Local plans to transform care for people with a learning disability and/or autism have been published, backed by millions of pounds of funding announced by health and care leaders.
The plans are the latest stage in delivering the reforms set out in Building the right support: A national implementation plan to develop community services and close inpatient facilities, published in October 2015 by NHS England, the Local Government Association (LGA), and the Association of Directors of Adult Social Services (ADASS).
Building the right support set an ambition of empowering individuals and their families to have more say in their care by developing and strengthening good quality support options in their communities and, as a result, reducing the number of people with a learning disability and/or autism in England who are in hospitals by up to half over 3 years.
To this end, 48 local Transforming Care Partnerships (TCPs) – which are made up of people who use services, their families, providers of services, clinical commissioning groups, local authorities and NHS England specialised commissioning hubs – are tasked with taking forward these intentions and designing new, high-quality, community-based services that reflect the wishes and circumstances of local residents.
The first awards from a £30 million, 3-year NHS England revenue fund to help TCPs where there is a need to speed up the delivery of new services have now been finalised.
Funding of almost £6.5 million has been designated to 23 TCPs on a match-funding basis to help get new services up and running while older models of care are still in place, allowing for safe and effective transition between the two. Bids for funding were assessed and approved on the basis of where the biggest impact will be anticipated to meet ambitions of Building the right support.
Plans include:
• Buckinghamshire TCP will explore the development of a shared-ownership housing scheme, one of a number of options being considered that aims to improve the quality of life for people with learning disabilities and/or autism by delivering services in their own homes, not hospitals
• Suffolk TCP – and others – will deploy Positive Behavioural Support to support people with a learning disability and/or autism, in this case offering training in this approach to families, schools and care providers
• Humber TCP – and others – will further develop the advocacy services available to people with a learning disability and/or autism and their families – in many cases involving local charities and voluntary groups
• Outer North East London TCP will develop its respite offer for families and carers that helps current arrangements to be maintained with positive family relationships.
NHS England has also confirmed that £100 million of funding will be available over five years to support Transforming Care projects – up from the £15 million announced at the time of Building the right support. Investment of more than £20 million has already been provisionally earmarked for schemes across the country in 2016/17, including new housing and services.
Jane Cummings, chief nursing officer for England and chair of the Transforming Care Delivery Board, said: “Building the right support was rightly praised for its ambitious and comprehensive plan to improve the lives of people with a learning disability and/or autism.
“This will by no means be easy, but it’s extremely encouraging to see how local NHS organisations and councils have taken up the mantle, built on existing good practice and engaged with families and organisations in their areas to develop their own innovative plans to suit their areas.
“We and our national partners are backing their plans, including with this significant additional investment over the coming years, and I look forward to seeing the improvements in people’s lives and health we can deliver together.”
Ray James, ADASS immediate past-president and vice-chair of the Transforming Care Delivery Board, said: “ADASS recognises the encouraging progress made by many local partnerships, who are working together to transform the choices available for local people.
“The transformation funds… will help ensure that more people with a learning disability and/or autism are supported to lead fuller, more independent lives in their local community.
“We know there is much more that needs to done, but today marks another important step in our work with and for local people, their families and carers.”
The LGA’s community wellbeing portfolio holder, Cllr Izzi Seccombe, said: “Councils remain absolutely committed to supporting people with a learning disability and autism to live close to family and friends, in good quality accommodation with support from highly skilled staff. On occasions when a person’s mental health needs does require an admission to hospital, steps must be taken to ensure it is properly managed with the individual discharged in a safe and timely way.
“As plans are implemented by Transforming Care Partnerships, councils will continue to work with individuals and families, health colleagues and other local partners to see that the support people receive directly meets their needs and wishes.”
In England, about 24,000 people who have a learning disability and/or autism are classed as being at risk of admission. On June 30, 2,530 were in inpatient settings, according to official figures; although that number has reduced by 10% since March 2015, about a third of patients had been in inpatient facilities continuously for five years or more.
As new and better alternatives become available in the community, Building the right support predicts a reduction in inpatient beds of between 30 and 50% nationally. In some areas that have relied on inpatient settings more than the average, the number of beds which will be commissioned may be reduced by up to 70%.
To achieve this, local TCP plans will be ‘living’ documents, continuing to be developed in partnership with service users and their families, as well as charities and other groups, to ensure they meet local need and continue to drive up the quality of care.
NHS England is developing packages of support for TCPs, ranging from a generic list of high impact actions TCPs can implement to a more intensive support package, along with accelerated learning events where TCPs can get together to share good practice.
