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One in five learning disability hospital patients there for five years of more

Nearly one in five people in learning disability hospitals such as Winterbourne View have been there for more than five years, Community Care has found, writes Vern Pitt

Although these facilities are intended for short-term assessment and treatment, patients had been living in them for 23 months on average. The client group typically involves people with learning disabilities and challenging behaviour or other complex needs, with places commissioned by the NHS.

Information gathered under the Freedom of Information Act from 32 primary care trusts, covering 247 patients, showed 18% had been in hospitals for five years or more and 3% had been resident for more than 10.

The longest stay was 20 years.

“It’s truly shocking,” said shadow care services minister Emily Thornberry. “It seems that primary care trusts have found an easy route for when people are difficult to place – they are just parked somewhere because people don’t want to address the issue.”

learning disability hospital graph

The spotlight turned on learning disability hospitals recently when BBC Panorama screened footage of alleged abuse of patients at Winterbourne View in Bristol, sparking a police inquiry, a serious case review and plans for a national inspection programme. After the broadcast, 86 experts and organisations called on the prime minister to end the use of learning disability hospitals citing “poor outcomes, often at very high cost”.

Anthea Sully, director of the Learning Disability Coalition, said the placements flew in the face of best practice guidance for people with learning disabilities and challenging behaviour.

“It raises serious questions about the quality of life that people are receiving; we have success stories about people who have quite high medical support needs living well in community settings,” she said.

learning disability hospital number

“They are imprisoned when they have not done anything wrong,” said Keith Smith, chief executive of the British Institute of Learning Disabilities, which produces good practice on this client group. “They are losing all the opportunities that come with living with family and community and in many cases people will become institutionalised.”

The figures on length of stay are, however, a fall from the last time official data were collected in March 2010. The final annual Count Me In census of learning disability inpatients found 31% of patients had been in hospital for five years or longer.

But Smith said he would expect people to spend between three and six months in hospital for assessment and treatment, though he did not advocate time limits.

The length of time people were spending in hospitals suggested the treatment was not working, said Mencap head of campaigns and policy David Congdon.

But David Stout, director of the NHS Confederation’s PCT Network, said: “The only reason you would still be in hospital after that length of time is because there’s not a better alternative placement in the community.”

PCTs fail to monitor clients

Primary care trusts are visiting learning disability hospital patients only twice a year on average, despite concerns over the client group’s vulnerability.

learning disability hospital tables

The Department of Health said it was aware of a variation in availability of suitable long-term placements for people with learning disabilities and would be taking action in the light of its review of the Winterbourne View case.

Derby City PCT, which had the second longest average stay for the seven patients it placed, said this reflected good data collection. “We have introduced a monitoring system for all of our placements and we believe that some of these historically long lengths of stays will not be occurring in future,” said Dave Gardner, head of mental health contracts and procurement for NHS Derbyshire, which covers Derby City.

In neighbouring Nottinghamshire, 11 patients spent on average only one year, three weeks in hospital, an outcome the PCT attributed to good case management by staff.

CASE STUDY

Terry Rooney (pictured) says the last five years spent in learning disability hospitals have “mentally destroyed” his son.

“He was supposed to be up there for six months and then back home,” he adds.

Terry Rooney’s son, who has autism and is also called Terry Rooney, has now been in learning disability hospitals since 2006, including several years at Winterbourne View, the hospital at the centre of an abuse scandal following a BBC Panorama investigation screened at the end of May.

Rooney Snr says his son, who is 29, has become more aggressive and difficult to deal with since entering hospital. “It mentally destroyed him,” he says.

“His behaviour is ten times worse than when he was a home. He blames us for putting him there, I’m the fall guy,” he adds.

However, it is the local adults' services department who Rooney Snr blames for the situation. He says that he was unable to get help when his son was still at home, saying the council only offered him one hour’s day care a week and his son had to be accompanied by him.

Rooney Jnr was subsequently placed in hospitals in Bristol and Cardiff, despite his parents living far away, making it difficult for them to visit. He was placed locally briefly but the facility was later closed due to lack of demand.

The effect of Terry Rooney Jnr’s prolonged “incarceration” on his parents was devastating. “My wife is on a lot of medication and she’s on the caseload of the mental health team for depression,” says Rooney Snr.

He has been offered medication to cope with stress. He says he just wants his son back home, but with adequate community support.

 

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