Policy paper

Table of Commitments (Annex A)

Updated 19 August 2022

Applies to England

Delivering the Building the Right Support Action Plan

The Building the Right Support Action Plan brings together, in one place, commitments across systems to reduce reliance on inpatient care in mental health hospitals for children, young people and adults with a learning disability and for autistic children, young people and adults by building the right support in the community.

This annex sets out the commitments that are set out in the action plan alongside:

• details of key milestones
• timescales for delivery
• measures of success
• organisations accountable for delivery

Some commitments appear more than once in the action plan where they are relevant to more than one chapter. If this is the case, we reference them only once in the table of commitments.

1. Keeping people safe and ensuring high-quality health and social care

We are determined to ensure that people with a learning disability and autistic people of all ages receive high-quality health and social care support, should they need it.

This support must prioritise safety and quality of life.

This means making sure that people are treated with dignity and respect, receive personalised care and treatment, and have opportunities to live an ordinary, independent life in their own home as part of the community.

To achieve this, chapter 1 of the action plan outlines:

• the importance of people’s voices being heard and having a clear plan for their care
• our expectations for health and social care services to provide high-quality care that keeps people safe from harm and abuse
• the ways we are tackling the inappropriate use of restraint, restrictive interventions and other poor practices in inpatient settings
• our ambition to build a health and social care workforce with the right skills, practice, leadership and culture, which empowers the workforce to provide the best possible care and support

Overview of commitments

Commitment 1a

Committing £4.5 million to a joint Department of Health and Social Care (DHSC) and NHS England (NHSE) review of inpatient advocacy.

Key milestone	Date of completion	Measure of success	Commitment owner
Complete review and develop recommendations for next steps	Summer 2022	Progress on this review will be reported to the Building the Right Support Delivery Board as appropriate	NHSE DHSC

Commitment 1b

Holding webinars with principal social workers and sector partners to promote use of the Revisiting safeguarding practice guidance. This guidance is an independent briefing published by the Chief Social Worker for Adults to support social workers and other safeguarding practitioners to carry out their safeguarding duties under the Care Act 2014.

Key milestone	Date of completion	Measure of success	Commitment owner
Webinars to take place	End of 2022	Guidance to be embedded at a local level, ensuring high-quality, consistent safeguarding practice across local authorities	DHSC

Commitment 1c

Proposal to make it a statutory requirement for responsible clinicians to have regard to the findings and recommendations from Care (Education) and Treatment Reviews (C(E)TRs) and include them in the patient’s care and treatment plan, unless there are good reasons not to.

Key milestone	Date of completion	Measure of success	Commitment owner
This is part of work to reform the Mental Health Act, On 15 July 2022, we published our consultation response and will continue to engage with stakeholders on the proposed reforms	Legislation to be introduced when Parliamentary time allows	New duty passes through Parliament. This means that if a responsible clinician or integrated care board deviates from the findings and recommendations of a C(E)TR, they would be expected to justify this	DHSC

Commitment 1d

Ensuring that people with a learning disability and autistic people have received a safe and wellbeing review if they were in mental health inpatient care as at 31 October 2021.

Key milestones	Date of completion	Measure of success	Commitment owner
Face-to-face reviews completed Integrated care system oversight panels completed	Summer 2022	Reviews have identified any concerns about individuals’ safety and wellbeing, and mitigating actions taken	NHSE
Commission an independent collation of the key national themes that emerged from the safe and wellbeing review programme	As above	Consider any necessary actions resulting from key themes that are identified	As above

Commitment 1e

Continuing Independent Care (Education) and Treatment Reviews (IC(E)TRs), and work with the Oversight Panel to improve the circumstances of people with a learning disability and autistic people who remain in long-term segregation.

Key milestone	Date of completion	Measure of success	Commitment owner
Carry out IC(E)TRs for those in scope	IC(E)TRs resumed in 2021. All those within scope to be offered a review by end of 2022	The IC(E)TR will help to improve the person’s circumstances, supporting them to be discharged or move to a less restrictive setting	DHSC

Commitment 1f

Completing a pilot to reduce the length of time people with a learning disability or autistic people remain in inpatient care in segregation, as well as to support earlier transfers of care to appropriate community settings or a transfer to a less restrictive setting while long-term solutions are developed.

Key milestones	Date of completion	Measure of success	Commitment owner
Appoint senior intervenors Identify individuals to be assigned a senior intervenor Implement the pilot and review findings	Extended until March 2023	The roles are expected to support 15 people in long-term segregation with the aim to identify and resolve barriers to progress and discharge	NHSE DHSC

Commitment 1g

Supporting employers to embed the learning disability and autism core capability frameworks across all aspects of the social care and health workforces that support people with a learning disability and/or autistic people.

