Report: Progress too slow since Winterbourne View

Progress has been too slow in reducing the number of autistic people and people with a learning disability in inpatient units, according to a new report commissioned by the government.

After the Winterbourne View scandal in 2011, which revealed criminal abuse of patients at a private hospital for people with a learning disability, the government committed to end all inappropriate placements by 2014.

This target was missed, as were other targets that successive ministers issued over the following years.

The new report, Building the Right Support, said that while the number of adults with a learning disability and autistic people in hospital fell by a third between 2015 and 2021, the rate of reduction had been too slow, with the figure for adults still around 50% above target levels.

‘Reducing the number of people in inpatient settings to be below the maximum target levels … needs to continue,’ said the report, written by management consultants RedQuadrant.

‘The number of people in inpatient settings is driven in part by the number of new admissions into inpatient settings. However, it is also due to the complexity in arranging appropriate homes with care and support in the community for people with the highest support needs. This includes people admitted via criminal justice routes, and in particular those who have been in inpatient settings the longest, and for whom community care packages in many cases seem likely (at least at first) to outweigh significantly the cost of an inpatient stay.

‘For example, of the 2900 people who were inpatients at the start of the programme, 790 (or 27%) were in hospital in March 2021. In November 2021, 355 people had been inpatients for more than 10 years and a similar number for more than 5 years.’

The report brings together commitments from across the government and public services to ensure there is suitable community support available for people with a learning disability and autistic people, including:

• speeding up discharges for people with a learning disability and autistic people supported by additional targeted funding of more than £90 million in 2022 to 2023 including
• limiting the scope under which people with a learning disability and autistic people can be detained by reforming the Mental Health Act
• building on specialist training for health and care staff to ensure they have the skills to better care for people with a learning disability and autistic people

Minister for care and mental health Gillian Keegan said: ‘For too long, autistic people and people with a learning disability have remained as inpatients in mental health units – not necessarily because it was the best place, but because of failings in the system and a lack of community facilities to support them.

‘I am committed to driving further, faster progress to ensure people with a learning disability and autistic people, of all ages, receive high-quality health and social care support in their communities when they need it.’

Photo by Sharon McCutcheon