Reflections on the use of a specialist acute assessment and treatment unit for adults with intellectual disability
| Published date | 05 May 2015 |
| Date | 05 May 2015 |
| DOI | https://doi.org/10.1108/AMHID-07-2014-0029 |
| Pages | 132-138 |
| Author | Kiran Purandare,Anusha Wijeratne |
| Subject Matter | Health & social care,Learning & intellectual disabilities |
Reflections on the use of a specialist
acute assessment and treatment unit
for adults with intellectual disability
Kiran Purandare and Anusha Wijeratne
Dr Kiran Purandare and
Dr Anusha Wijeratne are
Consultant Psychiatrists, both
at Central and North West
London NHS Foundation Trust,
London, UK.
Abstract
Purpose –The purpose of this paper is to evaluate the impact of a changing commissioning landscape on
the provision of specialist acute inpatient care from the perspective of a small category 2 unit in London.
Design/methodology/approach –The authors conducted a retrospective survey of all referrals to the unit
in 2012 and 2013.
Findings –There has been an increase in the referrals and admissions to the unit with referrals covering a
wider catchment area. This has resulted in a doubling of the average distance between the unit and the
respective catchment areas that patients and their relatives have to travel. The majority of admissions were
transfers from mainstream mental health services. There has been a reduction in the mean length of stay.
Research limitations/implications –This survey looks at trends in one category 2 unit in an outer London
Borough and therefore, limits generalisability. The data collection was retrospective and there was no
information on patients requiring admission but not being referred to the unit.
Practical implications –There continues to be a need for category 2 admission units to serve the needs of
a small group of patients with intellectual disability presenting with mental health needs and behavioural
problems. Consideration needs to be given to the entire mental health and challenging behaviour care
pathway, including the small but crucial element of specialist inpatient management if services are to remain
local and responsive to the needs of this group of patients and their carers.
Social implications –An ill-planned reduction in the number of specialist inpatient units without viable
community services, risks perpetuating a situation where patients and their relatives have to travel long
distances to obtain appropriate specialist help. Longer geographical distances could also potentially hamper
closer liaison between the unit and the community services, thereby reducing the degree of oversight and
prolonging the transition and discharge process.
Originality/value –This survey highlights the impact of recent commissioning and service changes on
delivery of specialist in patient services for adults with intellectual disability in the immediate aftermath of the
Winterbourne Review.
Keywords Adolescent, Adult, Commissioning, Intellectual disability, Assessment and treatment,
Inpatient unit, Winterbourne
Paper type General review
Introduction
Following the publication of the Department of Health Review, Transforming care: A National
Response to Winterbourne View Hospital in December 2012 (Department of Health, 2012), and
statistical findings from the “Count-Me-In”surveys (Glover and Olson, 2012) there has been an
emphasis on repatriating patients with intellectual disability in assessment and treatment units
closer to their homes. The government aspired to a “substantial reduction in reliance on inpatient
care for these groups of people”,a“dramatic”reduction in hospital placements for this group
and the closure of large hospitals (Department of Health, 2012). All hospital placements were to
Received 1 July 2014
Revised 19 December 2014
Accepted 13 March 2015
The authors would like to
acknowledge Manish Shah,
Business Manager and Eileen
Cassin, Business Process
Manager.
PAGE132
j
ADVANCESIN MENTAL HEALTH AND INTELLECTUAL DISABILITIES
j
VOL. 9 NO. 3 2015, pp.132-138, © Emerald Group Publishing Limited, ISSN 2044-1282 DOI 10.1108/AMHID-07-2014-0029
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