Key milestones	Date of completion	Measure of success	Commitment owner
Set specialist diploma routes linked to Skills for Care (SfC) and Health Education England (HEE) core skills frameworks, and work with the Institute for Apprenticeships to influence specialist apprenticeship routes	April 2023	Specialist pathways linked to the frameworks included in social care diplomas and changes influenced to pathways in apprenticeships, which will provide evidence of practice leadership that delivers high-quality support	SfC Supported by: – NHSE – HEE –DHSC
Expand programme of quality-checked positive behavioural support (PBS) training providers and develop PBS community of practice	April 2023	All SfC-endorsed PBS training providers to have been peer quality checked. Access provided to small providers	As above
Review the Level 4 adult social care diploma, and use the findings to influence changes to the associated apprenticeship standard and provide evidence of practice leadership	April 2023	Workforce Development Fund for practice leadership qualifications for services supporting people at risk of admission or recently discharged Care Quality Commission (CQC) expect qualified practice leaders in all services that support people in and recently discharged from assessment and treatment units (ATUs)	As above

Commitment 1h

Implementing a programme of personalised workforce development for the workforce that supports people with a learning disability and autistic people who may be at risk of admission or are ready to be discharged.

Key milestones	Date of completion	Measure of success	Commitment owner
Set up programme and confirm funding arrangements where appropriate Deliver personalised workforce development programme to first cohort Commence evaluation of programme and share existing learning Support employers and commissioners to trial the approach using their own resources	April 2023	Provide update to the Building the Right Support Delivery Board on progress and impact From evaluation of the pilot programme, existing evidence suggests that, by focusing on the person, the programme can: – lead to a reduction in inpatient admissions – increase in successful discharges – improve staff retention – reduce long-term costs of care – improve quality of life for individuals	SfC Supported by: – NHSE – HEE – Local Government Association (LGA) – Association of Directors of Adult Social Services (ADASS) – DHSC

Commitment 1i

The Health and Care Act 2022 introduces a new requirement for registered providers to ensure their staff receive specific training on learning disability and autism, which is appropriate to their role. A robust evaluation of the trials has taken place, and a final evaluation report was published in June 2022, which will inform the next steps of the Oliver McGowan Mandatory Training (OMMT) programme.

Key milestones	Date of completion	Measure of success	Commitment owner
Completion of the OMMT trials A formal public consultation on the DHSC-led code of practice	Ongoing	The National Development Team for Inclusion (NDTi) OMMT trials evaluation report complete with recommendations Publication of the DHSC-led code of practice A costed delivery model is agreed to support the rollout of the OMMT across the health and social care sector	DHSC Supported by: –NHSE –HEE –SfC

Commitment 1j

Providing community learning disability teams and intensive support teams with the opportunity to commence advanced and consultant-level practice training by April 2023.

Key milestones	Date of completion	Measure of success	Commitment owner
Develop and deliver multi-professional learning disability and autism credentials mapped to the learning disability and autism core capabilities frameworks	April 2022	40 clinicians from multi-professional backgrounds will be studying a credential	HEE Supported by: –NHSE – at a local level, integrated care systems and partners from the higher education sector
Offer advance practice MSc development to staff working in specialist teams	April 2022 to April 2025	Supported MSc advanced practice places will be available to staff working in specialist teams	As above
Make development packages available for non-medical consultants undertaking the portfolio route to recognition through the Centre for Advancing Practice	April 2022 to April 2025	Existing practitioners working at an advanced level will be able to follow a non-medical consultant-level education pathway	As above

Commitment 1k

Investing £1.5 million of funding into the development and trialling of autism training for staff working in adult inpatient mental health settings.

Key milestone	Date of completion	Measure of success	Commitment owner
Ongoing development and trialling of this training	March 2023	Progress will be reported to the Autism Strategy Executive Group, and the Building the Right Support Delivery Board will receive an update as appropriate	NHSE

Commitment 1l

Developing autism training for staff working in mental health community and inpatient settings for all age groups.

Key milestone	Date of completion	Measure of success	Commitment owner
Ongoing development and trialling of this training	September 2022 to April 2025	Progress will be reported to the Autism Strategy Executive Group, and the Building the Right Support Delivery Board will receive an update as appropriate	HEE

2. Making it easier to leave hospital

We want to support children, young people and adults who are ready to leave hospital to be discharged safely, in the right way and at the right time.

While treatment in a mental health hospital can sometimes be the right choice for a person who has a co-occurring mental health condition and would benefit from an intervention that can only be provided through inpatient care, we want to make sure that people who are ready to leave hospital are able to do so as soon as possible, with the right support ready in the community so that they can live in their own home.

To achieve this, chapter 2 of the action plan outlines:

• our expectations for a plan to be developed with the person from the outset of their admission to support them to leave hospital when they are ready, involving their families and advocates where appropriate
• the ways we are aiming to reduce barriers to discharge, including undertaking regular reviews of people’s care and support, introducing reforms to the Mental Health Act 1983 and providing financial support to make it easier for people to leave hospital
• the actions we are taking to reduce the number of people with a learning disability and autistic people detained under part III of the Mental Health Act

Overview of commitments

Commitment 2a

Working on a refresh of the C(E)TR policy. The refreshed policy will have an increased focus on the physical health of people in hospital and include an increased emphasis on the importance of the actions that should follow from a C(E)TR.

