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Lamb: Learning disability hospitals should be 'throttled'

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Alternative facilities should be commissioned for the majority of people with learning disabilities or autism who currently live in larger inpatient hospitals, the care services minister has said.

The Department of Health and the Care Quality Commission are also planning to review whether tougher regulatory or criminal sanctions should be brought in for care providers, a report into the Winterbourne View abuse scandal today reveals.

The DH report into the abuse of patients at NHS funded, privately run Winterbourne View was published this afternoon.

As revealed by HSJ last week, the DH, Local Government Association and NHS Commissioning Board have agreed the care of each individual in inpatient care for learning disability or autism will be reviewed by June, and a personal care plan will be drawn up for each patient.

Commissioners should then put these plans into action as soon as possible, so that all individuals receive personalised care and support in appropriate community settings no later than 1 June, 2014.

Care services minister Norman Lamb said 3,000 people with learning disabilities in full time hospital care should not be there.

He added: “We think the large hospitals are inappropriate settings for people with learning disabilities.”

The plan now is that larger facilities like the 48 bed Winterbourne View are “throttled by people not having their care commissioned there”, Mr Lamb said.

Caring for people in the community will save “bucketloads of money” and improve care, Mr Lamb said.

It is hoped that this will lead to a “dramatic reduction” in the number of learning disability inpatients. There are currently around 1,200 people in “assessment and treatment units”. Mr Lamb said he wanted to reduce that number to 300 or 400, and to cut the number of patients, currently totalling around 2,200, in other forms of inpatient care.

Next spring ministers will bring forward proposals to address the “gap in the law” on effective corporate accountability.

This could include new powers for the CQC. A “fit and proper person” test is being considered for people running companies that provide care, along with new criminal offences. The review will also consider whether the regulator’s primary legislative powers need to be strengthened to hold boards and shareholders to account.

In the mean time, the CQC has pledged to “tighten” its inspection regime. In future hospitals for people with learning disabilities will only be inspected unannounced, with teams including a person with a learning disability.

The LGA, the Association of Directors of Children’s Services and the Association of Directors of Adult Social Services will commit to working collaboratively with NHS commissioners.

The “strong presumption” will be in favour of pooled budgets. Local commissioners should have to offer justification where this is not done.

Peter Carter, chief executive and general secretary of the Royal College of Nursing, said: “What happened at Winterbourne View was deeply shocking, particularly as the abuse was carried out against some of the most vulnerable people in society.

“The RCN is fully supportive of the action outlined today and is committed to working with the relevant organisations to deliver real change. We are also committed to working with independent sector providers to ensure healthcare assistants receive support and guidance in delivering the best possible patient care.”

He added: “We know that learning disability nurses can greatly improve the quality of life for people with learning disabilities and their families. However, over the past 15 years we have seen under investment in learning disability care and we would like to see this trend reversed as a matter of urgency.”

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