Treatment of autistic people and individuals with learning disabilities

Health and Social Care Committee Closed Inquiry
Opened: 3 Feb 2021 Closed: 1 Aug 2022 Parliament page
Limited progress in improving the way autistic people and individuals with learning disabilities are treated is to be examined by the Health and Social Care Committee. The short inquiry will hold the first of two evidence sessions next week with particular focus on the use of restraint and “sectioning”. It … Read more
14 Recommendations
6 Conclusions
1 Report
3 Oral sessions
3 Letters
3 Events
Activity timeline 8 events
27 Jul
2022
Report published
26 Oct
2021
Correspondence
13 Jul
2021
Report published
22 Jun
2021
Correspondence
25 May
2021
Correspondence
27 Apr
2021
Oral evidence
13 Apr
2021
Oral evidence
9 Feb
2021
Oral evidence
Oral evidence sessions 3 sessions
27 Apr 2021
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Bengi O’Reilly, an individual with lived experience Claire Murdoch · NHS England Dr Sara Ryan, an individual with lived experience Fiona Walshe · Department of Health and Social Care Helen Whately MP · Department of Health and Social Care Roger Banks · NHS England
13 Apr 2021
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Baroness Sheila Hollins · Beyond Words Dr Ian Davidson · NHS and Royal College of Psychiatrists Dr Ken Courteney · Royal College of Psychiatrists Intellectual Disability Faculty Dr Theresa Joyce · Care Quality Commission Ian Birrell, Journalist Professor Philip Fennell · Cardiff University Sir Norman Lamb, former Minister at the Department of Health
9 Feb 2021
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Alexis Quinn, autism activist, author and Restraint Reduction Network Manager Dan Scorer · Mencap Ivan Olbrechts · Learning Disability England Julie Newcombe · Rightful Lives Vivien Cooper · Challenging Behaviour Foundation
Title HC No. Published Items Response
Fifth Report - The treatment of autistic people and people with … HC 21 13 Jul 2021 20 Responded
Recommendations & Conclusions
20 results
1 Conclusion Acknowledged
Fifth Report - The treatment of au…
Autistic people and people with learning disabilities have the right to live independent, free and...
Autistic people and people with learning disabilities have the right to live independent, free and fulfilled lives in the community and it is an unacceptable violation of their human rights to deny them the chance to do so. It is … Read more
Government Response
The government agrees with the importance of community support, acknowledges the funding complexity, and outlines current spending initiatives for people with learning disabilities and autistic people.
Department of Health and Social Care
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2 Recommendation Not Addressed
Fifth Report - The treatment of au…
We recommend that the Department of Health & Social Care provides us with a complete...
We recommend that the Department of Health & Social Care provides us with a complete assessment of the cost of providing community support for all autistic people and people with learning disabilities currently in inpatient units. Alongside this, an assessment … Read more
Government Response
The government states it is difficult to provide a complete assessment of community support costs and matching investment due to varied funding, highlights existing spending, but does not commit to the specific assessment or matching investment as recommended.
Department of Health and Social Care
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3 Recommendation Accepted
Fifth Report - The treatment of au…
We also recommend that the Department then needs to redesign the financial incentives in the...
We also recommend that the Department then needs to redesign the financial incentives in the healthcare system so that local authorities do not seek to ‘offload’ autistic people and people with learning disabilities onto the NHS or place these individuals … Read more
Government Response
The government accepts the recommendation, agreeing to redesign incentives by working to change the law to make local authorities and health services responsible for community support, improve housing, and ensure high-quality local support options.
Department of Health and Social Care
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4 Conclusion Not Addressed
Fifth Report - The treatment of au…
Since the Winterbourne View scandal, over 10 years ago, successive governments have committed to reducing...
Since the Winterbourne View scandal, over 10 years ago, successive governments have committed to reducing the number of autistic people and people with learning disabilities in inpatient settings and prioritising community support for these individuals. However, missed and delayed policy … Read more
Government Response
The government provides a generic response about the importance of mental health treatment and quality of care, which does not directly address the committee's conclusion regarding missed policy targets or the reasons for extended stays in Assessment and Treatment Units.
Department of Health and Social Care
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5 Conclusion Not Addressed
Fifth Report - The treatment of au…
While we welcome the vision set out by Helen Whately MP (Minister of State, Department...
While we welcome the vision set out by Helen Whately MP (Minister of State, Department of Health & Social Care), we believe this is a matter of delivery and The treatment of autistic people and people with learning disabilities 39 … Read more
Government Response
The government's response addresses a different suggestion regarding inadequate CQC-rated hospitals, and therefore does not engage with the committee's conclusion about The Building the Right Delivery Support Group.