Key milestones	Date of completion	Measure of success	Commitment owner
Learning from safe and wellbeing reviews included in policy refresh Collaboration with partners and stakeholders to shape policy refresh	Policy document to be published summer 2022	Policy published Appropriate offer of C(E)TRs to individuals at risk of admission or in inpatient care	NHSE Supported by: – LGA – ADASS – Association of Directors of Children’s Services – Department for Education (DfE) – DHSC

Commitment 2b

Helping to speed up discharges in England through the Community Discharge Grant, providing local authorities with additional funding.

Key milestone	Date of completion	Measure of success	Commitment owner
Payment issued for financial year 2022 to 2023	Spring 2023	Local authorities have used funding to support ‘double running’ costs, enabling discharges into the community	DHSC

Commitment 2c

Introducing a new power of supervised discharge to enable the discharge of restricted patients into conditions in the community that amount to a deprivation of liberty. This is in response to the Secretary of State for Justice vs MM judgement in 2018, which deemed that this is not possible under the current Mental Health Act legislation. This is part of work to reform the Mental Health Act.

Key milestone	Date of completion	Measure of success	Commitment owner
On 15 July 2022, we published our consultation response and engaged with stakeholders on the proposed reforms	Legislation to be introduced when Parliamentary time allows	That the power is used to discharge patients when appropriate and enable the patient to progress through their pathway of care	Ministry of Justice  (MoJ) Supported by:  – HM Prison and Probation Service

Commitment 2d

Publishing an action plan based on the recommendations in Neurodiversity in the criminal justice system: a review of the evidence report.

Key milestone	Date of completion	Measure of success	Commitment owner
Publication of the action plan	The first iteration was published on 30 June 2022	Improvements made to the identification, diversion and reasonable adjustments made for neurodivergent people or people presenting with neurodivergent traits coming into contact with the criminal justice system. To continue to monitor where this work can target the needs of the Building the Right Support cohort.	MoJ Supported by: – HM Prison and Probation Service – HM Courts and Tribunals Service – Home Office – National Police Chiefs’ Council – DHSC – NHSE

Commitment 2e

Participating in discharge planning for inpatients detained under part III of the Mental Health Act to help identify barriers and progress individual cases as appropriate.

Key milestones	Date of completion	Measure of success	Commitment owner
Establish links between the Mental Health Casework Section (MHCS) and NHSE for future casework queries Review cases highlighted by regional teams	Ongoing	Well established links between learning disability and autism regional leads, NHSE and MHCS MHCS will continue to work with partners in discharge planning on a case-by-case basis to progress individual cases and identify if any further barriers arise	MoJ Supported by: – HM Prison and Probation Service – NHSE – DHSC

3. Living an ordinary life in the community

People with a learning disability and autistic people of all ages can live an ordinary life when they have a home, feel involved in their community and have a reliable network of support.

Effective support helps people have a good quality of life in their communities. It helps people develop skills and achieve their potential, and supports people in their relationships with family and friends.

We want to make sure that there is the right housing, care and support available in the community so people with a learning disability and autistic people can live the lives they choose.

To achieve this, chapter 3 of the action plan outlines:

• the actions we are taking to improve availability and access to housing for people with a learning disability and autistic people
• the ways we are investing in good community support and building our understanding of effective models of care
• our expectations for commissioners of health and social care services, and the ways we want to build commissioning knowledge and skills
• the actions we are taking to improve support for people who may reach a point of crisis or be at particular risk of being admitted to a mental health inpatient setting
• our ambitions for people to have a good quality of life and be valued members of everyday communities, including how we can support people to fulfil their aspirations

Overview of commitments

Commitment 3a

Embed strategic commitment in all local areas to connect housing with health and care, increase local expenditure on support services and boost supply of supported housing.

Key milestone	Date of completion	Measure of success	Commitment owner
Invest at least £300 million from financial years 2022 to 2023 through to 2024 to 2025	End of 2024 to 2025	Local areas plan and deliver more housing with care and support to meet people’s needs	DHSC

Commitment 3b

Capital funding programmes underway to incentivise new supply of specialist and supported housing.

Key milestones	Date of completion	Measure of success	Commitment owner
The £11.5 billion Affordable Homes Programme 2021 to 2026 includes delivery within the programme of new supported housing	2026 (current Affordable Homes Programme to complete in 2026)	Increase the availability and choice of specialist and supported housing options for people with a learning disability and autistic people	Department for Levelling Up, Housing and Communities (DLUHC) DHSC NHSE
Continue to invest in the Care and Support Specialised Housing (CASSH) Fund from 2022 to 2023 through to 2024 to 2025 to deliver specialist housing, including for people with a learning disability and/or autism or mental ill-health	2024 to 2025 (by which all CASSH schemes to have at least started)	As above	As above
Utilise NHS capital programme to encourage regions and local systems to prioritise funding for housing for people with a learning disability and autistic people	Current NHSE capital programme to complete in 2024 to 2025	As above	As above

Commitment 3c

Commissioning independent research to understand the size, cost and demand of the supported housing sector, including that which meets the needs of people with a learning disability and autistic people.

