Reports on Seclusion and Restrictive Practice for People with Autism, Mental Health Conditions and Learning Disabilities

Today we have published two formal responses to independent reports that the then Secretary of State for Health and Social Care commissioned to address and reduce the use of restrictive practice in the care of people with a learning disability or autistic people. The first response is to the recommendations made by the Care Quality Commission (CQC) in its report “Out of Sight - who cares?” published on 22 October 2020. The second response is to the independent interim report by Baroness Hollins reviewing the care and treatment of people with a learning disability or autistic people in long term segregation. A copy of these responses will be deposited in the Libraries of both Houses.

We welcome these reports and strongly support their recommendations. It is our priority to ensure that the rights of people with a learning disability or autistic people are protected and that where needed they receive high-quality care in the least restrictive settings possible.

We have carefully considered these recommendations and are accepting in full or in principle the vast majority, including:

Developing a pilot for a senior intervenor role, which will be focused on reducing the length of time people with a learning disability or autistic people remain unnecessarily in inpatient care in segregation. The pilot will be funded as part of a wider package of £31 million to support learning disability and autism services, to address the diagnostic backlog as a result of the pandemic, and support intervention to prevent children and young people with learning disability, autism or both escalating into crisis.

Working with the Royal College of Psychiatrists to define good practice with respect to admission and discharge protocols, including the development of a clinical contract for admissions.

Supporting the continuation of an independent review process which provides necessary scrutiny in the care and treatment of people who are subject to segregation. The reviews, chaired by independent experts, are aimed at developing bespoke recommendations, offering advice on implementing person-centred care plans and, where appropriate, moving the individual to less restrictive settings.

Working with the CQC to ensure more transparent reporting about the use of restrictive interventions in order to improve practice and minimise all types of force used on patients so that it is genuinely only ever used as a last resort.

Our goal is to ensure that care for people with a learning disability and autistic people is therapeutic and beneficial and that the presumption is always that, individuals can be supported to live fulfilling lives in the community. We remain committed to delivering on the Government’s manifesto commitment to improve how people with a learning disability and autistic people are treated in law and to make it easier for them to be discharged from hospital. The steps we are taking in responding to these recommendations support this commitment and are part of our wider work on Building the Right Support and the Mental Health Act White Paper.