NHS England has today published a report setting out plans to transform services for people with a learning disability.

Building the right support: A national implementation plan to develop community services and close inpatient facilities is being published today (Friday 30th October) by NHS England, the Local Government Association (LGA), and the Association of Directors of Adult Social Services (ADASS).  It talks about how people with a learning disability and/or autism will be supported to lead more independent lives and have greater say about the support they receive under a national plan published today to radically improve learning disability services.

Mencap and The Challenging Behaviour Foundation say that today’s report is a start, but serious doubts remain on whether it adequately addresses the causes of failure to deliver change over the last 4 ½ years since the Winterbourne View scandal.

Jan Tregelles, chief executive of Mencap, and Vivien Cooper, chief executive of the Challenging Behaviour Foundation, said:

This report comes over 4 ½ years after the abuse scandal at Winterbourne View was exposed by the BBC and shocked the nation. Despite numerous reports and missed targets, the same number of people with a learning disability remain in these units. In the meantime they have often been at increased risk of poor care and even abuse. 

Whilst this report has strong ambitions which we welcome, significant questions remain unanswered. At this stage we were expecting a proper analysis of why there has been a lack of progress to date, alongside a well thought through, costed and robust implementation plan.  This report presents some good ambitions but it is unclear how they will translate to the right outcomes for people.

We are concerned about whether sufficient resource and investment is being made available up front to develop the local support and services required. At the same time as this report makes a commitment to close beds, we know there are new units planning to open. It is essential that local partnerships are held to account for delivery and there is a focus on early intervention and prevention including getting it right for children. 

Families will be fearful of the fact that there is little new in the report about how local areas can be compelled to make the necessary changes to support services and guard against a postcode lottery of poor care.  New money has been announced today but there is no indication as to whether this is sufficient to rapidly mobilise the new housing and care services needed, whilst also up skilling local area teams

Today’s report is a start. Doubts remain as to whether it addresses the causes of failure to deliver change over the last 4 ½ years. NHS England and the Government must adequately fund local areas to deliver this change, as well as hold them to account, and intervene where change is not happening.  People with a learning disability, families and carers need to see change on the ground before they will believe progress is being made.

Steve Sollars, father of Sam, who was at Winterbourne View, said:

My son, Sam, who was at Winterbourne View, was restrained 45 times in a six month period. Sam was unrecognisable because of what he had been through.

He is now flourishing in the place where he is. However, there are still far too many people in places like this getting high levels of restraint and medication, behind closed doors. It is shocking and very frustrating that this is still going on even after all these years. We have had enough talk, what we need now is action to bring about change for people with a learning disability and families.

The Learning Disability Census 2014– from the Health and Social Care Information Centre -- reveals:

  • 3,230 people with a learning disability are still in inpatient settings, showing that there has been no meaningful improvement since 2013, when there were 3,250.
  • The average length of a stay in an A&T unit is 5.4 years.
  • 1,915 patients have been in an institution for more than 1 year.
  • 175 patients have been in an institution for 10 years or more.
  • 1,055 patients do not need inpatient care according to care plan.
  • 2,345 patients (73%) had received antipsychotic medication either regularly or as needed in the 28 days prior to census collection. Use of antipsychotic medication had increased between 2013 and 2014.
  • 1,780 patients (55%) have had one or more incidents (self-harm, accidents, physical assault, restraint or seclusion) in the three months prior to census day (2014).

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