The Care Quality Commission (CQC) published an important report yesterday, looking at the state of care in specialist mental health services across England.

Their findings highlight many of the concerns that The National Autistic Society has been raising about the number of autistic people in inpatient mental health hospitals in England, sometimes for long periods, and about excessive restraint and over-medication.

The report is based on inspections the CQC has carried out across all NHS and independent specialist mental health services between 2014 and 2017. 

The report is timely, given that NHS England is almost two years through its Transforming Care programme, which aims to support people with a learning disability and/or on the autism spectrum, out of inappropriate mental health units and into the community, where they can be nearer their families and support networks.

What do we think?

Chapter 3.5 is dedicated to autism and learning disabilities. Here are some of the key points:

  • Inspectors frequently found people who had been in hospital for a long time. In some cases their care plans lacked discharge planning information.
  • More community services were rated good or outstanding by the CQC than inpatient ones: 80% good and 9% outstanding in the community; 64% good and 9% outstanding in inpatient. Over a quarter (27%) of inpatient services were rated ‘Requires improvement’.
  • There are concerns about safety, including how often restraint and medication were being used, in some inpatient units. However, the CQC also found examples where staff had managed to reduce these.

Tim Nicholls, Policy Manager at The National Autistic Society, said:

”The National Autistic Society welcomes this report, which reflects many of our concerns about the number of autistic people in inpatient mental health hospitals in England.

"Latest NHS figures show that, despite NHS England's Transforming Care programme, the number of autistic people in mental health hospitals is actually increasing. And, worryingly, the CQC have identified that in too many cases people's care plans don't include any discharge planning at all. This should be in place as soon as someone is admitted.

“Being stuck in inpatient care for a long period, in some cases a long way from home and family, can be extremely damaging and often causes people’s mental and physical health to deteriorate. Long waiting lists for community services show the need to develop more support which can meet people’s needs within their existing community.

"We need leadership from the Government and NHS England, backed up with the funding needed to ensure that autistic people are able to benefit from the Transforming Care programme as they should. Autistic people must not be left behind.”

Find out more about NHS England’s Transforming Care programme, and how you could help shape decisions in your area here.

This story has been covered widely in the media, including by the BBC.

Read the full CQC report here.