“Homes not hospitals”: What are the unintended consequences

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DimensionsNHS England today released a report, Homes not Hospitals, announcing the closure of up to 50% of NHS long stay hospital beds for people with learning disabilities, and a parallel announcement of £45m funding over 3 years for community based support.

 

 

Dimensions strongly welcomes this move. It has been a long time coming. At long last, deeds are backing up words.

However, all is not yet rosy. Steve Scown, CEO of Dimensions, said “Some private sector providers of long stay institutions will be rubbing their hands with glee as the announcement only covers NHS facilities. There is nothing to stop the commissioning of similar inappropriate beds outside the NHS.”

A second concern is the announcement of a dowry arrangement whereby NHS funding automatically transfers to the local authority for people who have been in the institution for 5 years. Scown added, “The dowry itself is a good idea. But why wait 5 years? A lower threshold – say, 2 years – would almost invariably be in the interests of the individual. It would allow the local authority to consider a broader range of support options sooner, and would also reflect the short term intent of referrals into assessment and treatment units.”

Analysts are already criticising the £45m transformation budget and Dimensions shares the view that this is low. However, today is not a day to grind that particular axe. Let’s celebrate progress, but be mindful of the unintended consequences.

 

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