‘Yet another failure’ on flagship programme for learning disabilities

In the long-term plan, published last year, NHS England and NHS Improvement committed to reduce the total number of patients with a learning disability and/or autism within inpatient units by 35 per cent.

According to figures for March 2020, published this week by NHS Digital, the total number inpatients was 2,095, a reduction of 27 per cent against a revised baseline of 2,890.

A target to reduce the number of adult inpatients to 37 in every one million head of population was also missed, with the figure reported as 43 adult inpatients per one million.

Reducing the number of people with learning disabilities and/or autism held within inpatient units has been the core measure of the Transforming Care programme, which was launched in 2015 in response to the abuse of patients exposed in the Winterbourne View scandal.

Mencap, the learning disability charity, said the main reasons for people being stuck in hospital are a lack of social care and housing provision within the community.

One barrier is a lack of providers of accommodation within the community, while another is that local authorities are often not incentivised to support discharge, as care costs for a person largely then transfer to social care.

The original aim was to reduce the total number of inpatients, both children and adults, by between 35 to 50 per cent by March 2019. NHSE extended this target last year as it became apparent the NHS would not even meet the 35 per cent marker. The original baseline figure of 2,395 for March 2015 was also changed.

NHSE did not respond to HSJ’s request for comment. 

Edel Harris, chief executive of the learning disability charity Mencap, said: “[These] 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…

“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.”

Ms Harris added the situation could worsen amid the covid-19 pandemic due to proposed emergency changes to the Care Act and Mental Health Act.

She said they could create a “perfect storm” as more people are left to reach crisis point because they cannot get help at home.

Although a new target was set for adult inpatients, no new target was set for a reduction of children held within an inpatient unit. New figures show there were 250 children within inpatient units as of March 2020.