NHS England has announced the appointment of its first national learning disability director as it attempts to get the Transforming Care programme on track to succeed by 2019.

Ray James, the former president of the Association of Directors of Adult Social Services and the long-standing executive director of health, housing and adult social care at the London Borough of Enfield, has been appointed on a two year secondment.

The news is shared by the NHS at a time when the government and the health and care sectors are facing increasing pressure by activists and charities to accelerate transitions out of 'hospital accommodation'.

The National Autistic Society's new report outlines "serious failings of care including incorrectly supplying heavy doses of anti-psychotics when no psychosis was present, unnecessary use of restraint and a lack of staff trained in autism."

The charity, which interviewed 13 families in conjunction with Mencap, says "urgent improvements" are needed. It has now published six recommendations to make Transforming Care a success:

  • The Government should urgently strengthen the law around the rights of people in (or at risk of) inpatient care.
  • NHS England must commission more specialist community-based services in line with the Transforming Care Service Model, and closely scrutinise individual plans for discharge to make sure they are acted on.
  • Local health and social care commissioners must commission community-based support and inpatient services, in line with the Service Model, including to prevent admission in the first place.
  • Inpatient care providers must ensure their staff are properly trained and their practices do not rely on excessive restraint and medication.
  • The CQC must robustly inspect and regulate inpatient services.
  • Professionals working with people with a learning disability, on the autism spectrum, or both must listen to individuals and their families and ensure their voices are at the centre of all decisions about their support.


Mr James will be expected to bring much needed momentum to the Transforming Care programme.

He will be tasked with providing leadership and sharing incentives for care providers to deliver transitions.

Several years on from the abuses exposed at Winterbourne View, close to 3,000 people with learning disabilities and autism continue to live in hospital settings.

The high fees accommodation providers are able to command has been highlighted as a key area undermining the desire for change.


Ray James said: “I’m delighted to have this opportunity to lead the NHS’s work with and for people with a learning disability and/or autism, their families and carers. I am particularly pleased to bring my background and values from a career in local government and social care to this role."

"There is much to do if we are to realise our ambition to support people to lead independent, inclusive lives in their communities, able to access high quality, care, support and/or treatment services when needed."

"I am looking forward to the challenges and opportunities over the next couple of years and also want to express my thanks to all at Enfield Council for supporting my secondment.”

Professor Jane Cummings, Chief Nursing Officer for England and Regional Director for London, said: “Ray has huge experience in local government and is a great addition to the NHS England team."

"We are committed to ensuring people with a learning disability get the right care and support using innovative services."

"Ray’s experience and knowledge will help ensure continuing progress across the NHS, local government and the third sector on our shared mission to drive new options for people with learning disabilities.”

You can contribute to the debate on what needs to change in order for Transforming Care to become a reality and hear from experts by joining us at Learning Disability Today London 2017 on November 22.