Room on the board

Board meetings, committee meetings, team meetings, planning
meetings. With so many meetings to attend, social care staff often
feel they have little time left to work with clients.

No doubt some senior council officers sighed when the learning
difficulty white paper Valuing People was published in
2001.¹ Their sighs
weren’t in response to the white paper’s laudable aims but because
it heralded a further round of meetings. Valuing People stipulated
that all councils in England had to establish a learning disability
partnership board by the following October. The Department of
Health pledged the boards would play a vital role in transforming
antiquated learning difficulty services.

Valuing People says the boards are “responsible for overseeing the
interagency planning and commissioning of comprehensive, integrated
and inclusive services that provide a genuine choice of service
options in their local community”.

The major difference between partnership boards and other forums is
that people with learning difficulties, their carers and supporters
must be included on them. They take their places alongside
community development, education, employment, independent
providers, health, housing, and leisure staff and are involved in
the planning of services.

So, after more than one year in existence, how are partnership
boards doing, and what sort of problems are they experiencing? Are
the efforts of some local authorities eclipsing others, and what
should be done to strengthen boards’ work?

Jean Collins, director of Values into Action, a campaigning group
for people with learning difficulties, says senior social care
staff may feel “partnership boards are just something else they
have to go to” but key decision makers must play an active role on
boards if they are to succeed.

Anecdotal evidence suggests that the main problem partnership
boards have is how they engage with and support people with
learning difficulties and their carers. Some councils –
deliberately or accidentally – are excluding this group from board
meetings.

Eve Rank, a commissioner for the Disability Rights Commission, has
a learning difficulty. She says some partnership boards are
“tokenistic” because, although people with learning difficulties
are included on them, little is done to enable them to contribute
to or challenge decisions. “I know of people who are threatening to
resign from partnership boards because they are so unhappy,” she
says.

Collins says the inclusiveness of partnership boards varies
greatly. “Some boards are relishing the challenge of finding ways
to make people with learning difficulties feel included and
involved,” she says. “But we hear reports that others expect them
to turn up to meetings without giving them any support.” Having
board members with learning difficulties and failing to support
them is just paying lip-service to Valuing People’s objectives, she
adds.

David Congdon, director of public affairs at learning difficulties
charity Mencap, agrees that some partnership boards are finding it
more difficult than others to make their work accessible to people
with learning difficulties and their carers. He supports the idea
that service users have their place on partnership boards and says
more should be done to improve their accessibility. “People with
learning difficulties and their parents are able to challenge the
board and are not just there to do their job,” he says.

The professionals and people with learning difficulties on
Norfolk’s partnership board are in the fortunate position of having
a positive working relationship. Amanda Reynolds, Norfolk Council
and Norfolk Primary Care Trust joint director of learning
difficulties, says this takes sustained effort and admits it has
not been plain sailing.

“At first, decisions still got made about services outside the
board meeting and we’ve had to challenge that,” she says.
“Sometimes we make mistakes but we talk about them and work things
out.”

Norfolk’s partnership board has 35 members. This includes eight
people with learning difficulties and three of their parents; six
chief executives of primary care trusts; a housing director; the
chief executive of the local Connexions service; and a private
sector provider. Reynolds says the variety of high-level staff
attending the board adds gravitas to it and has increased its
effectiveness. In turn, she adds, being on the board has improved
the work the senior staff do within their own organisations. “The
care trust chief executives have said the skills they’ve developed
from working with people with learning difficulties are directly
transferred to working with other client groups.”

Doncaster’s partnership board is not at the same stage as
Norfolk’s, according to the council’s learning difficulties service
manager, Peter Collier. He is responsible for overseeing the agenda
of the boards, which Doncaster’s head of community care Joan Beck
chairs. Collier says the board initially had problems with
producing reports in a format that its members with learning
difficulties could understand. Collier says the council resolved
this by funding a new service using a specifically developed set of
core symbols to translate all the board’s written information. They
are so pleased with the service that the council hopes to make it
into a social firm to provide work for people with learning
difficulties.

Collier says the board is also trying to increase the number of
people with learning difficulties it consults so the services
provided by all the board’s members are more appropriate.

Including all the necessary agencies on Doncaster’s board has been
a challenge. Collier says the local learning and skills council and
Connexions service are not yet involved because of the “sheer
pressure of their workloads”. He adds that the agencies are not
reluctant to join the board and is confident they will do so in the
months ahead.

The experiences of Norfolk and Doncaster show that the success of
partnership boards depends on the commitment from every agency
involved. But what steps can boards take to improve the way they
operate?

Rank says boards should look to consult a wider range of people
with learning difficulties and not just depend on individuals
involved in self-advocacy groups. “People who live in rural areas
and residential homes are likely to be left out,” she says.
“Self-advocacy groups don’t know how to change their services for
the better if they have no experience of them.”

She also wants to see the government provide specific funding so
people with learning difficulties can attend boards. “The
Department of Health should dip its hand into its pockets to help,”
she says. “If people with learning difficulties can’t physically
get to a meeting then it’s not accessible, is it?”

Collins adds weight to this. She says it must be made easier for
people with learning difficulties to access existing financial
support so they can take their places on boards. Her call stems
from Values into Action’s experience of having to distribute
£1.2m of government grants to learning difficulty
self-advocacy groups over the next three years. She says many of
the applications it has already received request money so that
individuals can attend boards. “Boards are funded through their
local authority whose responsibility it is to ensure that people
with learning difficulties have all the support they need to be a
fully involved board member,” she says.

Clearly the sector supports the concept of partnership boards, but
doubts remain over prospects for their success in the long-term.
There is also the question of how much influence councils are
prepared to allow them. Collier says: “Boards will vary in their
robustness depending on whether statutory organisations let them
make decisions about their areas of responsibility.”

After all the time and effort involved in establishing partnership
boards, Collier still believes they are worth it: “The decisions we
are making now are much more informed and are open to more
scrutiny. Our services better meet the needs of the people we’re
trying to help.”

¹ Department of Health, Valuing
People: A New Strategy for Learning Disabilities for the 21st
Century, DoH, 2001