Department of Health and Social Care
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6 Recommendation Accepted in Part
Fifth Report - The treatment of au…
The Trieste model of care—characterised by simplified and quicker admissions to and discharges from inpatient...
The Trieste model of care—characterised by simplified and quicker admissions to and discharges from inpatient facilities; limited number of individuals in inpatient facilities for lengthy durations; and emphasis on well-resourced community support—presents a clear and better alternative to supporting autistic … Read more
Government Response
The government agrees in principle with the recommendation for less restrictive care, stating it is already taking steps to ensure robust reporting of restrictive practices and emphasising therapeutic inpatient care. It highlights existing legislation like the Use of Force Act and notes CQC is improving its monitoring of restraint.
Department of Health and Social Care
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7 Recommendation Rejected
Fifth Report - The treatment of au…
We recommend that the Trieste model of care is implemented for autistic people and people...
We recommend that the Trieste model of care is implemented for autistic people and people with learning disabilities by the Department of Health & Social Care and NHS England & Improvement. All new long-term admissions of such people to institutions … Read more
Government Response
The government rejects the recommendation to ban long-term admissions and implement the Trieste model, stating it does not want to prevent necessary mental health hospital admissions but aims for shorter stays and increased community support.
Department of Health and Social Care
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8 Recommendation Accepted in Part
Fifth Report - The treatment of au…
In pursuing that policy, we recommend that by the end of 2021 the Department and...
In pursuing that policy, we recommend that by the end of 2021 the Department and NHS England & Improvement: i) introduce weekly formal reviews of the suitability of admission for all autistic people and people with learning disabilities who have … Read more
Government Response
The government accepts some parts of the recommendation, agreeing to regular checks (while noting existing reviews), that people should not be in hospital due to lack of community provision, and to remove the definition of autism as a mental health illness in forthcoming legislation.
Department of Health and Social Care
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9 Recommendation Accepted in Part
Fifth Report - The treatment of au…
Furthermore, we recommend that autistic people and people with learning disabilities should never be admitted...
Furthermore, we recommend that autistic people and people with learning disabilities should never be admitted to an inpatient facilities that has received an “inadequate” rating from the Care Quality Commission (CQC). The Department for Health & Social Care must bring … Read more
Government Response
The government agrees in part, stating the NHS will take action to avoid admissions to CQC-rated "inadequate" facilities but notes rare exceptions may occur, and commits to ensuring patient and family involvement in such decisions.
Department of Health and Social Care
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10 Recommendation Accepted
Fifth Report - The treatment of au…
We welcome the Government’s announcement that it will bring into force the Mental Health Units...
We welcome the Government’s announcement that it will bring into force the Mental Health Units (Use of Force) Act 2018 in November 2021. This will go some way to reducing the use of restricted practices in inpatient facilities. However, we … Read more
Government Response
The government states it already publishes monthly information on the use of force, exceeding the recommendation for twice-yearly publication, and notes that individuals and families should be involved in understanding incidents of force.
Department of Health and Social Care
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11 Conclusion Not Addressed
Fifth Report - The treatment of au…
Inpatient facilities do not consistently meet the needs of autistic people and people with learning...
Inpatient facilities do not consistently meet the needs of autistic people and people with learning disabilities and too often this is because of factors such as the unnecessary use of restrictive practices; inpatient facilities being unable to accommodate individuals’ needs … Read more
Government Response
The government's response addresses a different suggestion regarding investigating deaths, and therefore does not engage with the substance of the committee's conclusion about why inpatient facilities fail to meet the needs of autistic people and people with learning disabilities.
Department of Health and Social Care
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12 Recommendation Rejected
Fifth Report - The treatment of au…
We recommend that, in addition to the implementation of the Mental Health Units (Use of...
We recommend that, in addition to the implementation of the Mental Health Units (Use of Force Act) (i.e. ‘Seni’s Law’), all Assessment and Treatment Units (ATUs) are closed within two years and replaced with person-centred services that are: i) designed … Read more
Government Response
The government rejects the recommendation to close all Assessment and Treatment Units (ATUs) within two years, instead stating the importance of mental health treatment places and ensuring quality of care.
Department of Health and Social Care
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13 Conclusion Accepted
Fifth Report - The treatment of au…
We have significant concerns about the quality of training and support provided to staff working...
We have significant concerns about the quality of training and support provided to staff working in inpatient facilities and the negative consequences this can have on the treatment of autistic people and people with learning disabilities in inpatient facilities. While … Read more
Government Response
The government agrees with the importance of proper staff training and states they are starting new training programmes for health and care staff, including better training for those working in mental health hospitals.
