Mencap and Challenging Behaviour Foundation warn that the Covid-19 pandemic could lead to even more vulnerable people being admitted to inpatient units.
- The Government has failed to meet revised target by around 300 with at least 1,895 adults with a learning disability / autism still locked away in inpatient units
- 205 children with a learning disability and/or autism are locked away in inpatient units
- There has been little change in the number of admissions with around 100 admissions every month in 2019/20
- Delayed discharges continue with at least 125 people still stuck in hospital when they are ready for discharge in March 2020
The Government has failed to meet its own Transforming Care programme target for the second year running as experts warn that the coronavirus crisis risks more children and adults with a learning disability and/or autism being locked away in inpatient units at risk of increased abuse and neglect.
Data released today from NHS Digital shows that at least 1,895 adults with a learning disability and/or autism remain locked away in inpatient units in March 2020. This is almost 300 more adult inpatients than the target, set by the government last March, for the number of ‘adult’ inpatients we should expect to see at the end of March 2020 (which they said would equate to a 35% reduction from March 2015 in the total number of inpatient beds). This revised target followed the failure to meet a target set in 2015 to close, by March 2019, 35-50% of in-patient beds.
Over the last year, there has continued to be a steady stream of admissions with around 100 admissions recorded each month between April 2019 and March 2020. Delayed discharges also continue with at least 125 people still stuck in hospital when they are ready for discharge in March, with the main reasons being a lack of social care and housing provision in the community.
This comes as charities, advocacy groups, families and MPs warn that powers in the Coronavirus Act risk leaving vulnerable people unable to access the social care they need. This means that people with a learning disability and/or autism are at increased risk of being locked away while those who are currently locked away will remain stuck in inpatient units.
Edel Harris, Chief Executive of the learning disability charity Mencap, said:
“Today’s figures show yet another failure of the programme set up to support people with a learning disability and/or autism and give them an opportunity to thrive in the community. It’s hugely concerning that targets have been missed so severely – it’s clear that little is being done to fix the root cause of the problem.
“We might be experiencing lockdown at this time, which is challenging for anyone. But ‘modern day asylums’ are a whole different level of isolation; they are hospitals and not homes. People with a learning disability and/or autism are stuck in these hospitals, often hundreds of miles away from their family for years at a time. They are often subject to degrading treatment with inhumane levels of physical, chemical and mechanical restraint and in some cases are kept in solitary confinement.
“The steady stream in the number of admissions and continued delayed discharges shows just how desperately the need is for appropriate social care support in the community – the only proper alternative to these inpatient units. But worryingly, this gap is likely to become greater during this time of pandemic. Changes to the Care Act and Mental Health Act in the Coronavirus Act could create the ‘perfect storm’ as more people are left to reach crisis point because they can’t get help at home. Now more than ever, we need a cross-government strategy to stop inappropriate admissions and get people out of inpatient units and back into the community. And we need funding to reach frontline social care services immediately so that we do not see more people being locked up during this time of lockdown.”
Vivien Cooper OBE, CEO of the Challenging Behaviour Foundation, said:
“Children and adults with learning disabilities and autism remain in inappropriate services, often far from their homes, because the Transforming Care programme has not delivered what was promised 8 years ago. In 2015 the Government set a new target to improve support and services in the community and reduce the number of children and adults in inpatient units by 35% - 50% by March 2019. Last year the NHS 10-year plan moved the lower target of 35% to March 2020. Today’s figures clearly show the government has yet again failed to meet this target and transform care, and so many hundreds of people with learning disabilities and/or autism remain inappropriately in hospitals.
“The current pandemic is unprecedented and affects us all, but it is essential that the painfully slow progress that has been made is not lost. We expect the Government to ensure there is additional scrutiny on the care and support of those who are in inpatient services during this time as well as attention given to supporting people well in the community. The easement of the Care Act and Mental Health Act, combined with reduced services and restrictions placed on children and adults with learning disabilities and their families, increase the risks of inappropriate restrictive practices and admission to Mental Health hospitals. It is essential resources are invested in community support and action is taken to protect the human rights of children, young people and adults with learning disabilities and autism.”
