Care for people with learning disabilities inquiry
Closed
What the inquiry looked at
“Good progress has been made by the Department of Health and NHS England in setting up a programme to close hospital beds for people with a learning disability, but the programme is not yet on track to achieve value for money, the National Audit Office has found . In 2015, the Department and NHS England set up the Transforming Care programme to move people out of mental health hospitals more quickly. Early indications are that the programme is making progress in reducing the number of people in mental health hospitals. Transforming Care Partnerships reduced the overall number of people in mental health hospitals by 11% from October 2015 to December 2016. Programme partners do not yet, however, have confidence that Partnerships can close the planned number of beds by 2019. As of December 2016, 60 beds had closed since April 2016, out of 136 due to be closed by April 2017, and between 900 and 1,300 beds will need to close by 2019. National Audit Office report The NAO found that programme partners must resolve a number of complex challenges if they are to achieve the ambition of a substantial shift away from reliance on inpatient care. One of the key mechanisms designed to manage the flow of patients into mental health hospitals is not working effectively, and money is not yet being released from mental health hospitals quickly enough to help pay for extra community support. Between £135 million and £195 million annually will need to be made available to pay for health and social care support in the community for people with learning disabilities discharged from mental health hospitals. Unless the funding is released for local services this will be an unfunded pressure on local authorities and clinical commissioning groups. NHS England has recognised that it will take time for money to move from hospitals to community support. To help in the short-term, it has provided £30 million revenue funding over three years, to be match funded by partnerships and £100 million of capital funding. In addition, partnerships are struggling to put in place appropriate accommodation quickly enough. Providing specialist accommodation can take over 12 months. A small number of people have been delayed leaving hospital because there was not suitable accommodation in the community or in residential care homes. According to the NAO, unless solutions to these problems are developed, there is a risk that progress seen to date will not continue throughout the length of the programme. In supporting the wider learning disability community, central and local government spend £8 billion each year. In real terms, between 2010–11 and 2013–14 spending on adult social care fell by 8.4% while spending on learning disability services increased by 2.1%.”
The committee's words, from the inquiry page on parliament.uk ↗.
What it found
Two years ago, the previous Committee of Public Accounts reported on the Department of Health’s (the Department) efforts to move people with a learning disability out of mental health hospitals and into the community. At that time, the Committee found that progress had been poor but was promised improvements. We can see that the Department and NHS England have since made progress. They have developed the Transforming Care programme and moved some people out of hospital. However, more needs to be done to address known barriers: money is not moving with the patient to pay for support in the community, too many people are not having care and treatment reviews and the uncertainty caused by the proposed changes to local housing allowance risks hampering the provision of accommodation in the community.
We are also concerned that support for people with a learning disability who live in the community is patchy; there are significant local variations but, on average, fewer than 6% of people with a learning disability are in employment and only 23% of people with a learning disability are registered as such with their GPs. There needs to be a greater focus on measuring outcomes and improvements to the quality of life from the £8 billion central and local government spend each year on this support.
What the government said
No government response is linked to this report.
How the inquiry ran
Each dot is a dated item listed on this page, from the inquiry's opening on 21 February 2017 to its close on 4 January 2018.
- Oral evidence 29 Mar 2017
- Report 26 Apr 2017
- Correspondence 13 Sep 2017
What it recommended
The committee's recommendations are not listed here yet. Read them in 58th Report - Local support for people with a learning disability ↗ on parliament.uk.
Evidence
Oral evidence sessions 1
- 29 Mar 2017No witnesses recordedparliament.uk ↗