Three thousand people with learning disabilities, autism and/or behaviour that challenges are in specialist inpatient facilities in England, with 72% receiving antipsychotic medication in the previous months, new figures have revealed.
The third annual Learning Disability Census, by the Health and Social Care Information Centre (HSCIC), also found that 48% of inpatients in specialist inpatient units on September 30 were also receiving inpatient care at the time of the 2013 census.
The Learning Disability Census considers inpatients in specialist units with learning disabilities, autistic spectrum disorder and/or behaviour that challenges. It provides information about these patients and their experiences of care in NHS and independent facilities in England. The Census began in 2013 in response to events at Winterbourne View Hospital, which were revealed in 2011.
Of those 3,000 inpatients, more than a quarter (26%) experienced at least one accident, physical assault or episode of self-harm, as well as at least one restrictive measure, such as restraint or seclusion.
The Census also showed that the average length of stay in specialist inpatient units increased in the past year to 554 days, up from 547 in 2014. Additionally, the average distance that patients were from home increased in the past year – 38.6km compared to 34.4km in 2014. The proportion of inpatients receiving care more than 100km away from home in 2015 was 23%, up from 19% in 2014.
This is despite government-backed initiatives in recent years that aimed to – among other things – bring the average length of stay down, as well as ensure that people were placed in units closer to home.
The Census also found that:
• 75% of those in the 2015 Census were male
• The most common adverse experience type was self-harm. This involved 24% of inpatients in 2015, compared to 25% in 2014
• 72% of patients received antipsychotic medication either regularly or 'as and when needed' in the 28 days prior to the census collection, compared to 73% in 2014
• 92% of inpatients were aged 18-64 – substantially higher than the comparable England-wide population age distribution (59%).
NHS England recently published ‘Homes not Hospitals’, which aims to reduce the number of people with learning disabilities in inpatient units and close some inpatient units over the next three years.
Jan Tregelles, chief executive of Mencap, and Viv Cooper, chief executive of the Challenging Behaviour Foundation issued a joint statement in response: “[The] Learning Disability Census 2015 is stark reminder that since the abuse scandal of Winterbourne View, there has been little progress in moving people with a learning disability out of inpatient units. The fact that there has been a significant increase in the amount of people with a learning disability who have gone unreported is completely unacceptable. These people who have been lost in the system are at a greater risk of abuse and are not receiving the support to be able to return to their communities.
“Commissioners and providers failing to return any information on hundreds of people is another contributing factor to the minimal improvements we have seen for people with a learning disability so far.
“NHS England recently published their closure programme, which is welcomed, but until people see a change on the ground, this means little to people with a learning disability and their families. There are still too many people stuck in inpatient units, where they are at risk of abusive and restrictive practices.
“NHS England, CCGs [clinical commissioning groups] and the local authorities must act now to make sure the right services and support are developed as part of their Transforming Care Partnership plans, and people are moved back into their communities.”