The Care Act easements contained within the Coronavirus Act relieve local authorities of their full duties so that they can prioritise the cases they deem most urgent. Families have already expressed concern that local authorities are already making use of the Care Act easements to cut vital support for people with a learning disability and/or autism.
At least 2,095 people with a learning disability and/or autism continue to be locked away in inpatients units, of which 205 are children.
The average total length of stay in inpatient units is 5.6 years. While in these units, children and adults with a learning disability and/or autism are subject to restrictive interventions (like physical, prone, mechanical and chemical restraint) – 3,885 in one month, of which 745 were against children. This is likely to be just the “tip of the iceberg” as only data for 3 out of 16 private/independent providers and 19 out of 56 NHS providers.
For further information or to arrange interviews, contact Mencap’s media team on:
- 020 7696 5414 (including out of hours).
Notes to editors
- Mencap and The Challenging Behaviour Foundation have been campaigning with families on these issues since the abuse scandal at Winterbourne View eight years ago.
- The Assuring Transformation data from NHS Digital is the most accurate and up to date account of people with a learning disability and autism in institutions. It is a record of how many are in an institution, how long they have been in for, when their care and treatment is checked and what kind of unit they are in. Latest data shows that numbers have fallen from 2,260 at the end of March 2019 to 2,095 at the end of March 2020: https://digital.nhs.uk/data-and-information/publications/statistical/learning-disability-services-statistics/provisional-statistics-at-march-2020-mhsds-january-2020-final
- Figures for restrictive practices quoted from NHS Digital MHSDS Data: January 2020, published April 2020. For more information: https://digital.nhs.uk/data-and-information/publications/statistical/learning-disability-services-statistics/provisional-statistics-at-march-2020-mhsds-january-2020-final
- In the tables for restrictive practices we cannot distinguish between ‘less than 5’ and ‘missing data’, so we have to treat this all as missing data.
- Mencap and CBF are asking the Government to focus on:
- Developing local expertise, support and services
- Ensuring there is joint oversight and ownership of the national programme by the Ministers from the Department of Health and Social Care, Department of Housing, Communities and Local Government and Department for Education.
- Removing the red tape and funding barriers that are preventing so many people from returning home.
- There remains no robust plan from leadership for cross-government working.
There are 1.5 million people with a learning disability in the UK. Mencap works to support people with a learning disability, their families and carers by fighting to change laws, improve services and access to education, employment and leisure facilities. Mencap supports thousands of people with a learning disability to live their lives the way they want.
For advice and information about learning disability and Mencap services in your area, contact Mencap’s Freephone Learning Disability Helpline on 0808 808 1111 (9am-3pm, Monday-Friday) or email email@example.com.
What is a learning disability?
- A learning disability is a reduced intellectual ability which can cause problems with everyday tasks – for example shopping and cooking, or travelling to new places – which affects someone for their whole life;
- Learning disability is not a mental illness or a learning difficulty, such as dyslexia. Very often the term ‘learning difficulty’ is wrongly used interchangeably with ‘learning disability’;
- People with a learning disability can take longer to learn new things and may need support to develop new skills, understand difficult information and engage with other people. The level of support someone needs is different with every individual. For example, someone with a severe learning disability might need much more support with daily tasks than someone with a mild learning disability.
About The Challenging Behaviour Foundation
The Challenging Behaviour Foundation (CBF) is a charity which exists to demonstrate that individuals with severe learning disabilities whose behaviour challenges can enjoy ordinary life opportunities when their behaviour is properly understood and appropriately supported.
The CBF supports families across the UK caring for individuals with severe learning disabilities. Information and support around understanding challenging behaviour and supporting behaviour change is provided through a range of written and DVD resources, email networks, family linking scheme, and through individual telephone support.
For more information about the CBF’s work on restraint and seclusion:
- visit https://www.challengingbehaviour.org.uk/driving-change/restraintandseclusion.html)
- visit: www.challengingbehaviour.org.uk
- email: firstname.lastname@example.org
- phone: 01634 838739.
 According to calculations made by Mencap and the Challenging Behaviour Foundation, for NHSE’s 1 year target of ‘37 adult inpatients per million population’ by March 2020 to be met, it would mean there would be approx. 1,600 adults in inpatient units at the end March 2020.
 NHS Digital data breakdown does not total – this may be due to rounding or missing data.