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Action promised on long hospital stays and out-of-area placements

A Scottish Government report released on Monday detailed actions to tackle issues over the care of people with learning disabilities.

21 February 2022

The Scottish Government has said it aims to have “greatly reduced” long hospital stays and out-of-area placements for those with learning difficulties or complex needs by March 2024.

In a new report published on Monday, the Government and local authority body Cosla committed to setting up a national database of those in hospital, in an unsuitable location, or at risk of their support breaking down.

Earlier this month, figures from Public Health Scotland showed that complex needs were responsible for 321 delayed discharges of more than three days in December, while around 1,000 people were sent to placements outside their home local authority in 2019.

The register will allow for an individual’s progress to be monitored, with draft guidance suggesting local health and social care partnerships may discuss their situation as frequently as twice a month.

Through the review meetings, plans will be drawn up to allow the individual to have access to their required care, including accommodation and financial needs.

The report’s mission statement said: “By March 2024 we want and need to see real change with out-of-area residential placements and inappropriate hospital stays greatly reduced, to the point that out-of-area residential placements are only made through individual or family choices and people are only in hospital for as long as they require assessment and treatment.”

Mental wellbeing minister Kevin Stewart said the Government recognises “we have to do more” to tackle what has been identified as a “long-standing issue”.

“It is completely unacceptable that people are spending time in hospitals or other care settings when they are medically fit for discharge,” he said.

“For every day spent unnecessarily in hospital, a person loses part of their connection with their community, their family, and their friends.

“We are not protecting the rights of people with learning disabilities and complex needs if they remain in hospital when they should be living at home, or in a homely environment with the right support.”

The register will organise people into two categories of high and moderate risk.

Those at high risk will include people for whom there are concerns about the suitability of their surroundings, while the moderate risk category will cover people for whom the crisis has passed, but will still need to be monitored.

Mr Stewart added: “The recommendations are key to achieving our mission to significantly reduce delayed discharge and inappropriate out of area placements for adults with learning disabilities and complex care needs by March 2024.

“Visibility and accountability are critical. This is not going to be an easy task but we have a collective responsibility to take action.”

The report also recommended a peer support network for those working with people with learning disabilities and complex needs, so best practice can be shared and lessons learned.

Jan Savage, director of Enable Scotland, said the announcement of the March 2024 deadline is a “landmark moment”, but added: “The day for real celebration will be the day we know that no-one is still stuck in hospital or living in communities where they don’t want to be.

“By that date, the Scottish Government and Cosla have now said clearly that no person who has a learning disability in Scotland will be in hospital if they do not need to be, and no-one will be forced to live away from the communities they want to live in.

“No-one will be in that position again. And inappropriate institutional units will not be part of Scotland’s future.”

Ms Savage went on to say that investment and support must continue, ensuring the timeline is realised, adding: “Our campaign will continue to make sure progress is made quickly, and that Scotland meets this deadline. The human rights of our fellow citizens are depending on it.”

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