Key milestone	Date of completion	Measure of success	Commitment owner
Final findings report	End of 2023	Develop an up-to-date evidence base on supported housing supply to support government policy development and local system decision-making	DLUHC

Commitment 3d

Provide funding to local areas to deliver the Disabled Facilities Grant.

Key milestone	Date of completion	Measure of success	Commitment owner
Committed £573 million per financial year 2022 to 2023 through to 2024 to 2025	2022 to 2023 to 2024 to 2025	More people benefit from home adaptations to meet their needs	DHSC

Commitment 3e

ADASS, LGA and the Building the Right Support Advisory Group to identify ‘what good looks like’, which will be followed by a report that includes best practice examples, with an emphasis on initiatives that support citizenship and human rights.

Key milestones	Date of completion	Measure of success	Commitment owner
Complete initial scoping consultation with key stakeholders. The consultation will ask questions on the project’s scope such as: ‘Are we looking at the areas that are important to you?’ and ‘Is there anything we have missed?’	April 2022	Feedback from people with personal experience and their families from forum discussions. A minimum of 100 responses to be analysed	LGA ADASS Building the Right Support Advisory Group
Select initiatives to review using the developed template to gather information	April 2022	At least 25 initiatives will have been screened and reviewed	As above
Identify any outstanding good practice initiatives, how they came about and the critical factors that enabled them	July 2022	Agree a second clear consultation process on the draft final report and commence consultation	As above
Establish final report approvals, and develop a communications plan to make sure findings are communicated widely	September 2022	Approval for final report established and a communications plan developed	As above

Commitment 3f

NHSE, along with a range of partners, commit to continuing to roll out a programme across England that enables the development of small (supporting less than 30 people with a learning disability and autistic people) community-driven organisations to deliver high-quality, bespoke support wrapped around an individual that promotes choice, control, human rights and citizenship.

Key milestone	Date of completion	Measure of success	Commitment owner
Expand the programme to an additional 8 integrated care systems (ICSs)	March 2023	Successful rollout of the programme to an additional 8 ICSs	NHSE

Commitment 3g

Continue to commission funded peer reviews. The programme involves a small group of peers spending time in another area as ‘critical friends’ to support an area to develop and improve service delivery. This process involves a wide range of stakeholders, including people with personal experience, and reflects to the system where they need to focus attention.

Key milestone	Date of completion	Measure of success	Commitment owner
Undertake a peer review in an additional 4 ICSs	March 2023	4 peer reviews completed	NHSE

Commitment 3h

Continue to roll out an accredited commissioning qualification for current and aspiring commissioners. The qualification has been developed to support the commissioning workforce to understand the types of services they should be developing for autistic people and people with a learning disability.

Key milestone	Date of completion	Measure of success	Commitment owner
Rolling out the qualification to a cohort of commissioners	April 2023	Case example evidence to demonstrate how commissioners are changing their practice In the long term, a health and a social care commissioner per local area to have completed the qualification by April 2025	SfC Supported by: – HEE – LGA – NHSE – ADASS – DHSC

Commitment 3i

Rolling out a training programme for senior leaders to increase their skills and knowledge to support local commissioners.

Key milestone	Date of completion	Measure of success	Commitment owner
Two cohorts of senior leaders to have commenced commissioning programme each year	April 2023	Case example evidence to demonstrate how they are changing their commissioning practice A senior leader per local area to have completed the qualification	SfC Supported by: – HEE – LGA – NHSE – ADASS – DHSC

Commitment 3j

Developing commissioning guidance to build the capability and knowledge of the commissioning workforce that is designed to complement qualifications and training.

Key milestones	Date of completion	Measure of success	Commitment owner
Publish a range of guidance and information for commissioners to support them to commission for people’s lives and not just a service	July 2022	Autism-specific commissioning guidance is already available and guidance specifically written to support commissioning for people of all ages with a learning disability was published in July 2022	SfC Supported by: – HEE – LGA – NHSE – ADASS – DHSC
Hold webinars with sector partners to promote use of the guidance	Summer 2022	Two webinars to have been held	As above

Commitment 3k

Proposal to introduce new duties on commissioners to ensure that there are adequate community-based services in their local area to support people with a learning disability and autistic people. This is part of work to reform the Mental Health Act.

Key milestone	Date of completion	Measure of success	Commitment owner
On 15 July we published our consultation response on reforming the Mental Health Act and will continue to engage with stakeholders on the proposed reforms	Legislation to be introduced when Parliamentary time allows	This would ensure that a lack of appropriate support does not justify inappropriate admission and support is available close to a person’s home	DHSC

Commitment 3l

Proposal to introduce a new duty for commissioners to hold a dynamic support register – including an ‘at risk of admission’ component – that would ensure that commissioners understand and monitor the risk of crisis at an individual level for children, young people and adults with a learning disability or autistic children, young people and adults in their local population.

