Select Committee · Health and Social Care Committee

Treatment of autistic people and individuals with learning disabilities

Status: Closed Opened: 3 Feb 2021 Closed: 1 Aug 2022 9 recommendations 11 conclusions 1 report

Limited progress in improving the way autistic people and individuals with learning disabilities are treated is to be examined by the Health and Social Care Committee. The short inquiry will hold the first of two evidence sessions next week with particular focus on the use of restraint and “sectioning”. It will also consider issues around …

Reports

1 report
Title HC No. Published Items Response
Fifth Report - The treatment of autistic people and people … HC 21 13 Jul 2021 20 Responded

Recommendations & Conclusions

20 items
1 Conclusion Fifth Report - The treatment of autisti…

Autistic people and people with learning disabilities have the right to live independent, free and...

Autistic people and people with learning disabilities have the right to live independent, free and fulfilled lives in the community and it is an unacceptable violation of their human rights to deny them the chance to do so. It is also more expensive to detain autistic people and people with …

Government response. We agree with some of this suggestion. It is hard to say how much money it would cost to move everyone out of mental health hospitals and back into their community because the money comes from many different places. Between …
Department of Health and Social Care
2 Recommendation Fifth Report - The treatment of autisti…

We recommend that the Department of Health & Social Care provides us with a complete...

We recommend that the Department of Health & Social Care provides us with a complete assessment of the cost of providing community support for all autistic people and people with learning disabilities currently in inpatient units. Alongside this, an assessment should also be made of the cost of providing community …

Government response. We agree with some of this suggestion. It is hard to say how much money it would cost to move everyone out of mental health hospitals and back into their community because the money comes from many different places. Between …
Department of Health and Social Care
3 Conclusion Fifth Report - The treatment of autisti…

We also recommend that the Department then needs to redesign the financial incentives in the...

We also recommend that the Department then needs to redesign the financial incentives in the healthcare system so that local authorities do not seek to ‘offload’ autistic people and people with learning disabilities onto the NHS or place these individuals in inpatient facilities. The Department must instead offer a credible …

Government response. We agree with this suggestion. We are working to make sure people get the right support to live independently in their community. We want to make changes to the law to improve mental health support for Change people with a …
Department of Health and Social Care
4 Conclusion Fifth Report - The treatment of autisti…

Since the Winterbourne View scandal, over 10 years ago, successive governments have committed to reducing...

Since the Winterbourne View scandal, over 10 years ago, successive governments have committed to reducing the number of autistic people and people with learning disabilities in inpatient settings and prioritising community support for these individuals. However, missed and delayed policy targets suggest a more radical approach to unlocking funding for …

Government response. We agree with some of this suggestion. It is important that we have places that people can go for mental health treatment if they need it. Where people have to go to a mental health hospital we must check that …
Department of Health and Social Care
5 Conclusion Fifth Report - The treatment of autisti…

While we welcome the vision set out by Helen Whately MP (Minister of State, Department...

While we welcome the vision set out by Helen Whately MP (Minister of State, Department of Health & Social Care), we believe this is a matter of delivery and The treatment of autistic people and people with learning disabilities 39 not a matter for further review. At present, the work …

Government response. Suggestion 5 The Committee suggested that: • People with a learning disability and autistic people should not have to go to mental health hospitals that the Care Quality Commission (CQC) say are Inadequate. The Care Quality Commission (CQC) checks the …
Department of Health and Social Care
6 Conclusion Fifth Report - The treatment of autisti…

The Trieste model of care—characterised by simplified and quicker admissions to and discharges from inpatient...

The Trieste model of care—characterised by simplified and quicker admissions to and discharges from inpatient facilities; limited number of individuals in inpatient facilities for lengthy durations; and emphasis on well-resourced community support—presents a clear and better alternative to supporting autistic people and people with learning disabilities than is currently in …

Department of Health and Social Care
7 Recommendation Fifth Report - The treatment of autisti…

We recommend that the Trieste model of care is implemented for autistic people and people...

We recommend that the Trieste model of care is implemented for autistic people and people with learning disabilities by the Department of Health & Social Care and NHS England & Improvement. All new long-term admissions of such people to institutions should be banned except for forensic cases. For cases where …

Department of Health and Social Care
8 Recommendation Fifth Report - The treatment of autisti…

In pursuing that policy, we recommend that by the end of 2021 the Department and...

