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Updated 19 August 2022
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This publication is available at https://www.gov.uk/government/publications/building-the-right-support-for-people-with-a-learning-disability-and-autistic-people/table-of-commitments-annex-a
The Building the Right Support Action Plan brings together, in one place, commitments across systems to reduce reliance on inpatient care in mental health hospitals for children, young people and adults with a learning disability and for autistic children, young people and adults by building the right support in the community.
This annex sets out the commitments that are set out in the action plan alongside:
Some commitments appear more than once in the action plan where they are relevant to more than one chapter. If this is the case, we reference them only once in the table of commitments.
We are determined to ensure that people with a learning disability and autistic people of all ages receive high-quality health and social care support, should they need it.
This support must prioritise safety and quality of life.
This means making sure that people are treated with dignity and respect, receive personalised care and treatment, and have opportunities to live an ordinary, independent life in their own home as part of the community.
To achieve this, chapter 1 of the action plan outlines:
Committing £4.5 million to a joint Department of Health and Social Care (DHSC) and NHS England (NHSE) review of inpatient advocacy.
Holding webinars with principal social workers and sector partners to promote use of the Revisiting safeguarding practice guidance. This guidance is an independent briefing published by the Chief Social Worker for Adults to support social workers and other safeguarding practitioners to carry out their safeguarding duties under the Care Act 2014.
Proposal to make it a statutory requirement for responsible clinicians to have regard to the findings and recommendations from Care (Education) and Treatment Reviews (C(E)TRs) and include them in the patient’s care and treatment plan, unless there are good reasons not to.
Ensuring that people with a learning disability and autistic people have received a safe and wellbeing review if they were in mental health inpatient care as at 31 October 2021.
Continuing Independent Care (Education) and Treatment Reviews (IC(E)TRs), and work with the Oversight Panel to improve the circumstances of people with a learning disability and autistic people who remain in long-term segregation.
Completing a pilot to reduce the length of time people with a learning disability or autistic people remain in inpatient care in segregation, as well as to support earlier transfers of care to appropriate community settings or a transfer to a less restrictive setting while long-term solutions are developed.
Supporting employers to embed the learning disability and autism core capability frameworks across all aspects of the social care and health workforces that support people with a learning disability and/or autistic people.
Implementing a programme of personalised workforce development for the workforce that supports people with a learning disability and autistic people who may be at risk of admission or are ready to be discharged.
The Health and Care Act 2022 introduces a new requirement for registered providers to ensure their staff receive specific training on learning disability and autism, which is appropriate to their role. A robust evaluation of the trials has taken place, and a final evaluation report was published in June 2022, which will inform the next steps of the Oliver McGowan Mandatory Training (OMMT) programme.
Providing community learning disability teams and intensive support teams with the opportunity to commence advanced and consultant-level practice training by April 2023.
Investing £1.5 million of funding into the development and trialling of autism training for staff working in adult inpatient mental health settings.
Developing autism training for staff working in mental health community and inpatient settings for all age groups.
We want to support children, young people and adults who are ready to leave hospital to be discharged safely, in the right way and at the right time.
While treatment in a mental health hospital can sometimes be the right choice for a person who has a co-occurring mental health condition and would benefit from an intervention that can only be provided through inpatient care, we want to make sure that people who are ready to leave hospital are able to do so as soon as possible, with the right support ready in the community so that they can live in their own home.
To achieve this, chapter 2 of the action plan outlines:
Working on a refresh of the C(E)TR policy. The refreshed policy will have an increased focus on the physical health of people in hospital and include an increased emphasis on the importance of the actions that should follow from a C(E)TR.
Helping to speed up discharges in England through the Community Discharge Grant, providing local authorities with additional funding.
Introducing a new power of supervised discharge to enable the discharge of restricted patients into conditions in the community that amount to a deprivation of liberty. This is in response to the Secretary of State for Justice vs MM judgement in 2018, which deemed that this is not possible under the current Mental Health Act legislation. This is part of work to reform the Mental Health Act.
Publishing an action plan based on the recommendations in Neurodiversity in the criminal justice system: a review of the evidence report.
Participating in discharge planning for inpatients detained under part III of the Mental Health Act to help identify barriers and progress individual cases as appropriate.
People with a learning disability and autistic people of all ages can live an ordinary life when they have a home, feel involved in their community and have a reliable network of support.
Effective support helps people have a good quality of life in their communities. It helps people develop skills and achieve their potential, and supports people in their relationships with family and friends.
We want to make sure that there is the right housing, care and support available in the community so people with a learning disability and autistic people can live the lives they choose.
To achieve this, chapter 3 of the action plan outlines:
Embed strategic commitment in all local areas to connect housing with health and care, increase local expenditure on support services and boost supply of supported housing.
Capital funding programmes underway to incentivise new supply of specialist and supported housing.
Commissioning independent research to understand the size, cost and demand of the supported housing sector, including that which meets the needs of people with a learning disability and autistic people.
Provide funding to local areas to deliver the Disabled Facilities Grant.
ADASS, LGA and the Building the Right Support Advisory Group to identify ‘what good looks like’, which will be followed by a report that includes best practice examples, with an emphasis on initiatives that support citizenship and human rights.
