The treatment of all people with learning disabilities or autism receiving inpatient care is to be reviewed, ahead of a drive to rapidly reduce hospital placements and increase community provision.
The plans are set out in a concordat drawn up in the wake of the Winterbourne View scandal, which revealed abuse of people with learning disabilities in an NHS funded private hospital.
The final draft of the concordat has been leaked to HSJ. Signatories include the NHS Commissioning Board, the Department of Health, the Local Government Association, the Care Quality Commission, and representative organisations such as the English Community Care Association.
A “programme for change” agreed by signatories says that by June 1 2013, health and care commissioners will review the care of each individual in inpatient care for learning disability or autism, and draw up a personal care plan for each patient.
Commissioners should then “put these plans into action as soon as possible, so that all individuals receive personalised care and support in appropriate community settings no later than 1 June, 2014.
“These actions are expected to lead to a rapid reduction in hospital placements for this group of people,” the concordat says. “People should not live in hospital for long periods of time. Hospitals are not homes.”
In order to safeguard the dignity and rights of people with learning disabilities and autism, signatories pledge to develop “personalised, local, high quality services” while closing “large-scale inpatient services”.
Every area should also put in place a joint plan for care and support services for people with challenging behaviour. “These plans should ensure that a new generation of inpatients does not take the place of people currently in hospital.”
The “strong presumption” will be in favour of supporting these plans with pooled budgets. Local commissioners should have to offer justification where this is not done.
The Local Government Association, the Association of Directors of Children’s Services and the Association of Directors of Adult Social Services will commit to working collaboratively with NHS commissioners. Meanwhile the NHS Commissioning Board should also “promote and facilitate joint and collaborative commissioning by local authorities and clinical commissioning groups”.
Although the document says regulation and inspection of care providers will be “tightened”, there will be no new powers for healthcare regulators.
The Care Quality Commission will only “take steps to strengthen the way it uses its existing powers to hold organisations to account for failures to provide quality care”, and will report on changes it plans to make from spring 2013.
The CQC will continue to make unannounced inspections of providers of learning disability and mental health services, employing people who use services and family carers as vital parts of the team when relevant and appropriate to do so.
Beverley Dawkins, policy manager at Mencap, one of the few providers to have signed the agreement, said: “The Government appears to have listened… the concordat includes many actions which should result in the significant reform of support and services for the most vulnerable people.
“However, the reality is that achieving these targets will require a huge shift in both the thinking and practice of local commissioners.
“The ultimate test for us will be how far the government’s proposals actually lead to a positive change in the lives of people with a learning disability.”