Department of Health and Social Care
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14 Recommendation Accepted in Part
Fifth Report - The treatment of au…
We recommend that staff involved in the treatment of autistic people and people with disabilities...
We recommend that staff involved in the treatment of autistic people and people with disabilities in inpatient settings receive training in care planning which has a clear and unhindered focus on: i) understanding that autistic people and people with learning … Read more
Government Response
The government accepts the need for better staff training, stating they are starting new programmes, but indicates that not all staff will complete the training by the recommended April 2023 deadline.
Department of Health and Social Care
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15 Conclusion Accepted
Fifth Report - The treatment of au…
We conclude that the benefits of early diagnosis for conditions like autism are well- understood...
We conclude that the benefits of early diagnosis for conditions like autism are well- understood and late diagnosis presents a particular risk that autistic people will end up with mental illnesses such as anxiety and/or depression.
Government Response
The government agrees with the conclusion, stating it is already working to improve autism diagnosis by adhering to NICE guidelines for waiting times and investing money in autism checks.
Department of Health and Social Care
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16 Recommendation Accepted
Fifth Report - The treatment of au…
We recommend that the Government analyses the speed at which autism is diagnosed especially in...
We recommend that the Government analyses the speed at which autism is diagnosed especially in children and young people, and puts in place a strategy to increase early diagnosis with measurable outcomes by the end of the financial year 2021–22. … Read more
Government Response
The government agrees with the recommendation but states it is already working on increasing early autism diagnosis by adhering to NICE guidelines for waiting times and investing in autism checks.
Department of Health and Social Care
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17 Recommendation Rejected
Fifth Report - The treatment of au…
The physical health and wellbeing of autistic people and people with learning disabilities requires greater...
The physical health and wellbeing of autistic people and people with learning disabilities requires greater prioritisation. We believe that the creation of an Intellectual Disability Physician to co-ordinate care in line with the model established in the Netherlands should be … Read more
Government Response
The government has looked into creating an Intellectual Disability Physician role but is concerned about potential negative effects, opting instead to focus on training all doctors to work with autistic people and those with learning disabilities.
Department of Health and Social Care
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18 Recommendation Rejected
Fifth Report - The treatment of au…
We recommend that the Department and NHS England & Improvement undertake an assessment of the...
We recommend that the Department and NHS England & Improvement undertake an assessment of the merits of establishing the Intellectual Disability Physician as a new professional discipline within the NHS with the objective of reducing admissions 42 The treatment of … Read more
Government Response
The government has considered assessing a new Intellectual Disability Physician role but rejects it due to concerns about potential negative effects, preferring to focus on training all doctors to work with autistic people and those with learning disabilities.
Department of Health and Social Care
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19 Recommendation Rejected
Fifth Report - The treatment of au…
In recent years there have been too many incidences of autistic people and people with...
In recent years there have been too many incidences of autistic people and people with learning disabilities dying in inpatient settings. Families and friends have too often had to go to extreme and difficult lengths to have independent reviews into … Read more
Government Response
The government rejects the recommendation for mandatory independent reviews of deaths, stating they already look into reasons for deaths in mental health hospitals with appropriate local involvement.
Department of Health and Social Care
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20 Recommendation Rejected
Fifth Report - The treatment of au…
We therefore recommend that the Government and NHS England & Improvement bring forward the necessary...
We therefore recommend that the Government and NHS England & Improvement bring forward the necessary financial and workforce resources required to mandate the independent review of the deaths of all autistic people and people with learning disabilities in inpatient and … Read more
Government Response
The government rejects the recommendation to mandate an independent review of all deaths, stating they already investigate deaths of people with learning disabilities and autistic people in mental health hospitals locally.
Department of Health and Social Care
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Government Response AI assessment · 20 of 14 classified
Accepted 5
Accepted in Part 4
Acknowledged 1
Not Addressed 4
Rejected 6
Total 14 recs + 6 conclusions
Correspondence 3 letters
26 Oct 2021 Correspondence with the Minister of State for Care and Mental Health on Treatment of autistic people and people with learning disabilities dated 20.09.21 and 20.10.21
Parliament page
22 Jun 2021 To committee Letter from the National Mental Health Director on assuring transformation data re patients in mental health inpatient settings by CQC rating
Parliament page
25 May 2021 To committee Letter from NHS England and NHS Improvement on the Committee's inquiry into Treament of autistic people and individuals with learning disabilities
Parliament page