1. Tackle preventable deaths: stopping overmedication and improving health checks
Health checks in primary care will be improved in both uptake and nature, with the aim of reaching 75% of people aged 14+ with a learning disability annually. Hearing, sight, and dental checks will be given to young people in residential schools.
For the first time, autism-specific health checks will be trialed in pilot studies; if successful, they will be extended across the country.
The ten-year plan acknowledges that people with learning disabilities and autism are more likely to be prescribed psychotropic medication inappropriately, so initiatives such as Supporting Treatment and Appropriate Medication in Paediatrics (STOMP-STAMP) will be supported.
Funding for the Learning Disabilities Mortality Review Programme (LeDeR) will continue, with the aim of improving the lives of people with learning disabilities nationally.
2. Improve understanding of learning disabilities and autism within the NHS
NHS staff will receive training about how to best support people with learning disabilities and autism, with Sustainability and Transformation Partnerships (STPs) and integrated care systems (ICSs) being expected to ensure all local healthcare providers are making reasonable adjustments. The Department for Education and local authorities will be supported by the NHS to improve their awareness of and support for young people with learning disabilities and autism.
Over the next five years, national learning disability improvement standards will apply to every NHS-funded service to promote greater consistency. Rights, the workforce, specialist care, and working more effectively with people and their families are illuminated as key themes.
By 2023/24, a “digital flag” in patient records will signify to staff that someone has a learning disability or autism.
3. Reduce waiting times for specialist services
The long waiting times for diagnostic assessments for children and young people suspected as being autistic is highlighted. Indeed, the next three years will see autism being included alongside mental health services to achieve timely assessments.
NHS services will work with local authorites’ child social care and education services to develop packages to support children with neurodiversities – and their families – through the diagnostic process. Specialist charities will be consulted with in the formulation of these care packages.
By 2023/24, children with learning disabilities and autism with the most complex needs will each have a designated keyworker to ensure that they are being best supported. Initially, children who are inpatients or at risk of being admitted will be allocated these keyworkers. This support will be extended to the most vulnerable children such as children involved with social services and those in transition between services.
4. Increase investment in community support: reducing inpatient admissions
Care in the community should become more personalised and closer to home, with fewer people being subjected to preventable inpatient admissions. By March 2023/24, inpatient provision will have reduced to less than half of 2015 levels (on a like for like basis and taking into account population growth) and, for every one million adults, there will be no more than 30 people with a learning disability and autism cared for in an inpatient unit. For children and young people, no more than 12 to 15 children with a learning disability, autism or both per million, will be cared for in an inpatient facility.
Every local health system will be expected to have a seven-day specialist multidisciplinary service and crisis care, and specialist community teams for children and young people will continue to be developed to limit institutional care.
5. Improve quality of inpatient care across NHS and independent sector
By 2023/24, all care commissioned by the NHS will need to meet the Learning Disability Improvement Standard, with a particular focus upon seclusion, long-term segregation, and restraint.
Both the numbers of people in inpatient facilities as well as the length of admission will be closely monitored, with the aim of reducing inpatient admissions and supporting earlier transfers into the community. All areas of the country will implement and be monitored against a “12-point discharge plan” to ensure discharges are timely and effective. Existing Care, Education and Treatment Review (CETR) and Care and Treatment Review (CTR) policies will be improved, with the NHS working in partnership with people with learning disabilities and autism – as well as their families and clinicians – to assess their effectiveness.