Key milestone	Date of completion	Measure of success	Commitment owner
On 15 July we published our consultation response on reforming the Mental Health Act and will continue to engage with stakeholders on the proposed reforms	Legislation to be introduced when Parliamentary time allows	This would increase better planning for provision and more effective joint action being taken locally, leading to a reduction in inappropriate admissions to inpatient settings	DHSC

Commitment 3m

Strengthening the supported internship (SI) programme to support young people with an Education Health and Care Plan to secure and sustain employment.

Key milestones	Date of completion	Measure of success	Commitment owner
Announcement of up to £18 million investment in the SI programme over the next 3 years	Announcement: February 2022 Delivery of investment programme: 2022 to 2023 through to 2024 to 2025	Activities relating to this funding are expected to build capacity in the SI programme across the country, aiming to double the number of SIs to give more young people with an Education Health and Care Plan the skills to secure and sustain paid employment	DfE
Publication of updated SI guidance	February 2022	This guidance is expected to support education providers and employers to deliver good-quality internship placements for young people across the country	As above
Publication of a Quality Assurance Framework enables SI providers to review and improve the quality of internship provision	March 2022	This framework is expected to lead to improved quality and consistency in SI programmes	As above

Commitment 3n

Strengthening the use of dynamic support registers to identify children, young people and adults most at risk of admission.

Key milestone	Date of completion	Measure of success	Commitment owner
Guidance will be published in relation to minimum expectations for dynamic support registers	Summer 2022	Systems have an improved record of individuals who may require support and they ensure that support and action is taken at the right time when people are in crisis	NHSE LGA ADASS Association of Directors of Children’s Social Services DfE

4. A good start to life

We want to ensure that children and young people with a learning disability, and autistic children and young people and their families can access the support they need to ensure they have the best possible start to life and can live the lives they choose.

This includes getting a diagnosis as an important first step, having positive experiences of education and getting the support they need as they move from childhood to adulthood.

To achieve this, chapter 4 of the action plan outlines:

• the actions we are taking to improve autism diagnosis and reduce waiting times
• the importance of people having positive experiences in educational settings and how we will ensure this is achieved
• the ways we are supporting children who may live away from home
• our expectations for children and young people to be supported on their journey towards adulthood, including to have the right support in place to achieve their aspirations and to prevent crisis
• our ambitions to build the knowledge and skills of the education workforce to provide the best support for children and young people in education settings

Overview of commitments

Commitment 4a

Building on the £10.5 million COVID-19 Mental Health Recovery Fund and £2.5 million NHS Long Term Plan investment, we are investing a further £2.5 million to support the delivery of the Long Term Plan commitment to improve autism diagnosis pathways for children and young people.

Key milestone	Date of completion	Measure of success	Commitment owner
In 2022 to 2023, as part of the NHS Long Term Plan, we will continue to test and implement ways to reduce variation across diagnostic pathways	March 2023	Progress on work to test and embed diagnostic pathways will be reported to the Autism Strategy Executive Group, and the Building the Right Support Delivery Board will receive an update as relevant	DHSC NHSE

Commitment 4b

DfE is investing £600,000 into significantly expanding an autism early identification pilot in Bradford to at least 100 schools over the next 3 years.

Key milestones	Date of completion	Measure of success	Commitment owner
Draft ‘pathway’ developed	March 2022	Progress on the Bradford early diagnosis pilot will be reported to the Building the Right Support Delivery Board	DfE DHSC
Electronic screening tool developed	April 2022	As above	As above
Electronic screening pilot in 10 Bradford schools	December 2022	As above	As above
‘Pathway’ pilot in Bradford Evaluate screening tool and ‘pathway’	December 2022	As above	As above
Plan for delivery across other areas in Bradford (for academic year 2022 to 23)	January 2023	As above	As above
Delivery across other areas in Bradford	March 2023	As above	As above
Evaluate delivery across Bradford	July 2023	As above	As above
Plan for delivery across areas outside of Bradford – Leeds	Summer 2023	As above	As above
Delivery across other areas	July 2024	As above	As above
Evaluate delivery across other areas	December 2024	As above	As above

Commitment 4c

A further £1.6 million is being invested this academic year (2021 to 2022) to test and develop the pilot across other local areas with different demographics and commissioning models. These local areas will also look at upskilling the mainstream school workforce to better identify need and develop screening tools to better identify girls, and testing an ‘outsourcing’ model for multidisciplinary team members.

Key milestones	Date of completion	Measure of success	Commitment owner
Delivery across each of the 4 areas	July 2022	Mainstream school workforce is better able to identify need	DfE
Evaluate delivery across the 4 areas	January 2023	As above	As above

Commitment 4d

Putting forward proposals for the SEND review: right support, right place, right time, which will give children with special educational needs and disabilities (SEND) greater opportunities to succeed by fundamentally improving the way we deliver support.

