Yesterday saw the publicaton of the Department of Health’s “Transforming Care: A National Response to Winterbourne View Hospital” and an accompanying Concordat signed by health and social care ledaers, committing to deliver on the government’s pledges. This report was sparked by the 2011 BBC Panorama documentary on Winterbourne View, a privately run inpatient hospital. The BBC documentary found several cases of physical abuse against patients by carers. This Department of Health report seeks to determine the causes of the abuse, and to find methods of preventing such incidents happening again. Moreover, the report seeks to take a wider look at the care and support for people with learning disabilities or autism who also have mental health conditions or behaviours viewed as challenging.
Key actions that the report proposes are:
- The removal of residents from NHS-funded private hospitals to more appropriate community based support.
- To hold the senior managers, directors and board members of organisations accountable for quality of care within their organisation.
- Consideration of new criminal offences to hold corporate organisations to account for service failures, possibly including an offence of corporate neglect.
- Greater use of CQC’s enforcement powers in the event of service failings.
- A review of the adequacy of CQC’s current enforcement powers, with a report issued in spring 2013.
- To involve people with a learning disability and their families in their own care planning.
- Encourage the NHS and local county councils to work together to facilitate more intergrated care.
- Raise understanding of good practice and reduce the use of physical restraint and to take enforcement action where restraint is used improperly or illegally.
Amongst others, the report criticises CQC and its failure to follow up a report from a whistleblower regarding the abuse at Winterbourne. The report asks CQC to consider how it can use its existing powers to hold corporate providers to account. One suggestion is that a board member might be nominated to be accountable to the regulator for quality. The report also states that CQC should inspect learning disability providers against a new model of care that requires services to be provided locally and by skilled workers with an emphasis on quality of life and human rights. For inpatient services, a focus of CQC inspection of inpatient facilities will be on the effectiveness of planning in respect of moving service users back into the community.
The report sets ambitious goals for the removal of a “substantial” number of residents from NHS-funded private hospitals and into community based support within the next 18 months. Currently there are around 3,400 people within in-patient settings. Norman Lamb, the Care and Support Minister, said he hoped that this number would reduce to 300 or 400 by 1 June 2012, saying simply “hospitals are not where people should live”. However, Mr Lamb does concede that this relocation will depend on examination of each individual’s needs.
The report has been well received by Mencap and The Challenging Behaviour Foundation, and in a joint statement they said “the Government shows that it has listened to families and campaigners by committing to a national programme of change.” However, they emphasise that words alone are not enough, and “urgent” action must be taken to fulfill the proposals and goals set out within the report.
Both Mencap and The Challenging Behaviour Foundation have signed the Concordat, a document that the Department of Health say “sets out our commitment to work together, with individuals and families, and with the groups which represent them, to deliver real change, improve quality of care and ensure better outcomes.”