In pursuing that policy, we recommend that by the end of 2021 the Department and NHS England & Improvement: i) introduce weekly formal reviews of the suitability of admission for all autistic people and people with learning disabilities who have been kept in inpatient facilities for three months or more; …

Government response. Suggestion 4 The Committee suggested that we: • Work with the NHS to regularly check on people with a learning disability and autistic people in a mental health hospital to see whether they need to stay there. • Make sure …
Department of Health and Social Care
9 Recommendation Fifth Report - The treatment of autisti…

Furthermore, we recommend that autistic people and people with learning disabilities should never be admitted...

Furthermore, we recommend that autistic people and people with learning disabilities should never be admitted to an inpatient facilities that has received an “inadequate” rating from the Care Quality Commission (CQC). The Department for Health & Social Care must bring forward measures to ensure that service commissioners can no longer …

Government response. We agree with some of this suggestion. We want people with a learning disability and autistic people to have the best treatment. The NHS will take action to avoid people going into a hospital that the Care Quality Commission (CQC) …
Department of Health and Social Care
10 Recommendation Fifth Report - The treatment of autisti…

We welcome the Government’s announcement that it will bring into force the Mental Health Units...

We welcome the Government’s announcement that it will bring into force the Mental Health Units (Use of Force) Act 2018 in November 2021. This will go some way to reducing the use of restricted practices in inpatient facilities. However, we remain concerned that the use of restrictive practices remains commonplace …

Government response. We already give out information every month about how force has been used on people with a learning disability and autistic people. We are working to reduce the amount of force that is used in mental health hospitals. We have …
Department of Health and Social Care
11 Conclusion Fifth Report - The treatment of autisti…

Inpatient facilities do not consistently meet the needs of autistic people and people with learning...

Inpatient facilities do not consistently meet the needs of autistic people and people with learning disabilities and too often this is because of factors such as the unnecessary use of restrictive practices; inpatient facilities being unable to accommodate individuals’ needs to avoid sensory overload; and the distance inpatient facilities are …

Government response. Suggestion 11 The Committee suggested that we: • Must look into the deaths of every person with a learning disability or autistic person in mental health hospitals or getting care in their community. Our reply · ® This is a …
Department of Health and Social Care
12 Recommendation Fifth Report - The treatment of autisti…

We recommend that, in addition to the implementation of the Mental Health Units (Use of...

We recommend that, in addition to the implementation of the Mental Health Units (Use of Force Act) (i.e. ‘Seni’s Law’), all Assessment and Treatment Units (ATUs) are closed within two years and replaced with person-centred services that are: i) designed for easy discharge as well as easy admission; ii) physically …

Government response. We agree with some of this suggestion. It is important that we have places that people can go for mental health treatment if they need it. Where people have to go to a mental health hospital we must check that …
Department of Health and Social Care
13 Conclusion Fifth Report - The treatment of autisti…

We have significant concerns about the quality of training and support provided to staff working...

We have significant concerns about the quality of training and support provided to staff working in inpatient facilities and the negative consequences this can have on the treatment of autistic people and people with learning disabilities in inpatient facilities. While we welcome the pilot of the ‘Oliver McGowan’ training, it …

Government response. We agree with some of this suggestion. We agree that staff should have the right training. We are starting a new training programme for health and care staff so they understand more about New working with people with a learning …
Department of Health and Social Care
14 Recommendation Fifth Report - The treatment of autisti…

We recommend that staff involved in the treatment of autistic people and people with disabilities...

We recommend that staff involved in the treatment of autistic people and people with disabilities in inpatient settings receive training in care planning which has a clear and unhindered focus on: i) understanding that autistic people and people with learning disabilities have non-treatable conditions and therefore should not be assessed …

Government response. Suggestion 8 The Committee suggested that we make sure that staff in mental health hospitals who care for people with a learning disability and autistic people have proper training by April 2023. They should have training so they know about: …
Department of Health and Social Care
15 Conclusion Fifth Report - The treatment of autisti…

We conclude that the benefits of early diagnosis for conditions like autism are well- understood...

We conclude that the benefits of early diagnosis for conditions like autism are well- understood and late diagnosis presents a particular risk that autistic people will end up with mental illnesses such as anxiety and/or depression.

