Homes not hospitals

Building the Right Support update

Building the Right Support was published in 2015 by NHS England, the Local Government Association and the Association of Directors of Adult Social Services as part of the Transforming Care Programme. The guidance supports NHS and local authority commissioners to reduce the number of people with a learning disability and autistic people in a mental health inpatient setting and to develop community alternatives to inpatient care in line with the National Service Model. The guidance will be reviewed in the course of 2022/23, in the light of current needs and requirements and in line with the work of the ministerially led Building the Right Support Delivery Board.

Transforming care is all about improving health and care services so that more people can live in the community, with the right support, and close to home.

Our national plan, Building the Right Support, published in October 2015 set out what we are doing to make sure this change happens.

Following on from Building the Right Support we published a national service model which is also available in easy read.  We also published a document called supplementary guidance for commissioners (the people who plan and pay for care) which tells them what good services should look like and should be in place by March 2019.

Building on that service model we also published three model service specifications, also available in easy read, to give commissioners more detail about the kinds of specialist support they could provide in their local communities.

How is care changing?

Transforming care will mean that fewer people will need to go into hospital for their care. This means that we can close hundreds of hospital beds across England.  To do this we are making sure that services in the community are much better.

For people who do need to go into hospital though we want to make sure that they are as close to where they live as possible.  This means that in some areas of the country new hospital services need to be developed at the same time as community support.

In collaboration with the Local Government Association and Association of Directors of Adult Social Services as Partners in Care and Health, we have published a letter which identifies five key actions that will have the biggest impact on supporting people with a learning disability and autistic people to leave mental health hospital.

Nearly 10,000 discharges to the community have been achieved since 2015. The letter asks colleagues working in integrated care systems across health and social care to make a concerted effort to continue to help people with a learning disability and autistic people leave hospital when they no longer need hospital care.

This letter follows on from the publication of the Joint guiding principles for integrated care systems – learning disability and autism in October 2023. These principles for integrated care systems set out how partners in local systems should work together to improve the lives and outcomes of people with a learning disability and autistic people, of all ages.

Case study: Centre of excellence for disabled children in York

The Beehive, a purpose-built centre opened in November 2020 provides short overnight breaks for children and young people with complex disabilities in York. It provides a range of services to help children stay with their families and communities. This short film takes you on a tour of the centre and speaks to some of the people who were involved in the design, and some of the families and children who are now using the services.

You can find out more about how care is improving for people with a learning disability, autism or both in the following pages:

Supreme Court judgements

This updated generic briefing note is to provide a summary of the recent Supreme Court judgments and to outline some of the possible implications for the transforming care programme.