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This report presents initial findings from the 2014 Learning Disability Census. Data were collected via the Health and Social Care (HSCIC) on behalf of the Department of Health, the Care Quality Commission, Public Health England and NHS England.
The Learning Disability Census provides an individual record-level snapshot of inpatients with learning disabilities, autistic spectrum disorder and/or behaviour that challenges, and the services they receive, for patients who were inpatients in NHS and independent services at midnight on 30 September 2014.
This initial release reports at England level on key findings of the 2014 Census. This is the third release in a series of four and follows on from two previous reports on the 2013 Census. Where possible, comparisons are made within this report between 2014 and 2013 data.
The principal aim of the Census is to deliver action 17 in 'Transforming Care: A national response to Winterbourne View Hospital - "an audit of current services for people with challenging behaviour to take a snapshot of provision, numbers of out of area placements and lengths of stay".
The Learning Disability Census provides an individual record-level snapshot of inpatients with learning disabilities, autistic spectrum disorder and/or behaviour that challenges, and the services they receive, for service users who were inpatients in NHS and independent services at midnight on 30 September 2014.
Important: Please note that we reissued the reference data tables and the report on 23rd March 2015 in order to correct minor errors in the figures.
1. In Table 3 of the reference data tables, the values for the 2013 counts of patients on Census day by type of provider were erroneous. The independent sector provider figure should have been 1,446 rather than 1,399, and the NHS provider figure should have been 1,804 rather than 1,851. This also affected the per cent difference between 2013 and 2014 (which should have been 4 per cent for ISPs and -4 per cent for NHS (not 7 per cent and -7 per cent), and the per cent of patients for 2013, which should have been 44 per cent for ISPs and 56 per cent for NHS (not 43 per cent and 57 per cent). This also affected Figure 5 of the report (Number of patients by provider type), which includes all figure above except the per cent differences between 2013 and 2014.
2. In Table 4 of the reference data tables, the number of patients 'Not subject to the Mental Health 1983' in 2013 should have been 714 not 718; the number of patients under 'MHA Part III with restrictions' in 2013 should have been 613 not 573 and the percentage of patients under 'MHA Part III with restrictions' in 2013 should have been 19 per cent not 18 per cent.
Users of these statistics should ensure that, if re-using these figures, that they download the latest versions of the reference data tables and report (labelled as v2).
Responses from 92 provider organisations were received on behalf of 3,230 patients who met the inclusion criteria for the 2014 Learning Disability Census. The Mental Health and Learning Disabilities Statistics monthly report, published for the first time on 22 January 20151, showed that at the end of September 2014 there were 46,473 people in contact with learning disability services across England.
Key facts for 2014 show that on the 30 September 2014:
Reason for being in inpatient care:
- For 2,545 patients (79 per cent), the main treatment reason for being in inpatient care on census day was either due to a continuing behavioural treatment programme (21 per cent), the continuing need for inpatient care of mental illness (42 per cent), or where current behaviour has been assessed as being too high risk for the Ministry of Justice to agree any reduction in security level (15 per cent2.
- 2,310 patients (72 per cent) were recorded to have behaviour that presented a risk of violence or threats of violence to others.
- 2,970 patients (92 per cent) had their care plan agreed with the commissioner. 2,715 patients (84 per cent) had their care plan agreed with the community clinical team.
Experience of care
- Results suggest that the use of antipsychotic medication has increased between 2013 and 2014. On census day in 2014, 2,345 patients (73 per cent) had received antipsychotic medication either regularly or as needed3 in the 28 days prior to the census collection, compared to 2,220 patients (68 per cent) in 2013.
- The number of patients who experienced one or more incident (self-harm, accidents, physical assault, restraint or seclusion) dropped slightly. In 2014, 1,780 patients (55 per cent) had one or more incidents reported in the three months prior to census day, compared to 1,873 (58 per cent) in 2013.
Distance from home and length of stay
- Average length of stay and distance from home remained stable between the two census collections. On census day in 2014, patients had an average4 length of stay of 547 days and were staying 34.4km from home; patients in 2013 had an average length of stay of 542 days and were staying 34.5km from home.
Patients receiving care at the time of both censuses
- 1,975 patients were receiving care at the time of both census collections. Of these, calculations suggest that 1,830 patients (57 per cent of the 2014 head count) were receiving continuous inpatient care between both census collections.
1 This report does not round England level data (https://digital.nhs.uk/data-and-information/data-collections-and-data-sets/data-sets/mental-health-services-data-set/statistics-about-mental-health-learning-disabilities-and-autism-services)
2 Due to rounding, percentage figures do not add up
3 'Pro re nata': 'as the occasion arises; as necessary'.
4 Median average.