People with Learning Disabilities: Acute Illness

Lord Scriven Excerpts

Monday 20th July 2026 Lords Chamber

Asked by

[Lord Scriven]

To ask His Majesty’s Government what assessment they have made of the recommendations in the National Confidential Enquiry into Patient Outcome and Death report Acute illness in people with a learning disability, published on 11 June; and whether they intend to ensure those recommendations are implemented by NHS Trusts.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, we welcome the National Confidential Enquiry into Patient Outcome and Death’s report and its recommendations. NHS England has circulated learning from the report across the health and care system for regional teams to share it with integrated care boards. NHS accountability arrangements are in place, and immediate improvement actions are under way, including the reasonable adjustment digital flag. The Government are committed to high-quality care for people with a learning disability.

[Lord Scriven (LD)]

My Lords, enough is enough. Currently, with everything in place, people living with a learning disability still die on average 20 years earlier than their non-learning disabled peers. The key missing part of the jigsaw is a statutory independent review of every such death, legally compelling NHS trusts and other providers to implement the improvements identified. Why are this Government content to rely on the toothless, non-statutory reviews that have changed nearly nothing, and allow this 20-year life expectancy gap to continue?

[Baroness Merron (Lab)]

I certainly accept the point, and I am not quibbling about the number, because 19 years, which is where we are now, is totally unacceptable. In addition, there is the high percentage of avoidable deaths, which I know the noble Lord is very alive to. While I share the view that this is unacceptable, I would not put it all down to reports. I can say that there are strong expectations of ICBs. As I have mentioned, they are kept to account, and we are continually ensuring that the death of every autistic person and those with a learning disability that is notified is reviewed. The new national-level patient dataset will certainly provide what I would call a single point of truth, which has not been there in the past.

--- Later in debate ---

[Baroness Merron (Lab)]

That is the reason for the accountability measures that I have outlined. I should add that transparency is absolutely key to that. The guidance that we have issued about supporting the identification of people with learning disability is important; we are at that basic level. That is where we have started, but it will push this forward. Further to my answer to the noble Baroness, Lady Finlay, the guidance for acute hospital staff, for example, included standardised mental capacity assessment forms; they were not in place previously. Each ICB is required, via statutory guidance, to have an executive lead on learning disability and autism.

[Lord Scriven (LD)]

My Lords, every question that has been asked has shown that the system is failing: people are still dying. The key point is that the accountability mechanism is missing or is too diluted to work. Why do the Government allow this system, which kills people early, to continue? What has the Minister not heard in this debate that assures her that the system is working and that it will somehow change for the better? Evidence and history tell us that the system is broken.

[Baroness Merron (Lab)]

I hope that I have already agreed with the noble Lord and others about the progress that needs to be made in this area. I have certainly not said that it is acceptable—it is far from acceptable—and the questions have been very helpful in identifying that. The learning disability improvement standards support NHS trusts to measure the quality of care that they provide. All the areas that I have suggested and more are taking us forward. I gave the commitment —and I mean it—to keep these things under review and to seek to improve wherever we can. We look forward to working with the noble Lord in doing so.