NHSE, along with a range of partners, commit to continuing to roll out a programme across England that enables the development of small (supporting less than 30 people with a learning disability and autistic people) community-driven organisations to deliver high-quality, bespoke support wrapped around an individual that promotes choice, control, human rights and citizenship.
Continue to commission funded peer reviews. The programme involves a small group of peers spending time in another area as ‘critical friends’ to support an area to develop and improve service delivery. This process involves a wide range of stakeholders, including people with personal experience, and reflects to the system where they need to focus attention.
Continue to roll out an accredited commissioning qualification for current and aspiring commissioners. The qualification has been developed to support the commissioning workforce to understand the types of services they should be developing for autistic people and people with a learning disability.
Rolling out a training programme for senior leaders to increase their skills and knowledge to support local commissioners.
Developing commissioning guidance to build the capability and knowledge of the commissioning workforce that is designed to complement qualifications and training.
Proposal to introduce new duties on commissioners to ensure that there are adequate community-based services in their local area to support people with a learning disability and autistic people. This is part of work to reform the Mental Health Act.
Proposal to introduce a new duty for commissioners to hold a dynamic support register – including an ‘at risk of admission’ component – that would ensure that commissioners understand and monitor the risk of crisis at an individual level for children, young people and adults with a learning disability or autistic children, young people and adults in their local population.
Strengthening the supported internship (SI) programme to support young people with an Education Health and Care Plan to secure and sustain employment.
Strengthening the use of dynamic support registers to identify children, young people and adults most at risk of admission.
We want to ensure that children and young people with a learning disability, and autistic children and young people and their families can access the support they need to ensure they have the best possible start to life and can live the lives they choose.
This includes getting a diagnosis as an important first step, having positive experiences of education and getting the support they need as they move from childhood to adulthood.
To achieve this, chapter 4 of the action plan outlines:
Building on the £10.5 million COVID-19 Mental Health Recovery Fund and £2.5 million NHS Long Term Plan investment, we are investing a further £2.5 million to support the delivery of the Long Term Plan commitment to improve autism diagnosis pathways for children and young people.
DfE is investing £600,000 into significantly expanding an autism early identification pilot in Bradford to at least 100 schools over the next 3 years.
A further £1.6 million is being invested this academic year (2021 to 2022) to test and develop the pilot across other local areas with different demographics and commissioning models. These local areas will also look at upskilling the mainstream school workforce to better identify need and develop screening tools to better identify girls, and testing an ‘outsourcing’ model for multidisciplinary team members.
Putting forward proposals for the SEND review: right support, right place, right time, which will give children with special educational needs and disabilities (SEND) greater opportunities to succeed by fundamentally improving the way we deliver support.
£2.6 billion has been made available over the next 3 years to deliver new places and improve existing provision for pupils with SEND who require alternative provision.
Continue the Autism in Schools project with a further £2.5 million investment in 2022 to 2023.
A new £30 million fund to support local authorities in developing innovative approaches to the delivery of respite care and short breaks. This fund will allow local areas to develop and target new approaches to respite or short breaks, targeting those children and young people who may need a different model of delivery from what is currently available in their area. In the first year, we expect to fund a minimum of 5 local areas (total investment of £5 million) to trial different approaches.
A full ICS footprint rollout of designated keyworkers for children and young people with a learning disability, and autistic children and young people.
DfE is updating the national minimum standards for residential special schools, and engaging with Ofsted and other stakeholders on this update.
DfE has committed to continue support for autism awareness training for education staff in early years, schools and further education settings. Since 2011, this training has reached more than 305,000 people, and has developed good autism practice guidance and practice frameworks aimed at supporting and improving practice within education settings.
DfE has announced more than £45 million of continued targeted support for families and parents of children and young people with SEND and SEND services. This includes further funding for programmes that will directly support schools and colleges to effectively work with pupils with SEND.
Working in partnership with DHSC, DfE has commissioned Ofsted and the CQC to develop and transition to a new joint Ofsted-CQC area SEND inspection framework.
We recognise that the ambitions and commitments in earlier chapters of the action plan are only one part of making change happen.
There are a host of other factors that matter to people, which would significantly improve their experiences of navigating services and getting the right support.
A key part of this is transforming systems so that the right structures are in place to achieve long-term change for people with a learning disability and autistic people.
To achieve this, chapter 5 of the action plan outlines:
Proposal to limit the scope to detain people with a learning disability or autistic people under the Mental Health Act, as part of work to reform the Mental Health Act.
Undertaking a rapid review of funding flows, which will make recommendations that DHSC will consider and act on as appropriate.
Reviewing section 75 of the National Health Service Act 2006 (which allows partners such as NHS bodies and councils to pool and align budgets) to simplify and update the underlying regulations.
The following actions relate to wider policy developments relevant to improving outcomes for people with a learning disability and autistic people.
The Building the Right Support Delivery Board will note any wider risks and issues in relation to these reforms that may impact the delivery of the Building the Right Action Plan.
The actions listed below would not be scheduled to be regularly reviewed but updates may be requested.
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