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Those working in social care will play a pivotal role under planned changes to the support offered to people with learning disabilities – which will see hospital bed numbers halved over the next three years with care shifting to the community. 

Individuals with learning disabilities will be offered the opportunity to own their own home, access personalised care budgets and shape the services they receive whilst still receiving close support from designated care workers who will have an increased role within that framework.

More co-ordinated services

To achieve the shift from inpatient to community-based services, local councils and NHS bodies will join together to deliver more co-ordinated services with 49 new local Transforming Care Partnerships working on implementation plans. The scheme will receive £45m of funding with budgets shared between the NHS and councils. 

Partnerships will design and commission bespoke services that meet the needs of people in their area under the new Service Model, which includes the local housing option of enabling people with learning disabilities to have their own home but with ready access to on-site support staff.

Expansion of personal budgets

Integral to the changes – outlined as part of the ongoing cross-system Transforming Care programme - will be expansion of the use of personal budgets, enabling more people and their families to plan their own care but with continued access to a local care and key support workers. The changes will also see people with learning disabilities, autism or mental health conditions, who are at risk of hospital admission, get a named social worker to challenge decisions about their care.

Putting things right

Jane Cummings, Chief Nursing Officer for England and Chair of the Transforming Care Delivery Board, conceded that society had “failed this group of people for decades” but was confident the plan would “put things right” and “make quick, significant and lasting improvements to their lives.” 

The move follows an abuse scandal at Winterbourne View - a hospital in South Gloucestershire for people with learning disabilities and autism - and will see patients live in homes in the community. NHS England expects the number of hospitalised patients to fall to between 1,300 and 1,700 in the next three years. As a result, Calderstones (the only remaining standalone learning disability hospital trust in England) will close.

Homes not hospitals

The plans have been developed with significant contribution and constructive challenge from people with learning disabilities and/or autism, their families and carers, and a range of commissioners, providers, voluntary sector and representative groups. 

NHS England Chief Executive Simon Stevens said: “As good and necessary as some inpatient care can be, people with learning disabilities are clear they want to live in homes, not hospitals.”

While the plan predicts a reduction in inpatient beds of between 30% and 50% nationally, in some areas that may be 70%. 

Inpatient care costs the health and care system about £175,000 per patient a year and in England around 24,000 people who have a learning disability and/or autism are classed as being at risk of admission.

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