Who does what in LeDeR

Currently, it is the responsibility of clinical commissioning groups (CCGs) to make sure  that LeDeR reviews are done. As the NHS moves into new arrangements through 2021 and into 2022, local integrated care systems (ICSs) will become responsible for making sure that LeDeR reviews are completed for their local area, and that actions are implemented to improve the quality of services for people with a learning disability to reduce health inequalities and premature mortality.

As a result of the above governance changes and the new LeDeR policy, some of the roles and responsibilities within LeDeR will be changing. Below, we’ve outlined the key roles and any changes.

National LeDeR team 

The national LeDeR team is employed by NHS England and NHS Improvement. The team helps to support CCGs (and in future ICSs) to complete LeDeR reviews and use the information to change and improve the way they provide services in their local area. They also help local systems to learn from one another so that learning and good practice can be spread across the country.  They are responsible for making sure that there is an academic partner to support the programme and a web platform is commissioned to help reviewers complete reviews.

Regional coordinators 

There are 7 NHS England and NHS Improvement regional learning disability and autism programme teams across the country. A regional coordinator from each region sits in these teams and provides oversight for LeDeR. Regional coordinators provide operational support for local area contacts (LACs) and reviewer teams, and act as a point of escalation where issues cannot be resolved locally.

Local area contact (LAC) 

As we move into new NHS arrangements throughout 2021 and 2022, the LAC role will sit within the ICS. This is different to the current LAC role; there will be greater independence between the review team and the LAC in future.  

Within the ICS, it will be the LACs responsibility to act as the point of contact for the NHS England and NHS Improvement regional coordinator and will liaise with the review team. It is the LACs job to promote LeDeR at a local level across health and social care.

Reviewer teams

Review teams will be made up of reviewers and senior reviewers. Review teams carry out LeDeR reviews in a professional, compassionate, and caring way, treating bereaved family members and loved ones with respect, compassion and courtesy. They will share their findings with the local governance group or panel which will make recommendations on what should happen next to support service improvement.

Other stakeholders

Local governance group / panel – This group sits at ICS level and will have final sign off on reviews completed for that ICS area. The group will determine the actions to be taken as a result of reviews as well as develop and monitor the ICS LeDeR local action plan.

Independent advisory group – The LeDeR independent advisory group provides expertise and advice on addressing the premature mortality of people with a learning disability. The group makes recommendations and provides critical challenge to the approach for implementing the actions from learning, representing the views of a range of stakeholders.