Words and Numbers
In a week of a new onslaught of reports and scandals affecting autistic people and people with learning disabilities in Britain, I’ve looked back at the last 12 years of reports and government promises to provide better support in communities.
In the summaries of all the following plans, reports and reviews;
People is mentioned 218 times
Service is mentioned 162 times
Care is mentioned 159 times
Learn is mentioned 109 times
Money is mentioned 7 times
Urgency is mentioned once
Accountability is not mentioned
Publication of Department of Health Mansell report
In 1993, DH published ‘Services for People with Learning Disabilities and. Challenging Behaviour or Mental Health Needs’. This follow up was published in 2007.
“However, while good progress has been made, challenges still remain and this is perhaps
particularly evident in making real changes for people with learning disabilities who are
considered to have challenging behaviour.
Good quality commissioning and service provision is also vital in delivering that vision.
There are positive examples from across the country demonstrating progressive thinking and
innovative ideas. It is important that that knowledge and learning is shared and developed to the benefit of people with learning disabilities and those who work with them.”
Parliamentary Under Secretary of State for Care Services
CQC internal review and review of learning disability inpatient services
Dame Jo Williams, CQC chair, said:
“Winterbourne View was a watershed moment for CQC. We did not respond as we should have and we have taken steps to put things right. We also carried out a programme of unannounced inspections of 150 services for people with learning disabilities. While the findings showed up serious concerns about the nature of services for people with learning disabilities, there was no evidence that points to abuse on the scale which was uncovered at Winterbourne View.”
Department of Health Winterbourne View Review Concordat: Programme of Action published
The Government’s Mandate to the NHS Commissioning Board sets out: “The NHS Commissioning Board’s objective is to ensure that Clinical Commissioning Groups work with local authorities to ensure that vulnerable people, particularly those with learning disabilities and autism, receive safe, appropriate, high quality care. The presumption should always be that services are local and that people remain in their communities; we expect to see a substantial reduction in reliance on inpatient care for these groups of people.”
Time for Change- an independent report by Sir Stephen Bubb commissioned by NHS England
Prime Minister David Cameron said: “We have got to do more to get people out of hospitals and into loving and caring homes in the community.”
NHS England chief executive Simon Stevens has called for “radical changes” in care for those with learning disabilities, saying it would mean “challenging legacy models of institutional care”.
“NHS England’s recent work with people with learning disabilities, and this new report, all now prove that radical changes are needed in NHS and social care,” he said.
Department of Health Report: Winterbourne View 2 years on.
“While there continue to be these institutions … people will continue to be sent there.”
Sir Stephen Bubb
The scale of the problem remains unchanged. According to the HSCIC census, there were 3,230 hospital in-patients with learning disabilities, autism and or challenging behaviour on 30 September 2014, with an average length of stay of 547 days and living an average 34.4km from home. In 2013, equivalent figures were 3,250 in-patients (though this may have been an underestimate), 542 days and 34.5km.
Public Accounts Committee investigates lack of progress on ATUs
NHS CEO Simon Stevens quizzed by Public Accounts Committee promises to close most NHS ATUs and private sector beds for people with learning disabilities. Stevens said: “I am afraid the time has come to say that some of these remaining facilities are going to have to close and care is going to have to be re-provided in a radical way.”
Transforming Care progress report
“We now have a single shared Transforming Care programme that recognises the scale of the change required, and ensures that we address the underlying causes of why so many people remain in, and are continuing to be placed in, hospital settings.”
NHSE publishes Building the Right Support, a plan that says what services should be in place by March 2019
Jane Cummings, chief nursing officer for England, who will oversee the programme’s delivery, said: “Society has failed this group of people for decades. Now is the time to put things right and with this far-reaching plan I am confident that we can finally make quick, significant and lasting improvements to their lives.”
3rd March 2017
National Audit Office Report of on the progress of the closure of hospital beds.
“Too many people with a learning disability have been kept for too long in mental health hospitals. We welcome the steps the Department and NHS England have taken to set up a bed closure programme. The Department and its programme partners, however, have not yet put in place the necessary conditions to make the programme a success, such as community-based accommodation. They are, therefore, not yet on track to achieve value for money through the programme.” Amyas Morse, head of the National Audit Office, 3 March 2017
NHS England publishes its Long Term Plan
By March 2023/24, inpatient provision will have reduced to less than half of 2015 levels (on a like for like basis and taking into account population growth) and, for every one million adults, there will be no more than 30 people with a learning disability and/or autism cared for in an inpatient unit. For children and young people, no more than 12 to 15 children with a learning disability, autism or both per million, will be cared for in an inpatient services.
Speaking at the Association of Directors of Adult Social Services spring seminar, NHS England’s national director for learning disabilities Ray James said “posturing over money” by councils and the NHS had left some people with complex needs “forgotten” in an assessment and treatment unit (ATU) and other inappropriate settings.
Words and numbers
12 years of knowing the answers
403 Pages of Reports, Plans and Reviews
2295 Actual Human Beings remain in ATUs
Around 1000 people got out, many traumatized, destroyed
At least 40 people didn’t
Please, no more words.