Our Letter to Matt Hancock
Secretary of State for Health and Social Care
10th May 2019
Dear Mr Hancock,
We are writing to you about concerns we have with recent proposals published in the Health Services Journal on Mental Health Lead Provider groups under expansion of mental health new care models. The article states that learning disability and autism services are to be included to address the failure of Transforming Care to meet targets.
These provider groups are led by NHS Trusts and include private sector providers. Our concerns about this approach are multi-faceted but this letter is to outline our specific concerns about the provider led commissioning of learning disability and autism services.
Since the Mansell Reports 1 & 2 in 1993 and 2007 published by the Department of Health, it has been widely understood and evidenced that people with learning disabilities and autistic people need support in their communities, not hospitals. Despite this policy and several government/ NHS England strategies, programmes, plans and reviews the services needed in communities have not been developed and this has meant that commissioners have a continuing reliance on using hospitals inappropriately for services that should be met in communities.
The Service Model published by NHS England sets out the types of services that should be available in the community. The Chief Executive of the NHS and NHS colleagues were questioned by the Public Accounts Committee in 2015 and made a clear promise to close inappropriate Assessment and Treatment Units in the NHS and private sector. This announcement appears to be totally at odds with this promise.
We believe that one of the main reasons that targets have not been met under the Building the Right Support programme is that NHS commissioners do not have the skills, knowledge and experience to develop the community services outlined in their service model. They operate within a medical model and therefore this is understandable, but if community services are what is needed, asking hospitals to lead on delivering community services does not make any sense and again is totally at odds with this announcement.
The lack of accountability in delivery of the Transforming Care aims by commissioners and providers has also been an issue. Essentially some commissioners and providers have totally ignored government and NHS England guidance and continued to commission and/or develop inpatient services or services that attempt to replicate community services but remain institutional and restrictive in practice, therefore not addressing fundamental problems with institutional care. It is hard to trust that provider groups, particularly those who operate within a medical model, are the right organisations to be leading on developing the services needed in communities.
Some of the providers named in the provider groups are also of major concern. Providers that have been investigated by CQC for poor and restrictive practices, closed down after poor inspection results and the subject of countless complaints to the media, Equality and Human Rights Commission and the Joint Human Rights Committee.
There are models of Alliances between commissioners and providers that focus on delivering community services by working with community organisations, individuals and families that have merit and should be explored. We believe that the proposal to have provider groups deliver on Transforming Care is fundamentally flawed.
We would be happy to meet with you and discuss a better way forward.
Julie Newcombe, Mark Brown and Mark Neary
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Co-signatories as of 9-20 am 15/05/2019
Philipa Bragman CHANGE
Dr John Dixon
Colleen Brannon, Isle of Wight
Adrian James Hindle
Margaret and Gary Whipp
Glenn Batey RNLD
Barbara Keeley MP, Shadow Minister for Mental Health and Social Care
Lynn Williams, full time unpaid carer for husband
Claire Jones RSW (Wales)
Learning Disability England
Sarah Clayton and Abigail Hill
Jan Tregelles, Chief Executive, Royal Mencap Society
Martin Spooner BA(Hons); Dip CBT.
Wendy Burt Parent carer Founder of include ME solutions
Christian Kerr, social worker.
Steve Scown, on behalf of Dimensions
Jay Stephanie Mitchell
T J Singleton
Voice for Families
WeLDNurses - Sally Wilson, Daniel Marsden, Sam Abdulla, Ross Wyatt & Paula Richardson
Ashley Giles, London
Andrew Duncan Mather
David Hocken MB BS MS FRCS Retired Consultant Surgeon and former Chair of Wiltshire Law Centre
My Life My Choice
Agnieszka Malgorzata Lipian
Scott Watkin BEM
Peter McGill, Director of the Tizard Centre
John Crawford - CEO - Yarrow
Deborah Conway Read
Christian Raphael MBE Vicki Raphael
Jessy Martinez Mejias
Jane Harris, Director of External Affairs and Social Change, National Autistic Society
Lisa Hopkins, on behalf of SeeAbility
Dr Sally Morgan
Dr Noelle McCormack
Dr Minh Alexander
Challenging Behaviour Foundation
Frederick James Brockwell
David Naden, Trustee for charities, Linkability and Integrate (Chorley & Preston)
Clare Palmer Learn With Us
Steve Turner Managing Director Care Right Now CIC
Rachel Bannister Mental Health- Time for Action
Rick Burgess Manchester Disabled People Against Cuts
Dr Deborah Chinn
Mr M. Boddy
Sally Warren (MD Paradigm)
Karen Calladine (Parent)
Sam Bayley mASCot
Fiona Richards-Buckle & Dr Mike Buckle
A D Mather
Ekwutosi Evelyn Ezechukwu
Dr Nick Hacking
Kay Hayden (Carer/mother of an amazing young person with Autism/PDA)
Sylvie Cordier Harvey
DR. Anne Hamlyn
Sadia Nakimera (Let Us Communicate)
Richard Von abendorff
Pam and Roy Hickmott parents of Tony Hickmott Autistic still Detained 19years years June 29th
Lucy Burke, Learning Disability England Representative Body
Craig Derry on behalf of Strategic Arc Ltd
Tess Reddington, (parent and employer of small support team)
Larry Sanders Spokesperson on Health and Social Care Green Party of England and Wales
Ana Maria Spencer
Barry Haslam. Ex Chair of Oldham Tranx.
Rosemary Trustam - for C.L.Initiatuves ltd
Lesley M Reader
Bobbi Rohrer Elman
Paul Richards, Stay Up Late
Alexis Quinn, author of Unbroken and former autistic inpatient
Nikola Matulewicz-Evans and family.
Mr Allan Stevens
Sam Sly Enough is Enough Time4Change
Janet Willicott MRSPH ACIEH
Kay Murphy (parent of Autistic person)
C Jane Haines
Lawrence Grady, CEO, Purley Park Trust Ltd
Karen Callender Caplan
Mark S. Pearson
David Rogers, CEO, Midland Mencap
Dr Mervyn Eastman
Christine-Koulla Burke Head Foundation for People with Learning Disabilities
Carolyn F Canavan
Dr Sam Smith
Mjka Anne Scott
Nicola Herbertson Hao2.eu Ltd
Sarah An individual
Dr. Damian Milton
Cllr Neil Nerva Chair - Brent Council Disability Forum
Dr Sara Ryan
Guy Bosanko - IHL Group
Sarah Richardson Senior Lecturer Learning Disabilties University of Suffolk
Jan Loxley Blount - parent of adult with autism and founder of Parents Protecting Children UK.
Mrs. Jayne Moore
Sarah Burslem CEO - MacIntyre
Jo Hough, Inclusion East CIC
T A Greene
Steve Newby Chesterfield
Dr Christianne Pollock, Family Support Project.
Helen Daly Family Carer
Jane Street Clinical psychologist
Katharine Newman Parent of learning-disabled young person.
Mary O’Toole (trustee, sheltered community for adults with learning disability/autism owned by its families: sibling advocate)
Isabelle Garnett, HumanToo