The Government has published an action plan to reduce the number of people with a learning disability and autistic people in mental health hospitals in England.
Building the Right Support Action Plan brings together, in one document, commitments across government and other public services to ensure there is suitable community support available for people with learning disability and autistic people to live in their own home and have the right support in place to live an ordinary life. It builds on lessons learned from the Transforming Care programme.
It is key reading material for Integrated Care Boards, commissioners of health, social care and education services, providers in the public and independent sectors and the voluntary and community sectors. Charts A – J contain some useful data to set the scene.
Since the national plan, Building the right support was published in 2015, progress has been made on reducing the number of people in inpatient settings and supported more people to live in the community. The inpatient total at the end of May 2022 was 2,010 - with six out of 42 ICSs having met the 2023 to 2024 NHS Long Term Plan target (to reduce to less than half of 2015 level the mental health inpatient provision for people with learning disability and autism).
The action plan is divided into six chapters:
- Keeping people safe and ensuring high quality health and social care
- Making it easier to leave hospital
- Living and ordinary life in the community
- A good start to life
- Working with changes to the system
- National and local accountability to deliver
Each chapter focusses on a particular area to support people to live ordinary, independent lives in their own home as part of communities. The commitments (of which there are many) and timescales are set out in Annex A, with the lead organisations responsible for delivery. The Building the Right Support Delivery Board will support overall implementation of this action plan and hold organisations accountable for delivery.
Supporting the aims of this action plan are several changes taking place across government, such as the proposed reforms to the Mental Health Act and to adult social care, commitments under the Health and Care Act 2022 to integrate place-based working, building on roll out of personal health budgets and work on improving pooled budgets. Against this background, we particularly highlight the following commitments.
- Improving quality of care in mental health inpatient settings and ensuring people with a learning disability are not admitted to hospital settings rated ‘inadequate’ by CQC.
- Limiting the scope under which people with a learning disability and autistic people can be detained by reforming the Mental Health Act and introducing a new duty under the Mental Health Act which will allow some restricted patients to be discharged into conditions in the community which amount to a deprivation of liberty
- Providing specialist training for health and care staff to ensure they have the skills to better support individuals.
- Investment to boost the supply of supported housing and to improve understanding of the size, cost, and demand of the supported housing sector.
- Making sure that commissioners have the right training and information to commission the right services for people with a learning disability and autistic people
- Proposals to introduce new duties on commissioners to ensure that there are adequate community-based services in their local area to support people with learning disability and autistic people. This is part of Mental Health Act reform proposals.
- Continuing to roll out a programme across England to encourage the establishment of small providers that promote individual choice and control within communities
- Making it quicker and easier to get an autism diagnosis, including bringing multidisciplinary teams together in school settings to diagnose children more rapidly.
- Improving the experiences of children and young people - we have the SEND and alternative provision green paper and the government’s response to both the CMA market study into children’s social care and the Independent Review of Children’s Social Care.
- Supporting autism awareness training for education staff in early years, schools, and further education settings.
“Our ultimate goal is that across England, people with a learning disability and autistic people are equal citizens able to fulfil their potential. They are supported to live full lives in their community, in their home, with access to the care that is right for them, when and where they need it,” said Minister for Care and Mental Health, Gillian Keegan.
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