Home at last?
The same as you?
National Implementation Group
Report of the short-life working group on Hospital Closure and Service Reprovision
Easy-Read Summary
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Contents
Who wrote this report?
What is the report about?
What we found out?
What we think should be done?
Who wrote this report?
A National Implementation Group was set up in June 2001 to help make the recommendations of The same as you? happen.
The group agreed to work in smaller working groups to look at some of the changes that are most important to people with learning disabilities. One of these working groups looked at the recommendations about people moving out of hospitals. This is their report.
The group got information from other people and organisations. Most of the stories from people who have lived, or still live, in hospitals came from People First Scotland. Values into Action also told us about carers' experiences.
A major conference was held in December 2002 to look at progress with hospital closures in Scotland. It was called Home at Last. The programme was about the journey from living in a hospital through the planning stages and ending with life outside hospital. People with learning disabilities from an Aberdeen day centre helped to make a video of the conference. The video is available from SCLD.
What is the report about?
The same as you? said that no-one should have a hospital as their home. That is why there is a recommendation which states that all long-stay hospitals should close by 2005. But it also said that people who leave hospital need to have the right support to live in the community.
The report tells us:
what progress has been made in moving people from hospitals to their own homes;
what plans have been made for beyond 2005, when long-stay hospitals are closed;
how people with learning disabilities and carers are supported during and after hospital closure;
what is and what isn't working well, so others can learn from the work that has been done; and
what needs to be done to make sure people get the services they need.
What we found out
Many people have moved out of hospitals in the last 20 years or so. In 1980, there were over 7000 people in learning disability hospitals. By January 2003, the number of hospital places had reduced to around 900.
NHS Boards told us there were 652 people with learning disabilities in hospitals who are to be discharged by 2005.
NHS Boards have some beds for people who need to be assessed, or who need treatment. Some people who have been living there for a long time do not have their own home, so they need to have plans for moving out too.
Some NHS Boards and local authorities have not finalised plans for beyond 2005. Money has not been agreed between NHS Boards and local authorities. This needs to be done soon if The same as you? target is to be met.
A lot of progress has been made. But some people have been confused and unsure about moving from hospital. Some have moved to other wards or hospitals. People have moved to different types of accommodation from single tenancies to care homes.
Where people get good information and support, the move from hospital is a lot less confusing. People need to be involved in making choices about where they will live. Advocacy is not always available for people during or after the move from hospital.
What we think should be done
The report sets out a number of actions for different organisations, including:
The Scottish Executive
NHS Boards and local authorities
The Scottish Consortium for Learning Disability
NHS Quality Improvement Scotland
The Mental Welfare Commission
The Care Commission
Most of the actions are for local authorities and NHS Boards. The Joint Future agenda makes it possible for them to work better together. Single shared assessments will be in place for people with learning disabilities by April 2004. Local authorities and NHS Boards have joint committees or partnerships to assess progress on working together to deliver services.
We think NHS Boards and local authorities must make plans for services in the community for people with learning disabilities. Plans to move people out of hospital and ensure that all people have the services they need will depend on having the right support in the community. These plans must be clearly set out and agreed by the above committees.
All of the actions in the report are based on a set of principles:
We should learn from the experience of others to make sure there is proper support in the community and effective hospital closure.
Every person and their family should be as fully involved as possible in planning to leave hospital or move from one place to another.
No-one should leave hospital to move to another hospital for long-term care or as a delay to moving to the community.
No-one should live in or get 'short breaks' in a hospital/NHS unit by 2005.
People should have the choice not to live in care homes.
Plans and services should be developed to take account of individual needs and meet The same as you? objective of 2005.
Strong leadership is important to preparing and implementing hospital closure and developing community-based services.
Quality of life should be maintained during hospital closure.
Personal life plans should take account of individual needs and preferences.
Staff working in hospital and community services deserve support and training to meet the needs of people they care for.
Everyone should know what to expect when they leave hospital and representatives from independent organisations will check and check again.
There should be arrangements in place to support people to live a normal life in the community after getting out of hospital.
Some specialist services need to be in place at regional and national level to support people with very complex needs.
People can get the right information to know what is going on and to plan ahead.
A list of action points is set out at the back of the main report.