Key milestone	Date of completion	Measure of success	Commitment owner
Publication of SEND and alternative provision green paper for consultation following the SEND review	Published 29 March 2022	Implementation (longer term) will improve identification and ensure needs are met at the earliest stage. This will improve the educational experience and should be reflected in improved placement stability	DfE Supported by: – DHSC

Commitment 4e

£2.6 billion has been made available over the next 3 years to deliver new places and improve existing provision for pupils with SEND who require alternative provision.

Key milestone	Date of completion	Measure of success	Commitment owner
Announcement of up to 40 new special and alternative provision free schools, targeted at areas where need for new provision is greatest	Spring 2022	Successful bids announced	DfE

Commitment 4f

Continue the Autism in Schools project with a further £2.5 million investment in 2022 to 2023.

Key milestone	Date of completion	Measure of success	Commitment owner
There will be an Autism in Schools project in 2 ICS areas in each of the 7 NHS regions	March 2023	The 14 Autism in Schools projects will be offering support to 250 schools	NHSE

Commitment 4g

A new £30 million fund to support local authorities in developing innovative approaches to the delivery of respite care and short breaks. This fund will allow local areas to develop and target new approaches to respite or short breaks, targeting those children and young people who may need a different model of delivery from what is currently available in their area. In the first year, we expect to fund a minimum of 5 local areas (total investment of £5 million) to trial different approaches.

Key milestones	Date of completion	Measure of success	Commitment owner
Delivery commences on first projects	April to June 2022	Projects in year one areas delivering	DfE
Baseline evaluation activity	July 2022	Evaluation activity underway	As above
Launch of second year bidding round	Autumn 2022	Early evidence of promising approaches	As above

Commitment 4h

A full ICS footprint rollout of designated keyworkers for children and young people with a learning disability, and autistic children and young people.

Key milestone	Date of completion	Measure of success	Commitment owner
Each ICS will have a key worker programme for autistic children and young people, and children and young people with a learning disability with complex needs	March 2023	Operational keyworker programme in each ICS area (42 in total)	NHSE

Commitment 4i

DfE is updating the national minimum standards for residential special schools, and engaging with Ofsted and other stakeholders on this update.

Key milestone	Date of completion	Measure of success	Commitment owner
Publish revised national minimum standards, reflecting responses to consultation	Published May 2022 Implementation from September 2022	New national minimum standards rolled out and driving improvement in these settings, as reflected in Ofsted inspection evidence	DfE

Commitment 4j

DfE has committed to continue support for autism awareness training for education staff in early years, schools and further education settings. Since 2011, this training has reached more than 305,000 people, and has developed good autism practice guidance and practice frameworks aimed at supporting and improving practice within education settings.

Key milestone	Date of completion	Measure of success	Commitment owner
Procure new universal contract to provide continuing professional development for education staff, including specific key performance indicators around support to autistic children and young people	Contract commenced April 2022 Implementation from April 2022 to March 2025	Contract in place for April 2022 Progress will be reported to the Autism Strategy Executive Group, and the Building the Right Support Delivery Board will receive an update as appropriate	DfE

Commitment 4k

DfE has announced more than £45 million of continued targeted support for families and parents of children and young people with SEND and SEND services. This includes further funding for programmes that will directly support schools and colleges to effectively work with pupils with SEND.

Key milestone	Date of completion	Measure of success	Commitment owner
Procurement complete	Implementation April 2022 to March 2025	Contracts in place for April 2022	DfE

Commitment 4l

Working in partnership with DHSC, DfE has commissioned Ofsted and the CQC to develop and transition to a new joint Ofsted-CQC area SEND inspection framework.

Key milestones	Date of completion	Measure of success	Commitment owner
Ongoing cycle of inspections with local authorities being inspected every 3 or 5 years depending on grade and focus Visits and annual conversations to be monitored, resulting in an increased intelligence picture	Ongoing	A significantly enhanced picture of local area performance and specific improvement needs, with accountability identified across the 151 local authorities, is achieved. This will also enable comparison between areas A graduated improvements and intervention function will be designed with NHSE to address the needs identified. Reports to be published online	DfE Supported by: – DHSC – Ofsted – CQC – NHSE

5. Working with changes to the system

We recognise that the ambitions and commitments in earlier chapters of the action plan are only one part of making change happen.

There are a host of other factors that matter to people, which would significantly improve their experiences of navigating services and getting the right support.

A key part of this is transforming systems so that the right structures are in place to achieve long-term change for people with a learning disability and autistic people.

To achieve this, chapter 5 of the action plan outlines:

• the proposed reforms to the Mental Health Act. These reforms will prevent prolonged detention in mental health hospitals and include a proposed duty for commissioners to hold a local ‘at risk’ register which allows them to work with local authorities to understand, monitor and respond to the risk of crisis at an individual level for people with a learning disability and autistic people in their population
• the work the government is doing to improve how funding flows across and between services – for example, on pooled budgets
• the government’s 10-year vision to transform adult social care so that people receive the right support in the community at the right time

Overview of commitments

Commitment 5a

Proposal to limit the scope to detain people with a learning disability or autistic people under the Mental Health Act, as part of work to reform the Mental Health Act.

