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People with learning disabilities or autism in psychiatric hospitals in September 2013

Secondary analysis by the Public Health England Learning Disabilities Team

A 2011 BBC Panorama documentary ‘Undercover Care’ revealed appalling abuse of patients at Winterbourne View, a private (for profit) inpatient mental health unit in the South West of England. Transforming Care, the Government’s report into this scandal, identified system-wide failure to ensure that patients with learning disabilities or autism were treated wherever possible in the community, and that when inpatient stays were unavoidable, those stays were close to home and short-term. It set out a programme of action to transform services with the aim of reducing admissions, and moving those patients currently inappropriately in hospital to community-based support as soon as possible (Department of Health, 2012).

Transforming Care committed the Department of Health to commission work to identify the scale of the problem – ‘to take a snapshot of provision, numbers of out of area placements and lengths of stay’. At the time, the extent of inpatient psychiatric care funded by the NHS was not fully apparent from routine English hospital inpatient statistics. This was because a significant proportion of secure inpatient care as well as some specialist behavioural inpatient treatment happened in independent sector hospitals which, at the time, did not report details through the long-established statistical data collections monitoring NHS inpatient care. To fulfil their commitment, the Department of Health commissioned a census designed to cover patients in all inpatient psychiatric providers. This was carried out at the end of September 2013, to be followed by a repeat census to measure progress a year later.

The Health and Social Care Information Centre (HSCIC) were commissioned by the Department of Health to manage this census and provide descriptive analysis. As part of its commitment to the Winterbourne View Joint Improvement Programme, the Public Health England Learning Disability Team agreed to undertake detailed secondary analysis of the census data, with the aim of shedding some light on the factors driving patterns of inpatient care in England, with the intention of clarifying what needs to be done to achieve the aims of Transforming Care.