In its recently published report, Death by indifference: 74 deaths and counting, Mencap calls for the Government to make changes to ensure that people with learning disabilities receive safe NHS care. The report details the experiences of the families of 74 people with learning disabilities who died as a result of perceived NHS failures. The report follows up Mencap’s 2007 report, Death by indifference, which dealt with six earlier deaths in similar circumstances. The 2007 report sparked an investigation by the Parliamentary and Health Service Ombudsman and an independent inquiry which led to the recommendations in the report Healthcare for all. In response to Healthcare for all, the DH adopted a three-year strategy for people with learning disabilities Valuing People Now. Mencap concludes that although some progress has been made since the 2007 report, healthcare professionals are still, in some instances, failing to provide basic care and institutional discrimination within the NHS persists.
Some of the criticisms mirror those of the Care Quality Commission regarding the quality of care provided to the elderly and Mencap has explicitly drawn on that link in the report, doubtless hoping to tap into current public concerns about patients not being treated with dignity and respect.
Particular issues identified in the report include:
- a lack of compliance with the Equality Act and with the Mental Capacity Act 2005, underpins the failures identified by the families;
- do not resuscitate orders were used inappropriately; and
- the NHS complaints process is not fit for purpose.
The report makes a number of recommendations, including the following:
- mandatory training for all healthcare professionals that will challenge the assumptions made about people with learning disabilities and the discrimination against them;
- the nationwide implementation of a system for identifying people with learning disabilities and keeping record of the care they receive;
- standard hospital passports to be made available to all people with a learning disability;
- all hospitals sign up to Mencap’s Getting it right charter and put in place practice known to save lives;
- the employment of acute learning disability liaison nurses by every acute service; such nurses should be linked to senior leadership, who have a strategic role in supporting ward staff to make reasonable adjustments;
- a lead for learning disability within all acute trusts and primary care trusts, accountable to trust boards; and
- a complete overhaul of the NHS complaints system to ensure that complaints are dealt with quickly and effectively.
The report argues that successfully tackling the issues of discrimination against those with learning disabilities will lead to “getting it right” for other vulnerable groups including the elderly.