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Secure inpatient services: a needs assessment

Ian Hall (Lead Clinician for People with a Learning Disability, based at East London NHS Foundation Trust, London, UK)
Evan Yacoub (Consultant Psychiatrist, based at East London NHS Foundation Trust, London, UK)
Neil Boast (Consultant Forensic Psychiatrist, based at East London Forensic Service, London, UK)
Robert Bates (Clinical Director, based at North London Forensic Service, London, UK)
Rebekah Stamps (Consultant Psychiatrist, based at North London Forensic Service, London, UK.)
Sarah Holder (Administrator, based at East London NHS Foundation Trust, London, UK)
Matthew Beadman (Administrator, based at East London NHS Foundation Trust, London, UK)

Journal of Intellectual Disabilities and Offending Behaviour

ISSN: 2050-8824

Article publication date: 4 March 2014

262

Abstract

Purpose

The purpose of this paper is to complete a thorough needs assessment that would enable the development of a robust pathway of care for adults with a learning disability requiring secure care, and to assist commissioners to make informed planning decisions.

Design/methodology/approach

The paper identified people with a learning disability originating from London who were in secure care, and collected data about them. The paper used reference groups to inform the analysis.

Findings

The paper identified 249 people in secure services and was able to include 136 patients in the analysis. In all, 64 were in NHS provision and 72 in independent sector provision; 109 (80.1 per cent) were male and 27 (19.9 per cent) female; on average, patients were cared for 61.5 miles away from their homes; NHS patients were far closer to home; 69.1 per cent had a mild learning disability; 82.3 per cent had a history of violence; approximately one in six patients could not progress due to a lack of an appropriate ward, facility, resource and/or intervention.

Practical implications

Secure care for this population is a major public health issue. Many are placed a long way from home. Local services should be developed, and there should be sufficiently robust “step down” places for patients to be discharged to.

Originality/value

Systematic identification of the needs of a marginalised group to enable better more appropriate care pathways to be developed in the future.

Keywords

Acknowledgements

This project was funded by NHS London who determined the broad objectives of the project but were not involved in the detailed planning of the methodology or in data analysis. The authors would like to thank Drs Kiran Purundare, William Howie and Jean O’Hara and Mr Eddie Chaplin for their participation in the reference group.

Citation

Hall, I., Yacoub, E., Boast, N., Bates, R., Stamps, R., Holder, S. and Beadman, M. (2014), "Secure inpatient services: a needs assessment", Journal of Intellectual Disabilities and Offending Behaviour, Vol. 5 No. 1, pp. 38-53. https://doi.org/10.1108/JIDOB-09-2013-0023

Publisher

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Emerald Group Publishing Limited

Copyright © 2014, Emerald Group Publishing Limited

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