Address the national scandal of long-stay inpatient units – VODG report calls on incoming government to take action to transform care

The next government must urgently address the national scandal that sees 2,250 people with a learning disability, autism and/or mental health needs currently detained in long-stay NHS-funded care, with 15% of that group having been detained for more than 10 years without prospect of discharge.

In its report, published today, VODG (Voluntary Organisations Disability Group) calls on the country’s next leaders to take the necessary action to deliver the legislation and funding required to protect the thousands of people currently detained in long-stay NHS-funded care and move to provide them with comprehensive, effective and safe provision of care in the community.

• 463 people have been detained in NHS accommodation for more than five years.
• 355 people have been detained for more than 10 years with no serious prospect of them being discharged.
• The number of people aged under 18 in NHS accommodation and NHS-funded accommodation is increasing in absolute terms as well as becoming a larger proportion of the population overall.
• Data reports that women are less likely to be discharged from NHS care.

The report also reveals highly variable performance across transforming care partnerships in terms of successfully discharging people from NHS-funded care into the community, with just over half having actually achieved discharge from hospital. The rest have either failed to achieve any overall change or increased the number of people admitted. Furthermore, if the current rate of discharge is maintained, by early 2030, the population of people in long-stay NHS-funded care will have only halved since 2011 when commitments were made following the Winterbourne View abuse scandal.

VODG chief executive Rhidian Hughes, said:

“A rate that only halves the population of people living in long-stay units after twenty years is simply not good enough. Secluded institutionalised care is fundamentally wrong and exposes some of the most vulnerable citizens to serious risk of harm and risks damaging their wellbeing.

“While our research did show examples of transforming care partnerships working well, the majority of social care providers who can support people out of long-stay institutions are still experiencing significant challenges. We need to see significant improvement in the commissioning of services and a step away from NHS and privately run long stay provision.

“This report illustrates clearly the need for government to take action to end the reliance on long-stay inpatient units and to properly protect people who have been detained by the state. It is hard to imagine any other circumstances in which a British citizen could be detained indefinitely by the state, without trial.

“It is only through the levers of government and realistic investment that substantial progress can be made. Previous governments acted on the scandal of long-stay hospitals with legislation and funding. If the next government does not do the same, then the message is crystal clear, ‘these people do not matter to us and we do not care’.”

In the report, VODG outlines three proposals for action:

• that the Secretary of State for Health and Social Care direct the Care Quality Commission to rate all assessment and treatment units as ‘Requiring Improvement’ if any person has been living there for more than 12 months. The rating should be downgraded to ‘Inadequate’ if anyone has been living there for more than 24 months and all new admissions halted until the rating has improved.
• that HM Treasury establish a community development fund of £400m over four years to pump prime the development of community facilities.
• that the Secretary of State for Health and Social Care require the National Audit Office to publish an annual report to be presented to parliament on the progress of Transforming Care.