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Autism-specific health checks highlighted in NHS Long Term Plan

RCN sceptical as NHS plans offer ‘little that’s new’ and should focus on tackling workforce shortages

RCN sceptical as NHS plans offer ‘little that’s new’ and should focus on tackling workforce shortages


A digital flag in patient records to ensure staff know if a patient has a learning
disability or autism wherever they are treated will be introduced by 2023-24.
Picture: Tim George 

When he unveiled his NHS Long Term Plan, NHS England chief executive Simon Stevens was clear it would improve services for people with learning disabilities and autism.

Speaking at the official launch at Liverpool’s Alder Hey Children’s hospital, he pledged to address unmet need and inequalities in care.

He said services have ‘for too long been squeezed from national debate and unsupported by the NHS’.

But how is this to be done?

The plan only devoted two of its 136 pages to learning disability and autism.

Specific needs

The NHS Long Term Plan promises to:

  • Improve the uptake of annual health checks in primary care for people aged over 14 years who have a learning disability to 75% and, for the first time, autism-specific health checks will be trialled in pilots.
  • Continue funding the Learning Disabilities Mortality Review Programme with the aim of improving the lives of people with learning disabilities.
  • Expand the Stopping Over-Medication of People with Learning Disability, Autism or Both (STOMP) programme.
  • Introduce a digital flag in patient records by 2023-24 to ensure staff know a patient has a learning disability or autism wherever they are treated, while non-learning disability staff will receive awareness training.
  • Ensure all children and young people with the most complex needs have a designated key worker by 2023-24.
  • Reduce inpatient provision to less than half of 2015 levels over the next five years.
  • Ensure every local area has seven-day community crisis care by 2021-22.
  • Roll out national learning disability improvement standards to every NHS-funded service to promote greater consistency over the next five years.

Funding for these initiatives remain unclear. Under the Transforming Care Programme, learning disability services have been given more than £60 million of extra funding in recent years.

NHS England says in the future services will benefit from the increased investment in non-hospital care that is being made.

The plan says one third of the extra £20 billion promised for the NHS by 2023 will go on primary, community and mental healthcare.

RCN response

RCN professional lead for learning disability nursing Ann Norman remains sceptical.

She said there is ‘little that’s new’, adding it feels like ‘ongoing work not achieved’.

Tackling workforce shortages will be crucial – with 16% of posts remaining unfilled, added Ms Norman.

‘The government has not done nearly enough in the past few years to address some outstanding issues,’ she said.

‘We need very much to retain and develop a pathway for specialist learning disability nursing skills in the future.’ 

The government says a workforce plan will be published soon. It is being drawn up jointly by NHS Improvement and Health Education England.

Concerns over targets

Learning Disability England chief executive Samantha Clark has concerns too.

She said: ‘We hope this plan can lead to action and real change, so people know they matter and everyone gets good treatment.

‘There are some good things, but some things have been said before. We want to know how the targets will be checked and who will make sure they happen.’

In particular, she is critical of the ambitions to move care into the community.

Under the Transforming Care Programme between 35% and 50% of inpatient beds should have been closed by March this year as patients are moved into the community.

By autumn 2018, just under one fifth had, and so the target has effectively been shifted back by the NHS plan.

‘We don’t agree it needs to take another three to four years. This could be changed faster,’ added Ms Clark.

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