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Pace of care reform challenged

Published 14/07/2015

Panorama exposed abuses in the care system
Panorama exposed abuses in the care system

The author of a report on the care of people with learning disabilities has reported an "alarming absence of any tangible progress" since it was published six months ago.

Sir Stephen Bubb was asked to lead a review following the Winterbourne View scandal, which saw six workers jailed for ill-treatment and neglect after undercover filming by the BBC's Panorama programme showed them subjecting patients to serious abuse at the private hospital near Bristol.

It led to the government pledging to move patients with learning difficulties into community care by June last year, but the deadline was missed.

Sir Stephen's report last November called for such institutions to be closed as quickly as possible, but he said today that his review of progress so far found there were still not sufficient facilities for them to go to.

He said today that although the number of people being discharged from institutions is now greater than those being admitted, " it remains abundantly clear that a 'revolving door' of discharges and admissions will continue unless a closure and transition programme is acted on".

He said although NHS England has made it a "top strategic objective" to improve conditions for people with learning disabilities, " the pace of change remains slow, and this is unacceptable".

Offering his overview Sir Stephen, who is chief executive of the Association of Chief Executives of Voluntary Organisations (ACEVO), said there currently appears to be "no dialogue" between NHS England and third sector providers about how to deliver the transition.

He said today's review should be treated as a "warning call" ahead of a "formal stock take of actions" in a further six months' time.

"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," he said,

"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 the) Government to account."

Sir Stephen said he welcomed the Care Act and the Department of Health Green Paper on the rights of people with learning disabilities and/or autism along with the commitment made by NHS England chief executive Simon Stevens to publish a full transition programme in the autumn.

His report in November had also called for the creation of a ''charter of rights'' to protect patients and give them and their families the power to challenge the system, which he said he wanted to see enshrined in law right now.

He had also said he wanted to see the creation of a social investment fund to increase the capacity of community-based services, but he said this too had made "little progress".

He said he expected to see more change by the time he looks at the situation in six months' time.

"This is the opportunity for us, as a nation, to provide the care that people with learning disabilities and/or autism deserve and have been denied for so long," he added.

In a joint statement Jan Tregelles, chief executive of Mencap, and Viv Cooper, chief executive of the Challenging Behaviour Foundation, said people with learning disabilities and their families have seen "little meaningful change" in the past four years.

"Developing community services should have been started a long time to go and must result in high quality local support and services, or the change we all want to see will not happen," they said.

"This must include investing in a highly skilled community workforce to support children and adults with a learning disability to meet their individual needs.

"The next six months are a critical time, where NHS England and its partners must win the confidence of people with a learning disability and their families.

"As well as this, the government must introduce legislation into parliament and take meaningful practical action to bring about the changes set out in the Green Paper, including a right to challenge in-patient admissions, and changes to the Mental Health Act."

Jane Cummings, chief nursing officer for England and chairwoman of the Transforming Care Delivery Board, 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 reprovision plans in October as previously announced."

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