Only a tenth of the 2,577 people with learning disabilities in in-patient hospital settings have a date set for their transfer back into the community, NHS figures have revealed.
Data taken from the 211 clinical commissioning groups (CCGs) and 10 NHS England Area Teams responsible for specialised commissioning of secure mental health and child and adolescent mental health services revealed that, as at December 31, 2013, only 260 of the 2,577 patients have a transfer date of which. Of these, only 172 are set for transfer before June 1, 2014.
The information was on the number of patients currently in inpatient care and whether they have been transferred or there is a planned date to transfer and who had been admitted in the last quarter.
In more than 1,000 cases, the reason given for why people do not have a planned transfer date is a clinical decision. For example, many of these people have very complex needs, some may be too ill or are possibly a danger to themselves or the public. Some patients might have treatment orders or be detained due to Ministry of Justice order.
This is the first time this data has been collected and published. This was a commitment in the Winterbourne View Concordat, which was signed in December 2012. Figures will now be published quarterly.
NHS England noted that just because someone does not have a transfer date it doesn’t mean that they are inappropriately placed. It may mean that a date has not been set because there are issues that need to be dealt with – such as putting specialist community support in place – before the person can be given a timescale for moving.
More progress needs to be made
However, NHS England acknowledged that more progress needs to be made to help people move back into the community. It plans to use the data to establish, in the cases of people without a transfer date, whether they should be helped to move to a community-based setting; or, if the complexity of their needs is too great, whether on-going in-patient care is required.
NHS England will be working through local commissioners to drive change to ensure all patients are safe and agree the number of people who, with the right assessment, can be moved into the community. It will provide additional support to CCGs from the Improving Lives Team to review the care of former patients of Winterbourne View and other complex cases. It will also develop clinical guidelines to support local areas to provide good quality joint planning and assessment.
Jane Cummings, chief nursing officer for England, said: “Even though many of these patients have complex needs, they deserve a transfer date and to know when they will be returning home. Therefore, it is very important that we collect and publish this information so the public are aware of the progress being made in their local area. We need to be open and transparent without breaching patient confidentiality. We are increasing our efforts and will work with the Winterbourne View Joint Improvement Programme and other partners to escalate the urgency and priority of this programme. This will ensure the inclusion of safety, patient and family choice into the delivery of credible and sustainable care plans.”
Bill Mumford (pictured), director of Winterbourne View Joint Improvement Programme, added: “We are a long way adrift of where we want to be but the data has achieved its purpose: to provide transparency and hold us all to account. The national partnership has to do better and now we’ve established this quarterly reporting we can track our progress. Perhaps more importantly local area partnerships need to use the data relevant to them to aid local decision making and accountability and monitor local activity in support of this particularly vulnerable group of people and their families.”