by Paul Kelso, health correspondent

At least 40 people with a profound learning disability or autism have died while admitted to "barbaric" secure hospitals the government has promised to close since 2015, a Sky News investigation has found.

Image: Many families say they battle a complex care system that does not meet their needs

The deceased, nine of whom were under-35 when they died, were being held as in-patients in assessment and treatment units (ATUs), controversial hospitals considered inappropriate for some of the most vulnerable people in society.

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ATUs are in-patient units intended for the short-term assessment, treatment and stabilisation of people with mental health conditions who display challenging behaviour, and those with a learning disability or autism are supposed to be discharged within 18 months into community-based care.


Extended report: Trapped in care

In practice however, more than 2,000 people are currently in ATUs, with an average stay of more than five-and-a-half years.

Our investigation has found numerous cases of families whose loved ones have been confined to an ATU for years - including the case of one man who has been in an ATU 100 miles from his parents' home for 18 years.

His parents say the failure to have him released into community care has destroyed their family and left him a shadow of the young man who was first admitted to residential care when he was 20.

Health Secretary Matt Hancock told Sky News that such stories were "very harrowing".

"I've been following this since I became health secretary and I think it's absolutely heartbreaking," he said.

"There was a target put in place a few years ago to reduce by a third the number of people in secure hospitals in this way and we're making progress against that target, but I would clearly want to see that go further and it's something we're actively working on.

"The numbers are coming down, which is good, but clearly there's more that needs to be done.

"We announced this week a £2bn increase in the budget for mental health services - that's part of the answer but by no means the whole answer."

We've been told our son doesn't belong to us

He is one of more than 2,000 people with a learning disability or autism who remain in an ATU despite a government commitment to close up to half of the beds in these hospitals by next March.

That target, made after revelations of abuse at the Winterbourne View care home, is certain to be missed and the latest statistics from NHS Digital show that the number of people held in ATUs has barely fallen in three years.

Figures show the total fell by 80 people in three years, from 2,395 in March 2015 to 2,315 in September this year, while the number of children has increased, from 110 in March 2015 to 230 in September.*

Latest figures show 60% of patients in ATUs have been admitted for more than two years and 16% for more than a decade.

Figures released to Sky News under the Freedom of Information Act reveal that reported uses of restraint, categorised as including the use of medication, seclusion of patients, and physical restraint including face-down "prone restraint", have soared in the last two years.

The number of cases of restraint in England rose from 16,660 in 2016 to 28,880 last year. NHS England say the increase can be explained by better reporting of incidents. The health services in Scotland, Wales and Northern Ireland were unable to provide figures.

Sir Stephen Bubb, the author of two progress reports on the ATU bed closure program, said the government's failure to act was putting patients' lives at risk.

Image: Sir Stephen Bubb says money should move from the NHS to the social care pot

"There are deaths of people in these institutions, some of them unexplained. We know there are significant problems and there will be at some stage another scandal, and yet we know what we need to do.

"The idea that in the 21st century you lock people up, you restrain them, you use prone restraint, you hold them down, I think is disgusting, it is barbaric and it is unacceptable, and it needs to be made unlawful."

Ray James, NHS England national director for learning disabilities, said: "Improving the lives of people with a learning disability, autism, or both, is a priority for the NHS and as better community alternatives have come on line there are now 20% fewer people with a learning disability in hospital than in March 2015.

"But there is more to do, which is why NHS England is investing more than £75m to further improve community support to help hundreds more people to move out of hospital."

*Since this article was published NHS Digital, at the request of NHS England, have asked us to clarify the figures provided to Sky News. In May 2015, the number of people with a learning disability or autism recorded in an ATU at that date was 2,395. NHS Digital say these statistics are constant review, and have been updated to include late submissions from commissioners. As of 31 October 2018, they say the number of people thought to have been in an ATU in March 2015 was 2,885. This revised figure is only included on one of the slides published by NHS Digital, with the original number of 2,395 used elsewhere in its publication. The full statistical release can be seen here: https://files.digital.nhs.uk/3F/702DBB/ldsm-Oct-18-ref.xls