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Learning Disability Census 2015: almost half of inpatients with learning disabilities common to each census since 2013

15 December 2015: Just over a quarter of inpatients involved in one or more adverse experience and restrictive measure.

*HSCIC must be cited as the source of these figures

Almost half of inpatients (1,450 or 48 per cent2) with learning disabilities3 in specialist inpatient units on 30 September 2015 were also receiving inpatient care at the time of previous census collections dating back to 20134. This finding comes from the third annual Learning Disability Census, published by the Health and Social Care Information Centre (HSCIC) today.

The number of inpatients reported in the 2015 Census was 3,0005, compared with 3,230 in 2014 and 3,250 in 2013.

The Learning Disability Census considers inpatients in specialist units with learning disabilities, autistic spectrum disorder and/or behaviour that challenges. It provides detailed information about these patients and their experiences of care in NHS and independent facilities in England6. The Census began in 2013 in response to events at Winterbourne View Hospital7.

The Learning Disability Census 2015 has been linked at patient level with the Assuring Transformation data collection8, using the most up-to-date figures for the end of September 2015. The linked dataset shows that 2,140 patients out of the 3,000 from the Learning Disability Census were common to both collections.

Today's report also shows that in total, 26 per cent of patients experienced at least one adverse experience9, such as accidents, physical assault and self-harm, as well as at least one restrictive measure10 such as restraint or seclusion. Of all men included in the census, 22 per cent (485 out of 2,255) had at least one adverse experience and at least one restrictive measure compared to 39 per cent of women (290 out of 740).

The Learning Disability Census Report, England, 2015 also found:

  • Three in four inpatients (75per cent, or 2,255 of 3,000) in the 2015 Census were male.
  • The most common adverse experience type was self-harm. This involved 735 (24 per cent) inpatients in 2015 compared to 790 (25 per cent) in 2014.
  • 72 per cent of patients (2,155) received antipsychotic medication either regularly or 'as and when needed' in the 28 days prior to the census collection, compared to 73 per cent (2,345) in 201411.
  • The proportion of inpatients aged 18-64 (92 per cent) was substantially higher than the comparable England-wide population age distribution (59 per cent).
  • The median average12 length of stay was 554 days for the 2015 census, compared to 547 in 2014.
  • The median average distance from home13 was 38.6km for the 2015 census, compared to 34.4km for the 2014 census.
  • The proportion of inpatients receiving care more than 100km away from home in 2015 was 23 per cent (670 patients) an increase from 19 per cent (570 patients) in 2014.

Responsible Statistician for the report Chris Buttery said: "The third annual report provides a range of information that can help inform the planning and provision of care for people with learning disabilities and will be of interest to mental health professionals, as well as inpatients and their families.

"Several findings in the report show a similar picture to last year's Census, such as the use of antipsychotic medication and the proportion of individuals involved in adverse experiences and restrictive measures."

Read the full report here: http://www.hscic.gov.uk/pubs/ldcensus15.

