Most CCGs failing to provide learning disability crisis support

In 2015, NHS England said local commissioners must ensure crisis services were in place by March 2019 to help reduce the number of hospital admissions for these patients. But data HSJ collected from clinical commissioning groups has indicated many areas are at risk of missing this deadline.

The data also suggested a third of CCGs do not have appropriate community support services for children and young people.

Experts described the figures as “incredibly concerning”, while a former health minister said they showed a “pretty disturbing picture”.

In 2012, in response to the Winterbourne View scandal, the government launched its transforming care programme which aimed to improve the care of patients with learning disabilities and autism.

A target was set to close institutional type facilities for learning disability patients, such as Calderstones Hospital in Lancashire. NHS England subsequently set plans to close at least 35 per cent of inpatient beds and provide better services in the community instead. As of November 2018, 20 per cent of beds have closed, HSJ understands.

Under the programme, CCGs and local authorities were split into 48 patches and expected to have commissioned short-term crisis accommodation and enhanced community support services for both children and adults by March 2019, to help avoid admissions to inpatient units.

HSJ submitted freedom of information requests to all 195 CCGs and received responses from 169. Of the 169, 88 CCGs said there was no short-term crisis accommodation for patients in their area, while 49 CCGs said they did not have community support services for children and young people.

NHS England has not responded to requests for comment.

A number of CCGs said they had plans in place to implement the required crisis and children’s community services in their transforming care area by 2019-20, while some said they had focussed on commissioning alternative types of crisis services which did not fit with NHS England’s guidelines.

Dan Scorer, head of policy and public affairs at Mencap, said: “It’s shocking and alarming that children and adults with a learning disability and behaviour that challenges are at risk of entering inpatient units and remaining stuck in them as NHSE has not delivered on its promise of robust community support.

“Four months away from the deadline, it’s very clear that urgent action needs to be taken by the NHS and its partners.”

Norman Lamb, Liberal Democrat MP for north Norfolk who was also a health minister in the coalition government, said the data gave “a pretty disturbing picture”.

Mr Lamb claimed the key problem is that money has not shifted from the NHS into social care. He said this has created a “perverse incentive” for councils who are required to take on the “substantial financial cost” of patients being discharged from inpatient units.

Tim Nicholls, head of policy for the National Autistic Society, said the transforming care programme had “failed for autistic people”.

He added: “HSJ’s findings are incredibly concerning but, sadly, will not be a surprise to autistic people and their families.

“We can’t address this appalling situation without changing funding arrangements. NHS England has promised that autism will be a priority in its upcoming long-term plan. This must include a new way to put the millions spent on the wrong type of care into the right support, near family and friends.”