Key milestone	Date of completion	Measure of success	Commitment owner
On 15 July, we published our consultation response on reforming the Mental Health Act and will continue to engage with stakeholders on the proposed reforms	Legislation to be introduced when Parliamentary time allows	This proposal means that people with a learning disability and autistic people will only be able to be detained for treatment under section 3 of the act if a co-occurring mental health condition that would benefit from hospital treatment is identified. If no co-occurring mental health condition is identified, then detention will end	DHSC

Commitment 5b

Undertaking a rapid review of funding flows, which will make recommendations that DHSC will consider and act on as appropriate.

Key milestones	Date of completion	Measure of success	Commitment owner
Review to be commissioned and engagement to commence	August 2021	Findings will increase our understanding of funding and financial incentives in relation to services for people with a learning disability and autistic people, allowing us to develop better and targeted solutions Task and finish group established to consider report outcomes, reporting to the Building the Right Support Delivery Board	DHSC
Interim update presented to the Building the Right Support Delivery Board	September 2021	As above	As above
Review completed and published – see Building the Right Support: an analysis of funding flows	July 2022	As above	As above

Commitment 5c

Reviewing section 75 of the National Health Service Act 2006 (which allows partners such as NHS bodies and councils to pool and align budgets) to simplify and update the underlying regulations.

Key milestones	Date of completion	Measure of success	Commitment owner
Post review, DHSC will publish revised guidance on the use of pooled budgets	Spring 2023	Aligned financial arrangements and pooled budgets will become more widespread and grow to support more integrated models of service delivery, eventually covering much of funding for health and social care services at place level	DHSC

Other areas of relevant work

The following actions relate to wider policy developments relevant to improving outcomes for people with a learning disability and autistic people.

The Building the Right Support Delivery Board will note any wider risks and issues in relation to these reforms that may impact the delivery of the Building the Right Action Plan.

The actions listed below would not be scheduled to be regularly reviewed but updates may be requested.

