Learning Disability Services Monthly Statistics, AT: December 2023, MHSDS: November 2023

Assuring Transformation (AT) is a commissioner based return for inpatients in a hospital setting with learning disabilities and/or autism (LDA). 

The release comprises: 

• A summary of findings which presents England level analysis of key measures based on data submitted.
• Excel data tables covering a wide range of the data covered by the collection. Where possible historic data is refreshed each month to account for updates by data submitters (green tabs). For a small number of tables this is not possible and so the original cut of data is always presented (yellow tabs). If users require the most up-to-date information, then you are strongly advised to use information in the green tab sheets only.
• A CSV file which presents key measures at England level based on data submitted.
• A metadata file to accompany the CSV file, which provides information for each measure. This can be found at the bottom of the publication series page.
• An easy read version of the latest findings. 

The purpose of the ‘Assuring Transformation’ data collection is to ensure that public awareness of the NHS commitments in the Winterbourne View Concordat is transparent and robust. The Department of Health published Transforming Care: A national response to Winterbourne View Hospital and the Concordat: Programme of Action in December 2012. The review of services received indicated that failings were widespread within the operating organisation but importantly also evident across the wider care system. The Concordat and 63 actions detailed within the review seek to address poor and inappropriate care and achieve the best outcomes for people with a learning disability, or autism, who may also have mental health needs or behaviour that challenges.

Data for March from 2015 onwards is included as a benchmark for the start of the collection along with the latest 12 months of available data.

From February 2015, responsibility for its collection and publication were transferred to NHS Digital (now NHS England). This addressed key requirements around the improvement of data quality and reporting frequency. The revised collection methodology supports real time data capture from a “live” system that commissioners are required to update as and when changes occur in the care of a patient who falls within the scope of the collection. This has resulted in a significant burden reduction on the part of service commissioners / data submitters.

NHS England currently takes a snapshot of the data at the end of each month and reports on them on a monthly basis. The data published here shows the position as was reported within the “live” system at the end of the reporting month. Commissioners are expected to keep data in the system up to date; however, we are aware that this is not always possible and some data are known to be submitted after the period cut-off date. 

On 30th October 2015, NHS England published the report - ‘Building the right support’. This sets out “a national plan to develop community services and close inpatient facilities for people with a learning disability and/or autism who display behaviour that challenges, including those with a mental health condition”. Earlier AT data are available on the NHS England website.

Changes to AT dataset from April 2021

There has been some significant changes to the AT dataset (now v3.0) from 1 April 2021. More information can be found on the main AT data collection page.

Some of these changes impact on the breakdowns available in the AT data tables and these have been footnoted where relevant. In most cases these changes were not mandatory in submissions until June 2021. As a result, a number of changes have been made to a handful of the publication tables from June 2022 publication (affected tables listed on the June 2022 publication page - Learning Disability Services Monthly Statistics, AT: May 2022, MHSDS: March 2022 Final - NHS Digital) and further changes may be made once the relevant data submitted is deemed of suitable quality for publication.

This collection comprises of inpatients with ‘a bed’ normally designated for the treatment or care of people with a learning disability or those with ‘a bed’ designated for mental illness treatment or care who have been diagnosed or are understood to have a learning disability and/or autistic spectrum disorder.

Data has been collected from Clinical Commissioning Groups (CCGs) and Commissioning Hubs (Hubs) until June 2022. From 1 July 2022, Integrated Care Boards were established within Integrated Care Systems data and replaced Sustainability and Transformation Plans (STPs). Clinical Commissioning Groups have been replaced by sub-Integrated Care Boards. However, the ICB is responsible for commissioning NHS services, a function previously held by CCGs.

Data for the AT collection is now submitted by sub-Integrated Care Boards. In some cases, Commissioning Support Units (CSUs) may submit data on behalf of one or more sub-Integrated Care Board. Data in the tables are now presented by the current organisational structures. Old organisational structures have been mapped to new structures in any time series. These are English commissioners and healthcare providers typically providing services in England; although care commissioned for patients in England but provided elsewhere in the UK will be included.

From  October 2020,  some  patients  have  been  registered  to  commissioning organisations called Provider Collaboratives (PCs). Any references to specialised commissioning include PCs and hubs.