There has been virtually no change in the number of people with learning disabilities placed in hospitals since 2010, contrary to government policy aims.
A ‘census’ of inpatient numbers found there were 3,250 people with learning disabilities across all types of wards in England as of 30 September 2013, down just 4% from the 3,376 placed in March 2010. Of this group, 60% of patients had been on their ward for over a year and 17.6% for over five years – despite the supposed purpose of many such placements being to provide short-term responses to crisis. Just under one in five were placed more than 100km from their residential postcode, contrary to the policy objective of people with learning disabilities normally receiving support in their local communities. The census was carried out by the Health and Social Care Information Centre.
Significant failure of policy
The centre’s findings represent a significant failure of policy and also illustrates the scale of the challenge in meeting the coalition government’s objective of ending inappropriate placements of people with learning disabilities by 1 June 2014 – the key objective of its response to Winterbourne View.
Under the last Labour government, the 2001 Valuing People White Paper committed to moving people with learning disabilities out of old-style NHS long-stay hospitals into “more appropriate accommodation” in the community and provided funding for this to happen. While this was achieved, a census in 2006 revealed that there were still 4,435 people with learning disabilities placed in a hospital setting, either in the NHS or private sector.
This figure declined steadily to 2010, but today’s figure shows there has been little change since then. This was despite the 2009 follow-up to Valuing People – Valuing People Now – making the return of people from out-of-area hospital or residential care placements back to their home areas to receive community-based support a “key goal”.
The census also shows the lack of progress made in recommissioning services since May 2011, when the BBC Panorama investigation into abuse at Winterbourne View hospital in Bristol shone a light on the poor experiences of service users placed on wards, often far from home and for long periods of time.
The figures drew a highly critical response from sector leaders.
@ComCareAdults national disgrace – poor commissioning + self-int provs taking large fees 4 pple system washes hands of. We should b ashamed
— Martin Routledge (@mroutled) December 13, 2013
Leading learning disability charities also slammed the findings. “What it reveals is alarming – that the pace of progress has been distressingly slow,” said Jan Tregelles and Vivien Cooper, chief executives of Mencap and the Challenging Behaviour Foundation respectively. “This is undermining the confidence of families in the government process as they are increasingly concerned it will continue to fail to protect their loved ones.”
The census’s publication coincides with the government’s progress report on the 12 months since it launched its programme to transform services for people with learning disabilities in hospitals in the wake of Winterbourne View.
This programme was accompanied by a concordat signed up to by 51 sector organisations containing a host of commitments to transform care. The DH also provided funding to establish a Winterbourne View Joint Improvement Programme (WVJIP) to support councils and clinical commissioning groups to decommission hospital services and reinvest in community-based care. This week it was revealed that the WVJIP had lost its two programme leads, Chris Bull and Ian Winter, and was seeking to recruit a programme director.
In his foreword to the report, care and support minister Norman Lamb said the pace of progress needed to be picked up.
“The target date for everyone to be in appropriate care is June 2014. This is one of the chief areas for impatience. The right care is more important than the exact date – but there is no excuse for delay.”
He added: “I do not pretend that this will be easy. The agenda is crowded and resource is tight. But we are spending public money, putting many people inappropriately in institutionalised care. This is intolerable.”