Government to review inpatients with learning disabilities and autism

All mental health hospital patients with learning disabilities and autism will have their care reviewed over the next 12 months, health bosses say.

A spokesman for the Department of Health and Social Care (DHSC) said the government will commit to providing each patient with a date for discharge, or where this is not appropriate, a clear explanation of why and a plan to move them closer towards being ready for discharge into the community.

This comes following the report by Parliament’s Joint Select Committee on Human Rights which revealed young people with learning disabilities and autism are being detained in mental health hospitals, inflicting ‘terrible suffering on those detained and causing anguish to their distraught families’.

The damning report included harrowing stories of patients being held in hospital against their will for months and often years, miles away from their family. Along with distressing witness testimony from patients who described being left in seclusion for hours at a time, and suffering broken bones at the hands of staff who tried to restrain them.

In response, health bosses said an independent panel will be established to oversee the case reviews of those in long-term segregation to further improve their care and support them to be discharged into the community as quickly as possible.

The panel will be chaired by Baroness Sheila Hollins, who is professor of the psychiatry of learning disability at St George’s, University of London.  She said:

‘I don’t think it can ever be right to segregate someone as a form of care, and even more so when there is no planned end date.

‘The oversight panel will actively review progress of an action learning project designed to identify existing barriers, and implement solutions that will transform people’s lives.

‘Our focus will be on each person’s humanity, and entitlement to live an ordinary and safe life in a place where their own concerns and needs will be understood and met by supporters who treat them with respect and have the right skills and supervision.’

A further measure will see the government commit to greater transparency in this area, by agreeing to publish data on inpatients in mental health settings who have a learning disability or are autistic. This will take the form of an information dashboard, which will include data on inpatient rates in different regions, so areas can learn and share good practice.

Ann Norman, Royal College of Nursing professional lead for Learning Disability Nursing, welcomed the scheme but has raised concerns about the number of learning disability nurses available to support patients once they return home. She said:

‘Reducing unnecessary stays in hospital for those with learning disabilities is a welcome ambition and we are pleased to see mandatory training for NHS staff given the go-ahead – this must now be developed in collaboration with those with Learning Disabilities and the specialist nurses who work with them.

‘Ensuring patients can be discharged and cared for closer to home relies on there being enough Learning Disability nurses in both acute and community settings.

‘However, since 2009, the numbers of learning disability nurses in the NHS has fallen by over 40% with the numbers out in the community down by over 25%.

This part of the workforce, as much as any, needs investment and long term commitment to the recruitment and retention of the nurses it so desperately needs. We are pleased to see this pledge but it must to be turned into tangible action if we are to be able to see real change and address the failings that have left so many without the care they deserve.’

Jane Harris, director of external affairs at the National Autistic Society, said the announcement was important for making sure autistic people across England are properly understood and supported.  She said:

‘Hundreds of families across the country will be relieved to see plans to review the care of people in inpatient units and new actions to tackle the disturbing use of seclusion.

‘Importantly, the Secretary of State says he has asked for advice about changing the way mental health law applies to autistic people. Currently autistic people can be sectioned even if they don’t have a mental health problem.

‘It is vital to make sure our law and how it applies to autistic people is fit for the 21st century. Whoever makes up our next government must make sure this promise is realised.

‘To make any of these plans a reality, the next government must also invest in social care and community mental health services. Two in three autistic adults don’t have the support they need. Without it, autistic people can find themselves in a vicious cycle – forced to go into hospital because there’s no support and then unable to leave because there’s no support.’


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