Learning disabilities: policies to reduce inpatient care

Around 1.5 million people in England have a learning disability. The Government and NHS England are working to reduce health inequalities for people with a learning disability and have established national programmes to improve care and outcomes.

Tackling learning disabilities is one of the clinical priority areas in the NHS Long Term Plan (January 2019). The Plan committed the NHS to tackling the causes of morbidity and premature death for people with these conditions and set several targets, such as increasing annual health checks for people with a learning disability, introducing designated keyworkers for children and young people, and halving inpatient care for this group by 50% by 2023/24 (compared to 2015 levels).

In February 2023, there were 2,045 people with a learning disability and autistic people receiving inpatient care, of which over half (56%) had a total stay of two years or longer.

The Health and Care Act 2022 introduced a new legal requirement for all health and social care service providers registered with the Care Quality Commission (CQC) to provide employees with training on autism and learning disabilities (called Oliver McGowan Training).

In July 2022, the Department for Health and Social Care (DHSC) published an updated Building the right support for people with a learning disability and autistic people: action plan focusing on six areas to develop community services and reduce reliance on inpatient mental health beds.

The Government also proposed in the Draft Mental Health Bill 2022 to amend the criteria for detention under the Mental Health Act 1983, so a person could not be subject to long-term detention for treatment for autism or a learning disability.

NHS England’s learning from lives and deaths programme (LeDeR) (formerly known as the learning disability mortality review) started in April 2017. This aims to improve care, reduce health inequalities, and prevent premature mortality of people with a learning disability and autistic people by reviewing information about the health and social care support people received.

Integrated Care Systems (ICSs) are now responsible for ensuring that LeDeR reviews are completed on the health and social care received by people with a learning disability and autistic people (aged four years and over) who have died. ICSs are also responsible for ensuring the implementation of actions to improve the quality of services for people with a learning disability and autistic people to reduce health inequalities and premature mortality.