Winterbourne View:
The Department of Health
Patience Wilson
Deputy Director – Mental Health, Disability and Equality
The review has amassed a substantial body of
information on:
- what happened within Winterbourne View
- quality and safety of care provided in other
learning disability hospitals
- the experiences of care users and their
- the realities of care for people with learning
disabilities/autism and behaviours described
as challenging
Where are we now?
• CQC inspection of Castlebeck Care services
and programme of inspection of 150 LD units
• DH Interim Report published on 25 June 2012
• Serious Case Review published 7 August
• All 11 former staff charged have pleaded guilty
to all charges – sentencing expected week of 22
• Panorama follow-up programme expected week
of 22 October
• DH Final Report due this Autumn
DH Review – Final Report
The final report will build on the interim report to set
out the further actions to deliver change.
It will draw on all published investigations and
reviews as well as extensive engagement with
people who use services, their families, and the
groups which represent them.
The aim is for the report to set out a programme of
defined and timetabled actions to address failings in
provision for people with learning disabilities/autism
and challenging behaviours
DH Review: Concordat
• Alongside the final report, we are publishing a
Concordat setting out the programme for change
• This will be agreed with key external partners
• The Concordat will:
– Commit all signatories to working together to deliver
change for people with learning disabilities/autism
and challenging behaviours and
– set out the specific actions which each partner
commits to deliver
– We’re asking our voluntary sector colleagues to sign
up to a commitment to hold all other signatories to
account for delivery
DH Review: Programme for Change
The final report will set out a programme
for change building on the actions in the
interim report
This includes commissioning of an audit
of current services, to be repeated in 12
months to assess progress
We commit to publishing a progress
report on the programme for change one
year on
DH Review: Programme for Change
The programme will focus on action to:
ensure joint health and care planning and
commissioning of services to meet the needs of
children and adults with behaviours described as
incentivise the right model of local responsive
personalised care
thereby prevent the placing of people inappropriately in
in-patient settings
drive up quality in specialist health and care settings
establish robust monitoring of progress.
Planning and Commissioning
• Aim is to develop genuine joint planning and
commissioning of services around the needs of
individuals and their families
• DH will work with the NHS CB and ADASS on a model
service specification by March 2013
• NHS CB will support CCGs to work together
collaboratively in commissioning services for people with
learning disabilities
• Working with HealthWatch as champion for those who
use services and family carers to ensure their needs are
heard and understood by commissioners and providers
Delivering the right model of care
• We will incentivise the right model of local, personalised
care with every part of the system working together to
develop responsive, preventive services so that people
are not placed in in-patient settings unnecessarily
• The LD Professional Senate will carry out a refresh of
Challenging Behaviour: A Unified Approach
• DH will work with providers to develop and promote a
voluntary accreditation scheme
• TLAP national market development forum will work with
DH to identify barriers to providing effective local
• NICE will develop Quality Standards and clinical
guidelines on LD and challenging behaviour and MH.
Driving up quality of care
• Working with the NHS CB to embed Quality of Health
Principles in the system (and with TEASC Quality of Life
Principles into social care contracts)
• Work with key partners to identify and promote good
practice in personalised care in all settings
• Work with advocacy partners to drive up the quality of
independent advocacy
• Produce a progress report by end 2012 on actions in the
report of the UK Modernising LD Nursing Review.
• CQC will commit to improving the quality of inspections
including implementing the SCS recommendations
• Plan for new guidance on positive behaviour support and
physical intervention
Monitoring progress
• We will work with the NHS Information Centre
and NHS CB to develop measures and key
performance indicators (to underpin A LD MDS)
• Undertake an audit of LD services to establish
baseline to measure progress
• LD Programme Board to measure progress,
monitor risks and challenge external delivery
• Publish a follow up report in a year
Concluding Comments
• We know there are examples of good practice
(we described some in the interim report) and
the commitment from external delivery partners
to make changes
• All parts of the system have a role to play in
driving up standards for this vulnerable group of
• There should be zero tolerance of abuse or
• Together we can make a difference