People with a learning disability and/or autism* across the NHS England South region will be supported to lead more independent lives and have greater say about the support they receive under a national plan published today to radically improve learning disability services.

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

Central to the progress set out by the plan over the next three years will be new, high-quality, community-based services, so more people with learning disabilities are not kept in hospital unless absolutely necessary.

It represents a key milestone in the ongoing cross-government Transforming Care programme, which has seen a number of reforms including the roll out of Care and Treatment Reviews and a Government Green Paper on strengthening the rights of individuals.

Under the plan, local authorities and NHS bodies will work together to create 14 Transforming Care Partnerships in the South, 49 nationally. These will be able to draw upon a share of a national NHS England fund of £45m to aid the transition.

In addition to this national funding, NHS England South has already identified over £6m of capital investment to support CCGs across the region in redeveloping or building new facilities and accommodation to improve the availability of community-based care for those with learning disabilities. CCGs are developing their proposals and funding will be distributed once projects are ready to proceed in the comings weeks and months.

In the South region, good progress has already been made in reducing the numbers of inpatient beds for people with learning disabilities. The South region has the lowest per capita admission rate in the country, with around 310 inpatient beds commissioned for those with a learning disability or autism. Since April 2014, 190 people with learning disabilities have been discharged from inpatient hospital care either back home or to other community care, achieved by working with patients and families and providing the right community services,

Moving forward, the focus in the South will be on ensuring that there is the right mix of services for excellent care. This will include preventing admission to hospital in the first place, by providing more care in the community and at home, enabling the safe and timely discharge of those receiving inpatient care and for those who do need inpatient care, the aim is to increase availability close to home wherever possible.

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, allowing people and 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.

Another key strand of the Transforming Care programme is the provision of Care and Treatment Reviews (CTRs). These assessments are undertaken by a clinician but also involve the patient, their family or advocates, to ensure the right care package is in place for each individual.

For those with learning disabilities who are at risk of being admitted to hospital, pre-admission reviews will be held, where possible to identify how best to keep them at home. For those who are already in hospital, ongoing reviews will help to tailor their care and wherever possible facilitate safe and early discharge.   Across the South, there is early evidence that these Care and Treatment Reviews are helping to avoid admission in the first place and are helping to get people home earlier from hospital with the right supportive care.

Sarah Elliot, Regional Director of Nursing, NHS England South, said: “The future of best care for those with learning disabilities and autism is in providing high-quality community-based services and support which is close to home.

“Here in the South, we already have the lowest hospital admission rate in the country and we have some excellent initiatives underway across the region providing independent living, supportive intervention and ongoing assessment.

“Whilst we will still need inpatient facilities to provide safe care close to home for some, this ambitious national plan demonstrates a commitment to community-based care for those with learning disabilities, giving them and their families a far greater say in the care they receive, close to their friends and families.”