Key points

• Trusts providing mental health and learning disability services have played a key role throughout the pandemic by transforming care, both to maintain services and respond to the significant challenges presented by COVID-19 pressures.
• The majority of learning disability and autism services provide people with good care and there are a number of NHS services that have been rated as ‘outstanding’ by the Care Quality Commission, which provide helpful learning for all those involved in commissioning and providing care and support for these groups of individuals.
• However, COVID-19 pandemic has brought into sharp focus the longstanding, structural inequities facing people with a learning disability and autistic people. There is clear evidence of a historical inequity in the development, commissioning and provision of care and support for these groups of individuals, leaving service users disadvantaged in terms of their health and wellbeing, life chances and expectancy, and in extreme cases open to abuse.
• Further challenges impacting trusts’ ability to provide the right level and nature of support for people consistently include: increasing demand; workforce shortages – particularly of specialist staff; and constrained funding for high-quality services in the community and social care. These issues are placing unsustainable pressures on the health and care system and mean too many people are not able to access the care and support that they need in a timely way, from the point of diagnosis and throughout their lives.
• Rapid progress needs to be taken in the following areas to ensure high-quality care and support is available for everyone, no matter where they live in the country or the complexity of their needs:
  • tackling stigma and raising awareness of the need to improve the accessibility and quality of care and support.
  • improving and increasing the transparency of funding mechanisms to guarantee funding reaches the frontline services that need it most.
  • securing sustainable levels of funding across health, social care and wider public services to provide people and their families with the upstream support they need, including high quality housing provision in places where people want to live.
  • promoting careers in the sector and enabling the training, recruitment and development of the full range of professionals with the specialist skills required to deliver high quality care.
  • progressing plans to provide care closer to home and invest in community support: this work must be properly resourced and effectively commissioned with service users and experts by experience playing a leading role, and learning from what works shared nationally and locally.