Widespread plans to close inpatient facilities for people with learning disabilities will be implemented in the Midlands and East, and North regions of England in the coming months before being rolled out to other parts of the country, according to NHS England board papers.
Proposals for a closure programme of institutions deemed inappropriate were put forward last year in an independent report following the abuse scandal at the Winterbourne View home, which was uncovered in a TV documentary in 2011.
The report, chaired by Sir Stephen Bubb – chief executive of the Association of Chief Executives of Voluntary Organisations – called for “immediate action” to “close all Winterbourne-style institutions and ramp up community provision” so that people can be cared for closer to home.
“The care and treatment review programme has underlined weaknesses in community care for people with learning disabilities and/or autism”
In NHS England board papers due to be discussed later this week, a report by chief nursing officer for England Jane Cummings said the planned closures would initially be concentrated in certain areas, because this was where the majority – around 78% – of beds were in use.
Therefore, it would “have the highest impact on reducing beds overall”, she said.
Following the first phase, plans will be developed by early autumn 2015 to expand the programme across England, she added.
In her report to the board, Ms Cummings – who is the senior responsible officer for the NHS Learning Disability Programme – said that more than 1,400 reviews had been carried out so far to assess whether existing learning disability patients needed to be in hospital.
As a result of these newly introduced “care and treatment reviews”, 30% of patients – 650 in total – who were in hospital on 1 April 2014 have now been discharged into the community, with around 13% having been moved to more suitable inpatient settings, she added.
NHS England has set itself a target of discharging 50% of this cohort of patients by September.
However, the board report revealed that the review process has also highlighted problems that are stopping patients from being discharged.
These include a lack of appropriate clinical skills in the community to support patient discharge, a failure to agree on a future plan for the patient and the lack of a suitable care provider.
“The care and treatment review programme has underlined weaknesses in community care for people with learning disabilities and/or autism, which contribute both to admissions to hospital and delayed discharges,” stated the report.
To address the issue, Ms Cummings re-stated NHS England’s plan to develop a new service model that will provide a national framework describing the range of support and services people with learning disabilities and their carers can expect.