Post-scandal care pledge ‘not met’

Published: Wednesday 4th February 2015 by The News Editor

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Ministers have failed to honour a pledge made in the wake of the Winterbourne View abuse scandal to move patients with learning difficulties out of hospitals and into community care, the Whitehall spending watchdog has said.

The National Audit Office said that, two years after the Department of Health issued the so-called “Winterbourne View Concordat”, there were still 2,600 inpatients with learning difficulties in mental health hospitals in England.

It said that ministers had underestimated the “complexity and level of challenge” involved in discharging so many patients into the community while the Government’s NHS reforms meant they lacked the “traditional levers” to implement the necessary changes.

Margaret Hodge, the chair of the Commons Public Accounts Committee which oversees the work of the NAO, said the failure by the Government to meet such an important commitment was “unacceptable” and that patients had been “badly let down”.

The Government originally issued its concordat in December 2012 after undercover filming by the BBC Panorama programme exposed an appalling catalogue of abuse of patients by staff at the Winterbourne View private hospital in Gloucestershire.

Eleven people subsequently pleaded guilty to criminal offences of neglect or abuse, six were jailed, and the hospital was shut down.

The central plank of the Government’s concordat was a commitment to ensure that any inpatient with a learning disability or challenging behaviour who would be better off cared for in the community would be moved out of hospital by June 2014.

Ministers assumed it would lead to a dramatic reduction in hospital placements, large mental hospitals would close, and “almost all” the estimated 3,250 inpatients at the time of the concordat would be discharged.

However the NAO said that figures from NHS England showed that by March 2014 there were still more than 2,600 inpatients – a number that has remained broadly stable according to the latest figures from September 2014.

In June 2014, there were 2,024 inpatients who had no planned transfer or discharge date, with 1,614 of those having received a clinical decision that they should remain in hospital.

As of September, there were still 920 without a transfer or discharge date, with 691 having been told they were not ready to leave.

However, the NAO said that even when patients were discharged, there was a waiting list of people queuing up to replace them – in the nine months to June 2014 there were 902 new admissions as against 600 discharges.

While NHS England set a new “ambition” in August 2014 to transfer half the 2,600 inpatients to more appropriate care by the end of March 2015, the NAO said that so far only around 400 had been moved.

Of the 48 patients in Winterbourne View at the time of its closure, 10 were still in hospital, 20 were living in residential care, five were in supported housing, 12 had their own tenancies, and one had died.

The NAO said that Government’s efforts to discharge patients had been hampered by “poor quality” data while changes under the Health and Social Care Act meant ministers could no longer compel local healthcare commissioning bodies to act.

The head of the NAO, Amyas Morse, warned there were on short-term solutions to such a complex issue and that the Government still faced “formidable” obstacles.

“NHS England has made a disappointingly slow start to this task,” he said.

“Although it has now increased its activity, there are formidable care, organisational and service hurdles to overcome in establishing a new model of care in more appropriate settings.”

Mrs Hodge said she was “appalled” that so many patients remained in hospitals so long after the Government issued its concordat .

“People with learning disabilities, admitted to hospitals for assessment and treatment, have been badly let down by government,” she said.

“More than two years since its response to the abuse of patients at the Winterbourne View hospital, it is unacceptable for government to have failed in meeting its core commitment to move people out of mental health hospitals and into the community.”

In a joint statement, the charities Mencap and the Challenging Behaviour Foundation, said the report underlined the “abject failure” to tackle the issue.

“NHS England and its partners must learn from their failings and reassure people with a learning disability and their families that they will put in place a robust implementation plan to meet the challenge and deadlines set down by the NAO,” they said.

The chief nursing officer for England, Jane Cummings, acknowledged that the lack of progress had been “frustrating” and said that the NAO had provided a ” fair assessment” of the issues involved.

“This is why we have been rapidly carrying out care and treatment reviews for current patients, with over a thousand taking place in the last few months and hundreds of patients having been discharged,” she said.

Care and Support Minister Norman Lamb said the Government was redoubling its efforts to ensure patients received the right care in the right place.

“We know that the scale and complexity of the issue is a challenge and, although there have been some improvements, we have not gone nearly far enough fast enough,” he said.

“I am looking at legislative options to give people with learning disabilities and their families a stronger voice and more rights – and I’m looking at how we can increase specialised housing options, so that more people can live independently but with the support that they need.”

Published: Wednesday 4th February 2015 by The News Editor

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