner, technical, parent and child, and post-16 implementation guidance has been published. This is now being updated to reflect the extended implementation phase.
• The core, intermediate and advanced chapters of the additional learning needs professional learning pathway are available on Repository - Hwb (gov.wales), with just two final chapters of the advanced modules remaining for publication - ongoing.
• The establishment of a children and young peoples' participation group is underway through 'Children in Wales', to strengthen learner participation, improve understanding and awareness of ongoing implementation and ensure the voice of learners and parents is accounted for - ongoing.

6.1 To improve access to employment, training, and support for people with learning disabilities to remain in the workplace

Status: ongoing and on track

Actions:

• We will consider lessons learnt from the 'Engage to Change' programme and explore the scope and feasibility of a national job coaching service in conjunction with the Department for Work and Pensions by summer 2023.
• We will undertake a review of the learning from the supported employment pilot scheme on traineeships and the Jobs Growth Wales plus programme following its completion in March 2022.
• We will review existing support for employers such as the online employers toolkit to ensure it is up to date by April 2023.
• We will work disabled people employment groups to maximise impact on improving employment outcomes for disabled people – from December 2022. 

Since 2017, 'Skills Competition Wales' has delivered a portfolio of competitions designed for young disabled people with learning disabilities to challenge, benchmark and raise their skills by taking part in competitions across a range of sectors. Annually the competition portfolio has increased, from running 6 competitions in 2017 to aspiring to deliver 11 competitions in 2024. The competitions range from IT and woodwork through to media and catering plus many more and, have engagement from all further education providers in Wales alongside independent training providers and employers.

Wales continues to support the UK-wide regime for inclusive skills competitions and typically leads the way by providing an exemplar model of delivery. Wales frequently reaches the top of the UK league table for its involvement and success in inclusive skills competitions at the World Skills UK National Final Competitions. 

More recently, Inspiring Skills have collaborated with specialist college Coleg Elidyr to further enhance its delivery portfolio. Following a successful introduction into skills competitions with Coleg Elidyr, the college has delivered a skills week where they delivered a suite of 4 competitions internally to their learners.

Progress to date

An 18-month supported employment coach pilot was undertaken with the Jobs Growth Wales+ programme with the following aims:

• provide resources to further develop awareness and confidence in supporting disabled learners and those with additional learning needs
• inform a better understanding of the cohort of learners who would most benefit from following a learning pathway in line with the supported employment model
• inform how Welsh Government can support young people with moderate to severe learning disabilities and/or autism progress onto positive outcomes including inclusive apprenticeships and paid employment

An evaluation was undertaken which includes eight recommendations that we are working to implement along with imbedding and mainstreaming the support offered by the coaches in the main programme. This work will continually be monitored as part of the programme delivery along with future evaluations. 

We have also re-established the Disabled Peoples Employment Working Group, an external group that provides the Welsh Government with advice and guidance on emerging issues and priorities for disabled people’s employment in Wales and to assist with the aim of increasing the number of disabled people into work.

6.2 Supported apprenticeships

Status: ongoing and on track

Actions:

• We will endeavour to achieve and maintain apprenticeship starts for learners who have self-identified as having a disability /learning disability at above 9% - from 2023 onwards.
• We will deliver a supported shared apprenticeship pilot to test the suitability and feasibility of the supported/shared model for future mainstreaming - from 2023 onwards.
• We will continue to offer financial incentives for employers to provide apprenticeship opportunities for disabled people – from April 2022 with ongoing review.

Progress to date:

• Supported by the employer incentive to employ self-declared disabled apprentices has been maintained at above 10% for 2021 to 2022. 
• Supported shared apprenticeships is currently in its test and learn phase and there has been a significant investment to implement the support systems necessary to match those with complex employment and learning needs to paid employer placements that provide learning opportunities to demonstrate competency for the skills needed to complete the chosen apprenticeship framework. Opportunities within health boards across Wales are currently being developed. 
• Employer incentive payments are to be reviewed and as appropriate continue to March 2024.

