NHS England has been too slow to act in its closure of inpatient wards for people with learning disabilities, while failing to ensure the necessary replacement community support is in place, according to charities.
It is unacceptable there has been no “tangible” progress on the ground, despite a “clear roadmap” of action recommended six months ago in an independent report produced following the abuse scandal at Winterbourne View hospital, they said.
“Building capacity in the community is an absolute priority. But the recommendations made to this effect…have seen little progress”
Sir Stephen Bubb, the chief executive of the Association of Chief Executives of Voluntary Organisations (ACEVO), noted that his report – Winterbourne View - Time for Change – was commissioned by NHS England in the first place after the government failed to meet its own deadline to close large-scale inpatient services by summer 2014.
In today’s six month-review of progress, he acknowledged there had been “a definite shift in the commitment to change” by NHS England, demonstrated through plans in its Transforming Care programme.
He noted that a full timetable for ward closures was due to be published in October, which he is to review.
But he said there had been “little to no discussion” with providers and the third sector more widely about how to improve community facilities.
Sir Stephen called for NHS England to set up a “transition taskforce” mandated to work with providers, commissioners and families to set out the national framework for scaling up community provision.
“In the last four years, people with a learning disability have seen… deadline after deadline pass for moving people out of in-patient units”
Mencap and CBF
In the foreword to his review, Sir Stephen said: “Time for Change was clear that building this capacity in the community is an absolute priority.
“But the two recommendations made to this effect – workforce development, and investment in community-based services – have seen little progress,” he stated.
“This is unacceptable and risks undermining the work being done elsewhere to create a new framework of care for people with learning disabilities and/or autism,” he said.
The charities Mencap and the Challenging Behaviour Foundation echoed his concerns. They called for “urgent priority” to be given to improving community provision, including investment in the workforce.
Jan Tregelles, chief executive of Mencap, and Viv Cooper, chief executive of the Challenging Behaviour Foundation, said: “In the last four years, since Winterbourne View, people with a learning disability and their families have seen little meaningful change on the ground and deadline after deadline pass for moving people out of in-patient units.”
“Developing community services should have been started a long time to go and must result in high quality local support and services or the change we all want to see will not happen,” they said.
This must include investing in a highly skilled community workforce to support children and adults with a learning disability to meet their individual needs,” they added.
Earlier this year, NHS Engand board papers revealed plans to close inpatient facilities for people with learning disabilities would first be implemented in the Midlands and East, and North regions of England.
A report by chief nursing officer for England Jane Cummings included in the papers said 30% of learning disability patients in hospital on 1 April 2014 had now been discharged into the community following assessment.
However, a recent update by NHS England and other organisations on their work to improve learning disability care shows in places the rate of admissions to wards is outstripping discharges. It said from March 2014 to May 2015 there was an overall reduction of 140 people in inpatient care in England.
Ms Cummings, who is leading the work, said: “All the agencies involved in this work are clear that while a great deal of progress has been made we still have lots to do to transform and improve care for people with learning disabilities.
“We are committed to driving through changes at a fast but safe pace, we are on track to do so, and I will be setting out the closure and reprovision plans in October as previously announced,” she said.