30.10.15
NHS to close learning disability units while shifting care to the community
The number of hospital inpatient beds for people with a learning disability or autism is to be halved and replaced with better care options in the community, under new plans unveiled by NHS England.
It also means that some units will close altogether. For instance, plans in Lancashire and Greater Manchester include the closure of Calderstones, the only remaining standalone learning disability hospital trust in England.
The ‘Building the right support’ plans set out the need for local housing that meets the needs of these people, such having their own home but ready access to on-site support staff; an expansion of the use of personal budgets; people having access to a local care navigator, and investment in advocacy services run by local charities.
Simon Stevens, CEO of NHS England, said: “As good and necessary as some inpatient care can be, people with learning disabilities are clear they want to live in homes, not hospitals.
“We’ve seen some progress over the last few years, but now is the moment to grasp the nettle and build the excellent community-based support that will allow people to move out of hospitals.”
To deliver the ambitious plans, local councils and NHS bodies – mainly CCGs – will join together to deliver better and more co-ordinated services. By April 2016, 49 new local Transforming Care Partnerships will work with people with lived experience of these services to agree implementation plans, which will then be delivered over the next three years.
Budgets will be shared between the NHS and local councils to ensure the right care is provided in the right place, with a new financial framework aimed at speeding up discharges.
Additionally, national guidelines will set out what support people and families can expect, wherever they live.
Approximately 24,000 people in England have a learning disability and/or autism are classed as being at risk of admission. Although the number of discharges or transfers has increased by 38% over the last year, 2,595 people were in hospital settings as of 30 September, more than three quarters of whom had been in inpatient facilities continuously for longer than a year.
Over the next three years a national NHS England fund of £45m will be available to Transforming Care Partnerships to aid the transition.
NHS England said that bed closures will be staged, taking place when suitable alternatives are available. Progress made will be reviewed before the end of 2018, to see whether further reductions could be achieved.
Mark Lever, CEO of the National Autistic Society, said: “Following the abuse uncovered at Winterbourne View, the government and NHS have been working to move people out of inappropriate inpatient units. But this has not happened fast enough.
“We therefore welcome this promising plan which provides guidance to local areas on how to develop suitable community provision that should enable up to 50% of inpatient beds in England to close in the next three years. We are also encouraged that NHS England has made £45 million available to support this transition.”
Over the summer this year, NHS England, the Local Government Association and ADASS supported six ‘fast track’ areas to draw up plans for service transformation, closing some inpatient beds and shifting investment into community support.
A £10million transformation fund was made available to these areas to help fund the fast implementation of their local plans, which have been published alongside today’s national documents.
Cllr Izzi Seccombe, the LGA’s community wellbeing spokesman, said: “Councils want people with learning disabilities to have access to the right care and support they need in the right place, at the right time.
“Local authorities and the NHS have been working hard to make progress in providing this, but we also know that there is still more to be done.”