Commitment	Commitment owner
As announced, during the passage of the Health and Care Act 2022, we committed to go further by expecting that all integrated care boards (ICBs) will have a named senior responsible officer to oversee local implementation of NHS Long Term Plan ambitions for people with a learning disability and autistic people, and their families	DHSC
As part of our reforms to the Mental Health Act, the DHSC is proposing to extend the right to an Independent Mental Health Advocate (IMHA) to all people who are mental health inpatients, including voluntary patients who are not detained under the Mental Health Act	DHSC
As part of its strategic ambition, the CQC aims to deliver an inclusive, public ‘listening’ service that proactively and expertly monitors, encourages, enables and acts on a wider range and volume of people’s experiences to drive its decision-making	CQC
NHSE has developed Ask Listen Do resources. Ask Listen Do supports organisations to learn from and improve the experiences of people with a learning disability, autism or both, their families and carers when giving feedback, raising a concern or making a complaint	NHSE
In March 2022, the government launched a public consultation on the proposed changes to the Mental Capacity Act 2005 Code of Practice, including guidance on the new Liberty Protection Safeguards (LPS) system. The new LPS system will replace the Deprivation of Liberty Safeguards (DoLS) system	DHSC
DHSC is considering how to strengthen practice in local Safeguarding Adult Boards (SABs) and encourage effective join-up with local agencies. It is considering the recommendations made in the Independent Review of the Mental Health Act 1983 to which the government responded in its Reforming the Mental Health Act consultation in 2021	DHSC
NHSE is developing a digital Reasonable Adjustments Flag, which will show on a person’s health record that they may need reasonable adjustments to their care	NHSE
NHSE commissioned the NDTi to develop 10 principles with the aim of increasing awareness and provision of environments that are suited to people’s sensory needs	NHSE
DHSC is preparing for a public consultation on the proposed changes to the Mental Capacity Act 2005 Code of Practice	DHSC
To improve how they are undertaking inspections, the CQC is piloting a range of new tools, and have developed training that focuses on the principles of observing people and understanding the care they are receiving through their eyes. This includes a quality of life tool, communication tools such as Talking Mats and training for inspectors to understand what good practice looks like	CQC
On 7 December 2021, DHSC published statutory guidance on the use of force in mental health settings and the government response to the consultation on the guidance. The majority of the provisions within the act were brought into force on 31 March 2022 and the rest will be brought into force as soon as possible	DHSC
On 21 July 2021, DHSC published our response to the recommendations made by the CQC in their report Out of sight – who cares? and work is underway to implement these. In our response, we confirmed agreement – in full or in principle – to all of the recommendations made that DHSC as the lead	DHSC
Services across health and social care are expected to only use training in restrictive practices that is delivered by an organisation with UKAS accreditation and therefore compliant with the Restraint Reduction Network Training Standards The Mental Health Units (Use of Force) Act 2018 statutory guidance sets out the requirements for staff training in the use of force. The NHS Standard Contract 2022 to 2023 requires all providers of mental health and learning disability services to ensure all relevant staff have received training in restrictive practices that is delivered by an organisation with UKAS accreditation	Restraint Reduction Network NHSE
The Health and Care Act 2022 includes a provision for a new duty for the CQC to assess local authorities’ delivery of their adult social care duties under the Care Act 2014. DHSC is working closely with the CQC and other key stakeholders to design a system that will drive the best possible outcomes for people	CQC
NHSE has commissioned Mersey Care NHS Foundation Trust to deliver a HOPE(S) model programme, which is a national training model delivered through an NHS-led provider collaborative. Recruitment is underway for HOPE(S)-specialist practitioners as part of this work	NHSE
NHSE continues to lead the STOMP and STAMP programmes to make sure that people with a learning disability, autism or both are only prescribed the right medication at the right time and for the right reasons	NHSE
As set out in the Health and social care integration: joining up care for people, places and populations (published February 2022) white paper, we want to build on progress in recent years to go further and faster in pooling and aligning funding to enable delivery at place level. We are reviewing section 75 of the National Health Service Act 2006 (which allows partners such as NHS bodies and councils to pool and align budgets) to simplify and update the underlying regulations. Post review in spring 2023, DHSC will publish revised guidance on the use of pooled budgets	DHSC
The People at the Heart of Care: adult social care reform white paper set out the government’s commitment to reform adult social care through £5.4 billion over 3 years to accelerate a comprehensive reform programme which includes: – investing at least £500 million in learning and development for the adult social care workforce, which will ensure that the adult social care workforce have the right knowledge and skills to provide the best possible care and support for people – intending to invest in new social work training routes, and to improve the pre-qualification and post-qualification pathways in social work – providing up to £30 million to support local systems to build the right culture and capability to scale and embed innovative models of care into practice – investing up to £35 million to work with the sector to drive change in the services provided to support unpaid carers	DHSC
The People at the Heart of Care: adult social care reform white paper provided further detail on how we will develop an enhanced assurance framework for adult social care. This will allow us to understand where adult social care is working well and where support is needed. Our intention is that the CQC assessment function will roll out from 2023 to 2024, and we will work with the sector to support a smooth implementation of the new process	DHSC
The new Health and Care Act 2022 will increase integration between health and social care. It will put more power and autonomy in the hands of local system partners to plan and deliver seamless health and social care services. In addition, it is expected that all ICBs will have a named senior responsible officer to oversee local implementation of NHS Long Term Plan ambitions for people with a learning disability and autistic people, and their families	DHSC
The Health and Care Act 2022 includes provisions for a new duty for the CQC to assess local authorities’ delivery of their adult social care functions under part 1 of the Care Act 2014	DHSC
In February 2022, DHSC published the People at the Heart of Care: adult social care reform white paper, which is the next step in our journey of joining up health and social care for citizens. We expect that all places should identify a model of accountability and a person that will be accountable for the delivery of shared health and care outcomes by spring 2023	DHSC
As part of the government’s National strategy for autistic children, young people and adults: 2021 to 2026, the MoJ is working to improve the way in which the justice system supports autistic people. This includes supporting more prisons to learn from the good practice of those awarded accreditation from the National Autistic Society for working with people with autism. The MoJ will continue to learn from good practice developed at accredited prisons, and support prisons and probation areas that would like to be accredited	MoJ
The MoJ has committed to publish a national Neurodiversity Training Toolkit for frontline staff by the end of 2022, as announced in 2020’s A Smarter Approach to Sentencing white paper. This toolkit will enable frontline staff to manage people with neurodivergent conditions in the system more effectively. These measures seek to improve awareness of neurodiversity in the criminal justice system, and provide staff with the tools and knowledge to better understand and identify neurodivergent individuals, and support them to engage meaningfully with the rehabilitative aspect of their sentence	MoJ
Investing a £300 million package to transform Start for Life services and create a network of family hubs in half of the council areas across England	DfE DHSC
The DfE is consulting on and revising the behaviour in schools guidance (formerly the behaviour and discipline in schools guidance), which will better develop and communicate the role and expectations of school leaders, staff, pupils and parents to help create and maintain good standards in schools	DfE
NHSE is working with education and voluntary and third-sector partners to deliver mental health support teams in schools and colleges. Mental health support teams will cover 20 to 25% of pupils in England by 2022 – a year earlier than originally planned	NHSE DHSC DfE
The government commissioned the independent review of children’s social care to take a fundamental look at what is needed to make a real difference to the needs, experiences and outcomes of those supported by children’s social care. The review launched in March 2021 and published its final report on 23 May 2022. Government will consider the review’s recommendations and publish a children’s social care implementation strategy by the end of the year	DfE
The government is supporting local authorities through providing £259 million of capital funding to maintain capacity and expand provision in both secure and open residential children’s homes. Implementation will take place between April 2022 and March 2025	DfE