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, Whitehall’s spending watchdog has found.
Two years after the Department of Health promised to transfer 3,250 people from clinical environments into appropriate homes, a report by the National Audit Office (NAO) shows there were still 2,600 inpatients with learning difficulties in mental health hospitals in England.
Ministers underestimated the “complexity and level of challenge” involved in discharging so many patients into the community, the report says, and the government’s NHS shakeup meant they lacked the “traditional levers” to implement the necessary changes.
Margaret Hodge, who chairs the Commons public accounts committee which oversees the NAO’s work, said the failure to meet such an important commitment was unacceptable and that patients had been “badly let down”.
The government issued instructions to move those with learning difficulties out of hospitals in December 2012 after undercover filming by the BBC1 Panorama programme exposed casual and cruel 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.
Ministers drew up an agreement saying 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. They assumed it would lead to a dramatic reduction in hospital placements, large mental hospitals would close and “almost all” the inpatients would be discharged.
However, the NAO said figures from NHS England showed there were still more than 2,600 inpatients in March 2014, a number that had not fallen by the time of the latest figures from September 2014.
Auditors 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 600 discharges and 902 new admissions.
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 only about 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 charities Mencap and the Challenging Behaviour Foundation said the report underlined the “abject failure” to tackle the issue.
Norman Lamb, the Liberal Democrat care minister, 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.”
