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Government plans to close all learning disability institutions in England cause dismay

RCN learning disability forum chair says proposals are ‘far too simplistic’

RCN learning disability forum chair says proposals are ‘far too simplistic’


Plans to develop community services and close inpatient facilities for people who have 
a learning disability and autism has been challenged by nursing staff. Picture: Tim Gee
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Nurses have questioned how the closure of all institutions for people with learning disabilities and autism will be implemented.

Charity Futures think tank director Sir Stephen Bubb said that no progress would be made unless ‘we finally close all institutions for people with learning disabilities or autism’.

Writing in The Times, Sir Stephen, who produced an independent report for NHS England on the future care of people with learning disabilities in 2014, said money from the closures should be transferred to develop community services.

Reduce number of people in secure hospitals

Health and social care secretary Matt Hancock has indicated that he is ready to consider the closures and wants to go ‘much further’ than the target to reduce the number of people in secure hospitals by one third.

But RCN learning disability nursing forum chair Simon Jones said: ‘It is far too simplistic to say: “close all institutions for people with learning difficulties or autism”.

‘Many of the individuals in inpatient hospitals are more than ready to move. It’s just that there is nowhere for them to move to. They need community placements that have the appropriate support and expertise to support them.’


Jonathan Beebee: ‘If the 
government is going to close 
hospitals, it needs some effective
community-based solutions’
Picture: Chris Balcombe

Learning disability nurse and director of PBS4 social enterprise Jonathan Beebee added: ‘If the government is going to close hospitals it needs some real and effective community based solutions, which the figures on discharges and admissions from Transforming Care are not showing to be effectively in place now.’

Transforming Care programme

In 2015, NHS England, the Association of Directors of Adult Social Services and the Local Government Association published a Transforming Care national implementation plan.

It set out plans to develop community services and close inpatient facilities for people who have a learning disability and autism, with a target of closing 35%-50% of inpatient beds by March next year.

The Department of Health and Social Care says there has been almost a 20% reduction in the number of inpatients between March 2015 and September 2018, dropping from a baseline figure of 2,880 to 2,315.

A total of 5,700 people have been discharged into the community and 413 inpatient beds have been decommissioned.

A DH spokesperson said learning disability and autism will be one of four dedicated priorities in the NHS long-term plan and said there will be an update on the future of the Transforming Care programme and ‘the next steps’ before it is due to finish next March.


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