‘Homes not hospitals’ for people with learning disabilities

Saturday, October 10, 2015

People with a learning disability and/or autism will be supported to lead more independent lives and have greater say about the support they receive under a national plan published on 30th October to radically improve learning disability services.

Central to the progress set out by the plan over the next three years will be new, high-quality, community-based services.

Hundreds of people with a learning disability and/or autism are expected to benefit from new, better care options in the community instead of hospitals, with more never being admitted in the first place.

The plan predicts that, as these services are put in place, there will be a reduction of up to 50 per cent in the number of inpatient beds, meaning that some units will close altogether.

Building the right support: A national implementation plan to develop community services and close inpatient facilities was published on Friday 30 October by NHS England, the Local Government Association (LGA) and the Association of Directors of Adult Social Services (ADASS)

The plans it contains have been developed with significant contribution and constructive challenge from people with learning disabilities and/or autism, their families and carers, and a range of commissioners, providers, voluntary sector and representative groups.

While local areas will be able to design bespoke services with those who use them, the plan sets out the need for:


  • local housing that meets the specific needs of this group of people, such as schemes where people have their own home but ready access to on-site support staff;
  • a rapid and ambitious expansion of the use of personal budgets, enabling people and their families to plan their own care, beyond those who already have a legal right to them;
  • people to have access to a local care and support navigator or key worker, and;
  • investment in advocacy services run by local charities and voluntary organisations so that people and their families can access independent support and advice

To achieve the shift from inpatient to community-based services, Building the right support sets out three key changes:

  • Local councils and NHS bodies will join together to deliver better and more co-ordinated services – 49 new local Transforming Care Partnerships will work with people with lived experience of these services, families, carers and key local stakeholders to agree robust implementation plans by April 2016, and then deliver on them over three years. They will be made up of clinical commissioning groups, NHS England’s specialised commissioners and local authorities, and will cover the whole of England
  • Budgets will be shared between the NHS and local councils to ensure the right care is provided in the right place – A new financial framework will aim to speed up discharges, particularly for those who have been in inpatient care the longest, and make better use of resources so that services can be increased and improved. Central to the new framework will be the opportunity for local pooled budgets which encourage better use of resources for all people in a local area with learning disabilities and/or autism. Funding guidance will also be reformed to enable swift discharges. For people who have been in hospital five years or more, specific payments will be made by the NHS to local authorities to enable their needs to be met in the community.
  • National guidelines will set out what support people and families can expect, wherever they live – A new Service Model describes what good services should look like, framed around nine principles from the perspective of the people using them. It gives people a clear picture of what they can expect from the services they use, while at the same time allowing Partnerships the flexibility to design and commission services that meet the needs of people in their area. The new model, which was co-produced by people using services, commissioners and health and social care system leaders, has been finalised using the feedback from early implementation by six ‘fast track’ areas.

You can read the full article on the NHS England website, here:https://www.england.nhs.uk/2015/10/30/homes-not-hospitals/

You can view the report, Building the Right Support here: www.england.nhs.uk/wp-content/uploads/2015/10/ld-nat-imp-plan-oct15.pdf  



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