NHS England community living guidance for people with learning disabilities

NHS England has published guidance on supporting autistic people and people with learning disabilities to live well in the community, stating that people should receive help based on their needs rather than on whether they meet particular diagnostic thresholds.

The guidance is intended for Integrated Care Boards (ICBs), NHS providers, local authorities and partner organisations. It draws on the views of around 300 people with lived experience, families and professionals and is designed to support local systems to plan and deliver this support across all ages.

With changes to the Mental Health Act placing greater emphasis on community-based support, the guidance says that health, housing, social care, education and the voluntary sector must work together to prevent crises, rather than waiting until someone reaches breaking point.

Those reforms aim to reduce the inappropriate detention of autistic people and people with a learning disability by ensuring that improved community services are available before crises arise.

In addition, reasonable adjustments should be standard practice across all healthcare settings, not just in specialist services. People and families should co-produce services, rather than simply being consulted after decisions have already been made.

Community support for learning disability practitioners

For learning disability nurses, support workers, psychologists and commissioners, the guidance reinforces many areas long advocated but inconsistently delivered, including annual health checks, medicines optimisation and timely access to diagnostic services.

It also discusses support for people on waiting lists, access to suitable housing, employment and meaningful occupation.

The success of this guidance would depend on funding and on whether local Integrated Care Boards and councils have the workforce and resources to implement it.

This guidance builds on Building the Right Support (2015) and the principles outlined in the Service Model and in Developing support and services for children and young people with a learning disability, autism or both.

NHS England also plans to update the related service models published in 2017 and to provide more detailed guidance for specific NHS-commissioned functions, including:

• accommodation-based alternatives to hospital
• enhanced or intensive support for autistic adults
• enhanced or intensive support for children, young people and adults with a learning disability
• community-based forensic support for adults.

Alison Bloomer

Alison Bloomer is Editor of Learning Disability Today.

See Full Bio