ENDS


Notes to editors

  1. The Health and Social Care Information Centre (HSCIC) was established on April 1 2013 as an Executive Non Departmental Public Body (ENDPB). It is England's trusted data source, delivering high quality information and IT systems to drive better patient services, care and outcomes. Its work includes publishing more than 260 statistical publications annually; providing a range of specialist data services; managing informatics projects and programmes and developing and assuring national systems against appropriate contractual, clinical safety and information standards.
  2. Numbers have been rounded to the nearest 5. Percentages have been rounded to the nearest whole number; for this reason on some breakdowns, percentages may not add up to 100.
  3. The Learning Disability Census includes individuals who have one or more of the following: learning disabilities; autistic spectrum disorder and/or behaviour that challenges.
  4. This does not indicate continuous inpatient care, the patient may have left hospital and been readmitted.
  5. Admission dates given by providers for inpatients included in the 2015 census suggested there were 245 patients who may have been eligible for inclusion in the 2014 census, but were not included by data providers. This would have increased the total number in scope for the 2014 census to 3,475. However, the 2014 figures are used in order that detailed comparisons can be made.
  6. The census collected information on inpatients receiving treatment or care in a facility registered by the Care Quality Commission as a hospital operated by either an NHS or independent sector provider which provides mental or behavioural healthcare in England. Record level returns reflect only inpatients (or individuals on leave with a bed held vacant for them) at midnight on 30September 2015. The individual will have 'a bed' normally designated for the treatment or care of people with a learning disability or will have 'a bed' designated for mental illness treatment or care and will be diagnosed with or understood to have a learning disability and or autistic spectrum disorder.
  7. A May 2011 BBC Panorama programme broadcast footage of apparent abuse of inpatients, many of whom had learning disabilities, by staff at Winterbourne View Hospital. The census was initiated in order to deliver one of the actions in Transforming Care: A national response to Winterbourne View Hospital. It provides definitive and comprehensive information about the population size, characteristics, and experience of care, of people whose treatment, care and support needs may be similar to those treated in Winterbourne View. For more information on the Learning Disability Census, including a full list of the details of the questions asked of providers, see here: http://www.hscic.gov.uk/ldcensus.
  8. The Learning Disabilities Census has been linked with the Assuring Transformation data set to try to understand the difference in headcount reported by both collections. For the same point in time Assuring Transformation reported 2,625 inpatients. After linking the collections, there were 855 patients in the Learning Disability Census who did not appear in the Assuring Transformation collection and 480 patients in the Assuring Transformation collection who did not appear in the Learning Disability Census. Allowing for rounding this equates to 1,340 unreported from either collection. Linking both data sets also helps to inform and influence the Winterbourne View Joint Improvement Programme which was set up to provide support to local partners in transforming services for people with a learning disability and / or autism with behaviour that challenges or a mental health condition. Further information can be found at: http://www.local.gov.uk/place-i-call-home.figures for the end of September as published for the end of October collection were used. See: http://www.hscic.gov.uk/pubs/ldsmoct15 for more information on the October release. The Assuring Transformation data collection was transferred from NHS England to the HSCIC from January 2015. The purpose of the collection is to ensure the public were aware of NHS commitments within the Transforming Care Programme. As a result of the transfer to the HSCIC a revised collection and methodology process supports real time data capture. Work is ongoing between the HSCIC, NHS England and care providers to ensure that all patients are included in the Assuring Transformation data set. . The Assuring Transformation collection is a commissioner based collection. Data are provided by English commissioners and healthcare is typically provided in England (although care commissioned in England and provided elsewhere in the UK will be included). There is a slight difference in scope between this collection and the Learning Disability Census since the Census comprises data from providers based only in England, but does include care provided in England but commissioned from other UK countries.
  9. Adverse experiences include: accidents, physical assault and self-harm. To be included in the adverse experiences category, the criteria is for more than one incident to have taken place in the 3 months prior to the census collection. The proportion of patients who experienced one or more of each adverse experience are: accidents; 18%; assault: 22% and self-harm: 24 %.
  10. Restrictive measures include: hands-on restraint and seclusion. To be included in the restrictive measures category, the criteria is for more than one restrictive measure to have taken place in the 3 months prior to the census collection. The proportion of patients who experienced one or more of each restrictive measure are: hands-on-restraint: 34% and seclusion: 13%
  11. NHS England released a pledge around medication usage for people with Learning Disabilities https://www.england.nhs.uk/2015/07/14/urgent-pledge/
  12. The length of stay is calculated as the difference between admission date and census day. The median average has been used measure since this measure is less influenced by data outliers then the mean average calculation.
  13. Distance has been measured as the crow flies between the facility where the individual is staying and the residential postcode. Patients for whom no home address was supplied by providers or who have a hospital address as their home address are not included in this statistic. This percentage includes the following breakdowns; Up to 10km (22%), 10-20km (12%), 20-50km (23%), 50-100km (19%) and 100km or more (23%)
  14. For media enquires please call 0300 30 33 888 or email media@hscic.gov.uk
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