Quality statement 1: Lead commissioner

Quality statement

Local authorities and clinical commissioning groups jointly choose a lead person to oversee strategic commissioning of services for all people with a learning disability. [new 2019]

Rationale

Having a lead commissioner who is experienced in working with children, young people and adults with a learning disability, including those with behaviour that challenges, will help to make sure that services meet their needs. In the longer term, the lead commissioner can bring together commissioning across health, social care and education for children, young people and adults. This will simplify the system, make better use of resources and clarify responsibilities. It might also improve the experience and outcomes of people with a learning disability, for example by reducing crises and the need for more intensive support.

Quality measures

Structure

a) Evidence of local arrangements for local authorities and clinical commissioning groups to jointly choose a lead person to oversee strategic commissioning of services for all people with a learning disability.

Data source: Local data collection, for example from joint working protocols.

b) Evidence that the lead commissioner role specifies that they have in‑depth knowledge and experience of working with children, young people and adults with a learning disability and behaviour that challenges, including knowledge of local services.

Data source: Local data collection, for example job descriptions.

What the quality statement means for different audiences

Commissioners (local authorities and clinical commissioning groups) jointly choose a lead commissioner to oversee strategic commissioning of services for people with a learning disability. They choose a lead commissioner who has in-depth knowledge and experience of working with children, young people and adults with a learning disability and behaviour that challenges, including knowledge of local services.

People of all ages with a learning disability use services for health, social care and education that are organised by one person who has worked with people with a learning disability and behaviour that challenges before, called the 'lead commissioner'. The lead commissioner is in charge of making sure that these different services work together to meet the needs of people with a learning disability.

Source guidance

Learning disabilities and behaviour that challenges: service design and delivery (2018) NICE guideline NG93, recommendation 1.1.1

Definitions of terms used in this quality statement

Lead person to oversee strategic commissioning

A commissioner who plans and oversees joined-up commissioning arrangements for health, social care and education services for all children, young people and adults with a learning disability, including those who display, or are at risk of developing, behaviour that challenges. They have in‑depth knowledge and experience of working with people with a learning disability and behaviour that challenges, including knowledge of local services. They ensure that:

  • resources are pooled across services and with neighbouring authorities to develop local and regional services

  • service planning and delivery are based on assessments of current and future service needs

  • services are planned and delivered in a way that is co-produced with people using services and their families, carers and independent advocates (see the definition of co‑production in the Think Local, Act Personal care and support jargon buster)

  • organisations take joint responsibility for managing risk when developing and delivering care and support

  • services liaise regularly with the named worker, keeping them informed and involved in decision making.

[NICE's guideline on learning disabilities and behaviour that challenges: service design and delivery, recommendations 1.1.1 to 1.1.3, 1.1.6, 1.1.7, 1.1.9 and 1.2.11]

Behaviour that challenges

Behaviour of such an intensity, frequency or duration as to threaten the quality of life and/or physical safety of the person, or others around them. It also includes behaviour that is likely to severely limit, or result in the person being denied, access to and use of ordinary community facilities.

[Adapted from NICE's guideline on learning disabilities and behaviour that challenges: service design and delivery, terms used in this guideline]