Learning Disabilities is included in the NHS Operational Planning and Contracting Guidance for 2017-19. One of the nine ‘must dos’ for organisations is to deliver actions set out in local plans to transform care for people with learning disabilities, including implementing enhanced community provision, reducing inpatient capacity, and rolling out care and treatment reviews in line with published policy.
Our Learning Disabilities project, which runs every two years, supports organisations to measure their performance against that of their peers. The LD project aims to cover the provision of both community and inpatient Learning Disability services across providers in the UK. Learning Disabilities has complex commissioning frameworks and provider arrangements, and the project aims to bring some clarity to aid understanding of provision and performance.
A total of 47 provider organisations took part in the project making 63 data submissions, including 41 English Trusts and Foundation Trusts four Welsh Local Health Boards, two Irish Health and Social Care Trusts and one Scottish Health Board. Participants can view their position on the benchmarked metrics via an online tool accessible through the Network website members’ area: http://members.nhsbenchmarking.nhs.uk/home. In addition to the online toolkit, members can access a national report, which provides illustrative charts from the online tool and good practice compendium and, for the first time this year, bespoke reports will also be made available to project participants.
Findings from the Learning Disabilities 2016 project include:
- The data supports a hypothesis that overall investment levels in specialist LD services may have reduced over the two-year period. This trajectory is evident in locally commissioned community healthcare LD services and needs to be aligned with the position on the commissioning of local and nationally commissioned inpatient services.
- As expected, the NHS England Transforming Care strategy has led to a decrease in the numbers of inpatient beds. Findings from this year’s project show a 36% reduction across all bed types since 2014, with providers reporting a further 24% decrease in beds in the next 12 months.
- Despite this decrease in bed based provision, the project did not find an increase in the availability of community learning disability services. The total number of contacts delivered by community teams over the last two years has decreased by 18%, and there has been a 23% decrease in spend on community LD services in line with the reduction in activity.
- Workforce skill mix continues to be an area of interest. This year’s project found that 34% of the adult inpatient nursing workforce were registered nursing staff, and 66% were unqualified nurses and support workers. In comparison, adult community teams have a much richer nursing skill mix (61% registered nursing staff) and more therapy input is evident.
The Learning Disabilities project runs on a biennial cycle with the next phase of data collection due in 2018/19, however further scoping and refinement of this project will take place in 2017/18.
For more information on this work please contact:
Leigh Jenkins, Project Manager