Government response. We agree. We are already working on this. The National Institute for Health and Care Excellence (NICE) says that people shouldn’t have to wait more 13 than 13 weeks between their doctor weeks saying they should have a check for …
Department of Health and Social Care
16 Recommendation Fifth Report - The treatment of autisti…

We recommend that the Government analyses the speed at which autism is diagnosed especially in...

We recommend that the Government analyses the speed at which autism is diagnosed especially in children and young people, and puts in place a strategy to increase early diagnosis with measurable outcomes by the end of the financial year 2021–22. (Paragraph 94) Wellbeing and accountability

Government response. We agree. We are already working on this. The National Institute for Health and Care Excellence (NICE) says that people shouldn’t have to wait more 13 than 13 weeks between their doctor weeks saying they should have a check for …
Department of Health and Social Care
17 Conclusion Fifth Report - The treatment of autisti…

The physical health and wellbeing of autistic people and people with learning disabilities requires greater...

The physical health and wellbeing of autistic people and people with learning disabilities requires greater prioritisation. We believe that the creation of an Intellectual Disability Physician to co-ordinate care in line with the model established in the Netherlands should be fully explored by the Department and NHS England & Improvement; …

Government response. We agree. Government has looked into this. But we are worried this could have some bad effects within health care services. We would rather all doctors are able to work with people with a learning disability and autistic people. We …
Department of Health and Social Care
18 Recommendation Fifth Report - The treatment of autisti…

We recommend that the Department and NHS England & Improvement undertake an assessment of the...

We recommend that the Department and NHS England & Improvement undertake an assessment of the merits of establishing the Intellectual Disability Physician as a new professional discipline within the NHS with the objective of reducing admissions 42 The treatment of autistic people and people with learning disabilities and the length …

Government response. We agree. Government has looked into this. But we are worried this could have some bad effects within health care services. We would rather all doctors are able to work with people with a learning disability and autistic people. We …
Department of Health and Social Care
19 Conclusion Fifth Report - The treatment of autisti…

In recent years there have been too many incidences of autistic people and people with...

In recent years there have been too many incidences of autistic people and people with learning disabilities dying in inpatient settings. Families and friends have too often had to go to extreme and difficult lengths to have independent reviews into such deaths. Of even greater concern is that in some …

Government response. · ® This is a very important issue, but we i' do not agree with saying that we 0 must do this. We already look into the reasons why people with a learning disability and autistic people have died in …
Department of Health and Social Care
20 Conclusion Fifth Report - The treatment of autisti…

We therefore recommend that the Government and NHS England & Improvement bring forward the necessary...

We therefore recommend that the Government and NHS England & Improvement bring forward the necessary financial and workforce resources required to mandate the independent review of the deaths of all autistic people and people with learning disabilities in inpatient and community settings, and ensure there is a structured way to …

Government response. · ® This is a very important issue, but we i' do not agree with saying that we 0 must do this. We already look into the reasons why people with a learning disability and autistic people have died in …
Department of Health and Social Care

Oral evidence sessions

3 sessions
Date Witnesses
27 Apr 2021 Bengi O’Reilly, an individual with lived experience, Claire Murdoch · NHS England, Dr Sara Ryan, an individual with lived experience, Fiona Walshe · Department of Health and Social Care, Helen Whately MP · Department of Health and Social Care, Roger Banks · NHS England View ↗
13 Apr 2021 Baroness Sheila Hollins · Beyond Words, Dr Ian Davidson · NHS and Royal College of Psychiatrists, Dr Ken Courteney · Royal College of Psychiatrists Intellectual Disability Faculty, Dr Theresa Joyce · Care Quality Commission, Ian Birrell, Journalist, Professor Philip Fennell · Cardiff University, Sir Norman Lamb, former Minister at the Department of Health View ↗
9 Feb 2021 Alexis Quinn, autism activist, author and Restraint Reduction Network Manager, Dan Scorer · Mencap, Ivan Olbrechts · Learning Disability England, Julie Newcombe · Rightful Lives, Vivien Cooper · Challenging Behaviour Foundation View ↗

Correspondence

3 letters
DateDirectionTitle
26 Oct 2021 Correspondence with the Minister of State for Care and Mental Health on Treatme…
22 Jun 2021 To cttee Letter from the National Mental Health Director on assuring transformation data…
25 May 2021 To cttee Letter from NHS England and NHS Improvement on the Committee's inquiry into Tre…