'Unacceptably slow' progress to community care for learning disabilities patients

The progress made by NHS England in closing inpatient wards for people with learning disabilities has been too slow and no ‘tangible’ community facilities have been provided as alternative support, a coalition of charities has warned.

Sir Stephen Bubb, chief executive of the charity leaders’ organisation ACEVO, has published his six-month review into the progress made by NHS England’s Transforming Care programme to improve services for people with learning disabilities.

Sir Stephen assessed what steps have been taken to act on the recommendations of a review he headed up following the Winterbourne View care home abuse scandal in 2011.

His review led to the publication of his report, Winterbourne View – Time for Change, last November, which called for such institutions to be closed as quickly as possible and led to the government pledging to move patients with learning difficulties into community care by June last year. However, the deadline was missed and his six-month review of progress found that so far there are still insufficient facilities in the community for people with learning disabilities.

Sir Stephen acknowledges that there is much to commend in the approach taken so far by NHS England and its partners, but he adds that there is an ‘alarming absence of any tangible progress on the ground’.

His report states: ‘The pace of change remains slow and this is unacceptable. While a priority for NHS England, the Transforming Care programme has not yet delivered anything tangible in terms of new community facilities or closures. This is worrying; robust community provision does not appear overnight. And yet the closure of institutions can only happen where there are sustainable alternatives built up by commissioners and providers.’

Commenting on his progress report, Sir Stephen said that while the NHS has finally accepted the need to close Winterbourne-style institutions they cannot do that unless there are sufficient community facilities.

‘The core recommendation of my report was the need to close these institutions as quickly as possible and you can’t close them until there is good, strong community provision - people with learning disabilities and their families deserve action now. There’s huge scepticism that anything will happen - NHS England needs to prove them wrong. And until I see action on the ground I will continue to hold government to account.’

Responding to the progress report, chief nursing officer for England and chair of the Transforming Care Delivery Board Jane Cummings said: ‘All the agencies involved in this work are clear that while a great deal of progress has been made, we still have lots to do to transform and improve care for people with learning disabilities.

‘We are committed to driving through changes at a fast but safe pace, we are on track to do so, and I will be setting out the closure and re-provision plans in October as previously announced.’

Meanwhile, a report by Public Health England estimates that up to 35,000 adults with learning disabilities are being prescribed an antipsychotic, antidepressant or both without clinical justification.

As a result NHS England has sent a letter to professionals and patients as a ‘call to action’ and to urge them to tackle the issue of inappropriate and overprescribing of medications.

To view Sir Stephen’s progress report, click here.