Slow progress is being made on transferring people with learning disabilities or autism out of hospitals and into community care, NHS figures for the first quarter of 2014 reveal.
The government wants all individuals who have been placed inappropriately in hospitals to enter community settings by 1 June, but just 182 of the 2,615 patients in England are due to be transferred by then and only 74 have planned move dates for after that date.
NHS England said that clinical decisions had prevented the transfer of 1,702 of the 2,358 patients who lack a transfer date.
“These are patients with complex and very specific needs, some of who are in secure hospitals and will have longer-term treatment plans,” said Jane Cummings, the chief nursing officer for England.
“It is vital that commissioners provide person-centred care in the best setting for each individual and that care is reviewed on a regular basis.”
Other reasons for the lack of a planned transfer date include a lack of appropriate health and social care services in 173 cases, a lack of suitable housing in 165 cases, a lack of agreed health or social care funding in 80 cases.
A further 564 patients without a transfer date are in high or medium secure services.
The figures also showed that more people with learning disabilities were admitted to hospital than moved out of in-patient care, resulting in a net increase of 82 individuals.
Joe Godden, professional officer at the British Association of Social Workers, said more integration of health and social care is needed to get people out of in-patient care.
“Commissioning issues are the key to unlocking the situation, coupled with a real understanding that institutions cause problems,” he said.
“The journey to institutions often starts with an individual not getting sufficient support where they live – their home, (this support mainly funded by overstretched social care budgets), the lack of support leads to a breakdown, which leads to admission to hospital – which health pays for.
“In the health setting institutional care kicks in, which can lead to exporting people to even more expensive institutions, the person losing touch with their community and behaviour getting worse.
“Getting people back into communities then becomes a bigger challenge because of deteriorating behaviour and because the NHS won’t easily pay for community care and tend to favour the medical model of behaviour and disability.
“Where there are genuine pooled budgets and genuine multi-agency community teams that are well resourced, with social workers being given equality of importance in teams, real results are evident.
“Such teams need to be grounded in local authorities, who have access to services that can meet the whole range of people’s needs – including social work, leisure, housing, adult education, community work and local voluntary based services.”