Transforming Care – building the right support

In 2011, a BBC Panorama programme exposed systemic abuse of people with learning disabilities and autism at the Winterbourne View care home. Winterbourne View was an independent sector hospital that took NHS-funded patients.

In response, the Department of Health had established the ‘Transforming Care’ programme to reform care and support for people with learning disabilities and autism. But, in 2014, the ‘Winterbourne View – Time for change’ report – commissioned by NHS England – highlighted the lack of progress on a key commitment to move care for learning disabilities from inpatient to community settings.

Building the right support

NHS England, the Local Government Association (LGA), and the Association of Directors of Adult Social Services (ADASS) published 'Building the right support' in October 2015.

The national plan set a target to transfer the care of between 35–50% of people with learning disabilities and autism from inpatient to community services by March 2019.

To achieve this, CCGs, NHSE commissioners and local authorities would collaborate and share budgets as part of 49 Transforming Care Partnerships. The plan stated that commissioners would have to invest in community support before closing inpatient services.

Limited progress

However, progress was limited. When the target was introduced in October 2015, NHS commissioners reported that there were 2,620 adults and children with a learning disability and/or autism in secure inpatient settings in England. The number of people in inpatient care reduced by 14% to 2,260 by March 2019.

When the NHS Long term plan was published in January 2019, it was clear that the target for March 2019 was going to be missed and many people with learning disabilities and autism remained in inpatient services. The long term plan refreshed the target, with the new aim to reduce inpatient provision of care by 50% of 2015 levels by 2023/24.