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NHS to close many residential hospitals for people with learning disabilities

NHS England will close many of the 58 residential hospitals where people with learning disabilities are still being sent to live despite a government pledge to move people out of these facilities in response to the Winterbourne View scandal.

Simon Stevens announced the plans while being quizzed by MPs on the failure to move people with learning disabilities and challenging behaviour out of these facilities revealed in a report from the National Audit Office last week.

He told the Public Accounts Committee that he also intends to force closure or reform of up to 49 private facilities that provide long-term accommodation for such people as well.

Stevens said: “I am afraid the time has come to say that some of these remaining facilities are going to have to close and care is going to have to be re-provided in a radical way.”

He added that the next 12 to 24 months would be used to “to chart out what that substantial transition programme is going to look like for those facilities”.

The announcement comes as somewhat of a surprise as there was no reference to closure plans in a report published last month by NHS England on its care reform agenda following the Winterbourne View scandal.

Stevens said: “In this instance, my belief is that none of us should be sitting here defending the indefensible. I think people have been badly let down.”

He added that the closures will take a “twin-track” approach. NHS facilities will go through a planned transition programme, while independent providers will face a “more engaged approach to the front end”.

He said: “Rather than waiting for people to have been in hospital for six to 12 months and do the care and treatment reviews that we have just been going through for the April 2014 cohort, we have got to do those right up front at the point when people are about to be admitted, or after they have been admitted for a few days, to ask the question. The right to challenge, which was talked about in Stephen Bubb’s report, is the right way to go.”

He added: “We cannot just have the situation where we simply reduce the NHS provision and instead it just flows over into third-party providers that expand on the back of it.”

Jane Cummings, the chief nursing officer for England, told the committee that the CQC had recently rejected an application from a private company for a licence to open a new learning disability hospital. The CQC had consulted NHS England, which had said it did not support the proposed model of care.

Margaret Hodge, the chair of the committee, said she was delighted to hear at last a firm commitment to close outdated hospital services and provide a better life for thousands of people with profound learning disabilities.

A commitment to move people with learning disabilities and challenging behaviour out of mental health hospitals and into the community was made in the wake of the Winterbourne View scandal in 2011. But NAO figures have found that there were still 2,600 such inpatients as of September 2014.

Following the scandal the Department of Health set out an action plan in the ‘Winterbourne View Concordat’, which was published in December 2012. It pledged that any inpatient with a learning disability or challenging behaviour, who would be better off cared for in the community, would be moved out of hospital by June 2014.

But the NAO said that at the time of making the promise ministers “had not determined the scale of the challenge involved in increasing the capacity of community placements”.

The report said: “When the Concordat was published, the government did not have information on the ability of local commissioners to put in place the bespoke community placements and personalised care plans required to manage patients’ risks effectively, and prevent patient readmission. Nor had the government analysed the reasons for new patient referrals to mental health hospitals (including the impact on the total inpatient mental health population) or quantified the resources needed to accelerate patients’ readiness for discharge, to meet the 1 June 2014 target date.”

(Image source: Tim Ireland/PA Wire)

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