NHS England has been too slow to act in its closure of inpatient wards for people with learning disabilities, while failing to ensure the necessary replacement community support is in place, according to Sir Stephen Bubb in his six-month follow up to his earlier report ‘Winterbourne View – Time for Change’.
In today’s six month-review of progress, he acknowledged there had been “a definite shift in the commitment to change” by NHS England, demonstrated through plans in its Transforming Care programme.
He noted that a full timetable for ward closures was due to be published in October, which he is to review.
But he said there had been “little to no discussion” with providers and the third sector more widely about how to improve community facilities.
Sir Stephen called for NHS England to set up a “transition taskforce” mandated to work with providers, commissioners and families to set out the national framework for scaling up community provision.
Commenting on the report, Sarah Lambert, Head of Policy at the National Autistic Society (NAS), said: “Following the abuse uncovered at Winterbourne View, the Government has rightly focused on getting people out of inappropriate in-patient units. While we recognise that progress is being made, we share Sir Stephen Bubb’s frustration about how long this is taking.
“According to recent progress reports although 650 people have now moved out into the community, the number of admissions means that there has only been a net reduction of 140 people.
“Everyone involved recognises that this can only change when there are appropriate services and support in the community to prevent people going into these units inappropriately in the first place and – where they may have to be temporarily in a unit – to which they can move at the earliest possible opportunity.
“We welcome the work NHS England has been doing, so local commissioners will have the information they need to put the right services in place. In the short to medium term, this is likely to require increased investment, which needs to be urgently considered as part of the comprehensive spending review in the autumn. Longer term, making sure that the right support is available at an earlier stage will prevent people from falling into crisis and placements breaking down, which is both good for the individual and will lead to savings to the public purse.”
Fellow charities Mencap and the Challenging Behaviour Foundation echoed these concerns. They called for “urgent priority” to be given to improving community provision, including investment in the workforce.
Earlier this year, NHS Engand board papers revealed plans to close inpatient facilities for people with learning disabilities would first be implemented in the Midlands and East, and North regions of England.
A report by chief nursing officer for England Jane Cummings included in the papers said 30% of learning disability patients in hospital on 1 April 2014 had now been discharged into the community following assessment.
However, a recent update by NHS England and other organisations on their work to improve learning disability care shows in places the rate of admissions to wards is outstripping discharges. It said from March 2014 to May 2015 there was an overall reduction of 140 people in inpatient care in England.