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Government response to No voice unheard, no right ignored – a consultation for people with learning disabilities, autism and mental health conditions

No voice unheard, no right ignored: a consultation for people with learning disabilities, autism and mental health conditions was presented by the previous (coalition) Government because not enough progress had been made to transform their care – principally to relocate them from inpatient units to community-based care – as promised in the wake of the Winterbourne View scandal. Reducing inpatient numbers, and reliance on inpatient care, remains a key goal of the revitalised Transforming Care Programme for system-wide change shared by NHS England, Local Government Association (LGA), Association of Directors of Adult Social Services (ADASS), Care Quality Commission (CQC), Health Education England and the Department of Health.

The consultation recognised stark variability in commissioning approaches and in resulting outcomes across the country. This reflected the fact that some commissioners have failed to grasp and act on the urgency of putting in place suitable community provision. Too many have not changed their behaviour, in part because the system is not set up to make it easy for them to do so or to make it hard for them not to do so. As well as the impact on individuals and their families, this represents a failure to act on strategic imperatives to plan, design and deliver the right services now. These imperatives include:

• growing evidence that, over time, the right care and support in the community can reduce the incidence of behaviour that challenges services and, in turn, reduce costs to the NHS and other parts of the public sector, such as the criminal justice system, and
• increasing demand – by 2030 the number of adults aged 70+ with learning disabilities using social care (and also very likely to be using health services) is expected to double.

The consultation accordingly set out to explore views on a range of proposals intended to strengthen or build upon existing policies, and sought views on those likely to have most impact. It posed 50 questions primarily related to:

• assessment in mental health hospitals for people (all age) with learning disability or autism
• adult care and support, primarily for those with learning disability but also for adults with autism (and the links to support for children and young people), and
• all those to whom the Mental Health Act 1983 currently applies (including children and young people).