Modernisation of North West learning disability services to improve care for patients and see closure of Calderstones Learning Disability Hospital

People with a learning disability, autism or both in the North West will be supported to lead more independent lives in their communities thanks to plans given the final go ahead today, which include the closure of Calderstones (now known as Mersey Care Whalley site) – England’s last stand-alone NHS learning disability hospital.

The plans to address the historic lack of high quality community-based services in the region, which has resulted in an over-reliance on long stay inpatient care compared to other parts of the country, were given the green light following an extensive three month consultation involving patients, their families, staff and the public.

The consultation received over 1,000 responses from people with learning disabilities, autism spectrum disorder (ASD) or both, family members and carers, staff and national experts.

Plans will now be finalised setting out how local NHS and social care leaders in the region will deliver the reforms set out in Building the right support, the widely-supported cross-government plan which set out to ensure that people with learning disabilities and/or autism will:

  • Have greater choice in the kind of care they receive and how that supports the ambitions they have for themselves;
  • Be able to live in their own community, closer to family and friends;
  • Continue to receive care and treatment, closer to home, at the appropriate level to meet their needs;
  • Receive proactive healthcare to maintain their mental and physical health and wellbeing, and;
  • Have access to acute assessment services/ inpatient provision when needed.

To achieve this, new services will be provided across the region including:

  • In Greater Manchester, a fully-integrated Custody Healthcare/Liaison and Diversion service
  • In Cheshire and Merseyside, Intensive Support Teams to provide a range of positive behaviour strategies and appropriate responses to people to avoid crises, and;
  • In Lancashire, a Specialist Support Team to work with people at the earliest opportunity to avoid admissions and speed up discharges from inpatient care.
  • Smaller units across the region co-located with other mental health services, and the development of a medium-secure mental health service at the Maghull site, with beds in smaller units for patients with a learning disability, autism or both.

Dr Michael Gregory, Regional Clinical Director for NHS England  in the North, said: “These plans represent a real step forward in terms of how we support people in the North West who have a learning disability, autism or both, and their families, in the future.

“Nobody doubts the dedication of the staff at Whalley, but for too long we have been too reliant on institutional in-patient care, often for unnecessarily long periods of time.”

Margaret Kitching, Regional Chief Nurse for the North, added: “Now is the time for us to work closely with staff and the people who use these services to build the kind of services we all want to see across the region over the next three years and beyond.”

The closure of Mersey Care Whalley site, formerly called Calderstones hospital, was called for by Sir Stephen Bubb, author of the ‘Winterbourne View – Time for Change‘ report, and the Public Accounts Committee.

The results of the consultation showed that the development of bespoke inpatient and crisis invention services for people who present with extremes of challenging and offending behaviour will be central to the NHS delivering a modern service for people with a learning disability, autism or both.

Over the next three years, care will increasingly be provided through teams in the community, with a number of smaller inpatient units located across the North West providing medium and low secure services when needed, for short periods of time.

Whilst the NHS will no longer commission secure forensic services at the Whalley site, a new clinical model for secure and forensic learning disability care is being implemented, and the expertise and skills of current staff at the site and elsewhere in the North West will be central to this.

Staff will be offered opportunities for further training and development so that individuals and teams can be re-deployed across the new services.

In cases where staff cannot or do not wish to be re-deployed, NHS England, local CCGs and Mersey Care will work with staff representatives and trades unions to explore other options.

Patient safety remains paramount – as beds reduce community services will be developed at the same pace, and intensive support will be provided to patients and their families as they transition from inpatient care to a more appropriate setting.

During this process, quality standards at the current site -which were recently rated as Good by the CQC – will be monitored and maintained.

NHS England has worked with colleagues at Mersey Care NHS Foundation Trust to ensure that briefing sessions are organised for staff, service users, their families and carers, with additional ongoing support being provided for service users while the changes take place.

A copy of the minutes of the National Decision Making Group and paper presented to them are available below. Easy read versions of the documents are also available.