7.1 Promote regional partnership boards engagement with stakeholders to ensure inclusion of the voice and views of people with a learning disability

Status: ongoing and on track

Actions:

• We will ensure regional partnership boards needs assessment and planning arrangements must include meaningful engagement with key stakeholders including those with a learning disability.
• We will ensure that as part of Welsh Government’s rebalancing care and support work programme, we will work with regional partnership boards to promote and facilitate coproduction and inclusion of service user and carer voice in service design and delivery.

Progress to date:

• Consultation on revisions to the part 2 code of practice and on revised part 9 statutory guidance on partnership arrangements will be launched on 22 May 2023. These include updated and expanded requirements and guidelines on engagement, voice and co-production in all aspects of service design and delivery, including population assessments and planning arrangements.  
• Task and finish group on engagement and voice is preparing further good practice materials on co-production for use by regional partnership boards.

7.2 The Regional Integration Fund

Status: on track

Actions:

• We will work with regional partnership boards to ensure the needs and views of people with learning disability are fully considered in future co-ordination of the new Regional Integration Fund revenue and capital programmes.

Progress to date:

• In designing each of the national models of integrated care, regional partnership boards must consider how they will meet the specific needs of the Regional Integration Fund population groups. These population groups were identified as priority groups for integrated service under the Social Services and Well-being Being Act and includes ‘people with learning disabilities, neurodiverse and neurodevelopmental conditions’.
• The fund builds on the principles and priorities of the Learning Disability Improving Lives Programme (2018 to 2021); the reduction of health inequalities, increasing community integration and improving planning and funding systems.
• In year one of the Regional Integration Fund, the seven regional partnership boards implemented 62 projects where ‘people with learning disabilities, neurodiverse and neurodevelopmental conditions’ were listed as a population group benefiting from the transformation projects.
• We will continue to work with regional partnership boards to ensure the needs and views of people with learning disabilities are fully considered in future co-ordination of the new Regional Integration Fund revenue and capital programmes and are currently reviewing the end of year reports with a view to publishing an annual revenue report in due course.

7.3 Housing and accommodation – voice and control in decision-making

Status: red

Actions:

• We have issued guidance to regional partnership boards relating to the Housing with Care Fund (Housing with Care Fund (HCF) guidance 2022 to 2023 May 2022) to ensure we continue to invest in housing and accommodation for people with learning disabilities to support independent living; increase the provision of housing and accommodation close to home and reduce the number of out of county placements; and ensure residents and service users are involved in decisions which affect them.
• The HCF supports the priorities of the Learning Disability Improving Lives Programme and the learning disability action plan and the guidance sets out that commissioners of independent living accommodation for people with learning disabilities should follow the guidance 'Commissioning Accommodation and Support for a Good Life for People with a Learning Disability' issued by the National Commissioning Board in 2019 (ldw.org.uk). This guidance puts rights, choice, control and inclusion front and centre.
• We will monitor and evaluate the impact and effectiveness of these programmes and guidance.

Progress to date

No update provided.

8.1 Improved public transport

Status: amber

Actions:

• While developing the Wales Transport Strategy (WTS) we worked closely with all groups who share protected characteristics including those with learning disabilities. As a result of those discussions, we built accessibility as a key pillar in the WTS. We have developed an equality pathway as part of the national transport delivery plan. We will consider the responses to the current 12-week consultation and develop further proposals accordingly – from Autumn 2022.
• Subject to ministerial approval we will work with Transport for Wales to develop equality stakeholder groups to advise on delivery both for policy and operations and to run a pilot for raising awareness for bus drivers with regards to equality and accessibility.

Progress to date:

• The National Transport Delivery Plan published in February 2023 includes a number of specific actions which will increase the accessibility and safety of people using public transport in Wales. This includes both physical accessibility but also ensuring that people have access to travel information in a number of formats and being supported whilst travelling through stations and interchanges. 
• Officials are working to support the Minister for Social Justice’s Disability Rights Taskforce, which has a specific workstream focusing on travel. The working group has so far met three times out of a total of four meetings (with the ability for an extra meeting if felt necessary). The findings of this taskforce will be presented to both the Minister for Social Justice and the Deputy Minister for Climate change for action. The taskforce is made up of people with lived experience of disability, including learning disabilities.
• Alongside this work we are developing the equality pathway which will bring together the commitments made within the Wales Transport Strategy relating to accessibility, inclusion and equality issues with the actions we will take to achieve them.