English councils face deprivation of liberty safeguards (DoLS) case backlogs that in some cases would take years to clear, according to official estimates released this week.
The annual DoLS report, published by NHS Digital, estimates that local authorities have accumulated uncompleted applications that would take on average about seven months to process, if no new applications were received. The largest estimated clearance time, according to the report, is 71 months.
The report covers the period from 1 April 2016 to 31 March 2017. While councils completed many more applications than in previous years, the overall reported backlog in cases rose by 7%, to 108,545.
This is, however, a far smaller rise than the previous year, when uncompleted cases jumped from 75,000 to almost 102,000.
The backlogs are a result of the Supreme Court’s ‘Cheshire West’ ruling in March 2014, which effectively lowered the threshold for cases requiring DoLS authorisations and triggered a tenfold rise in applications.
While DoLS applications are meant to be completed within 21 days, the new figures show that on average councils took 120 days to process them in 2016/17.
Earlier this year Community Care reported that plans drawn up by the Law Commission for a full-scale replacement to the DoLS that would ease the situation had been put on hold until at least 2019, because of Brexit-related pressure on government resources.
This week Jackie Doyle-Price, the care minister, said that any changes arising from the Law Commission’s proposals would take account of the recently announced review of the Mental Health Act, which is due to conclude in autumn 2018.
Responding to this week’s figures, a Department of Health spokesperson said: “We are carefully considering the recommendations made by the Law Commission on reform of the deprivation of liberty system and will provide a final response shortly.”
The annual DoLS report found that overall applications rose by 11% during 2016/17, a reduction in the rate of increase compared with other years since Cheshire West. Nursing and residential homes accounted for almost seven in 10 applications.
London experienced the steepest year-on-year growth – 62% – while the North East continued to experience a disproportionately large number of DoLS applications compared with other regions. The report noted that more people in the North East were subject to multiple applications during the review period, with councils in the region correspondingly more likely to grant authorisations for short periods of time.
In line with the rising backlog, the report found that for the third consecutive year more applications were received than completed. During 2016/17, for every three applications that were completed or withdrawn, four were received.
Despite this, across the country there was a striking increase of 44% in applications completed by councils, to 151,460 during the year. Last year Community Care revealed that councils were turning to controversial desktop assessments in order to deal with ‘low-priority’ cases more quickly.
The annual DoLS report noted that the steepest rise was among applications completed but not granted, which increased year-on-year by 95%, from 28,530 to 55,580. This, it said, reflected councils clearing older cases, in which people subject to applications had in some instances died or their circumstances changed.
While councils’ reported uncompleted applications stood at 108,545*, the review found that taking last year’s reported backlog, adding the number of applications received and subtracting the number completed or withdrawn produced an alternative, much larger figure – 143,090.
“NHS Digital is working with local authorities to fully understand the issue and to ensure increased robustness for 2017/18 data,” the report said.
Despite the reported backlog’s gradual rise, the number of applications that were still uncompleted after a year rose by 29,585, or 68%, year on year. All regions apart from London saw an increase in such cases, which accounted for 28% of the reported uncompleted total nationally.
Nationally, the proportion of standard (as opposed to urgent) applications that were completed within the DoLS code of practice’s 21-day limit fell from 32% to 23%. The average length of time to complete a DoLS application jumped from 83 to 120 days from 2015/16 to 2016/17.
“This increase in average duration to complete an application should be viewed in the context of the increase in older applications as local authorities addressed their backlogs,” the report said. “Although the number of applications that were completed within 90 days increased by 31% to 99,285 compared with 2015/16, the number that took more than one year to be completed increased by 244% to 14,765.”
The report found considerable variation in the average length of time to complete a DoLS application, with East Midlands authorities taking on average four times longer than their counterparts in the North East.
The Department of Health spokesperson said that geographical discrepancies were being looked at, adding: “Where there is variation at a local level we will work with the sector to support [councils].”
‘Protecting vulnerable people’
Responding to the DoLS report, Izzi Seccombe, chair of the Local Government Association’s community wellbeing board, said that the sharp rise in completed applications spoke of councils prioritising people most in need, despite budget cuts. But she warned that reform needed to come soon.
“We have long warned of the need to overhaul the current DoLS process so councils have the time and money to do this properly,” Seccombe said. “Failure to do this will have a damaging impact on crucial council services on which people rely, and lead to vulnerable people continuing to face long waiting times for assessments.”
Margaret Willcox, president of the Association of Directors of Adult Social Services (ADASS), echoed Seccombe’s concerns, adding: “We look forward to working with government to develop and implement a reformed scheme so that we are able to fund the work necessary to safeguard some of the people most in need in our communities.”
*A second figure for uncompleted applications quoted in the report, 105,325, removes Northamptonshire council’s data as the authority was unable to supply a complete set.