Medication Pathway

Section B Medication Facts and National Guidance

What are the issues surrounding inappropriate medication?

Recognition that people with a learning disability, autism or both were at risk of over-medication grew after the BBC Panorama programme about Winterbourne View hospital in 2011. The abuse exposed by Panorama led to the beginning of the Transforming Care Programme, which was a commitment to improving services for people with a learning disability, autism or both to ensure they could live a good life in the community.

The Serious Case Review that investigated practices at Winterbourne View found many people in the hospital were prescribed antipsychotic and antidepressant medication without a diagnosed mental health need. These findings led to a specific recommendation to reduce the use of these medications when there is no diagnostic reason for them to be prescribed.

Five years later in 2016, a survey by the Care Quality Commission (CQC) found that inappropriate medication was still a widespread problem. Their survey of people with a learning disability receiving inpatient care found that high numbers of people (86%) were prescribed antipsychotic drugs on a regular basis. More worryingly, they also found that for more than half of these prescriptions, the individual did not have a diagnosis of a disorder for which that drug was for. A study carried out by University College London in 2015 suggests that this is not just an issue for people receiving inpatient care. Of the 33,000 adults with a learning disability in this study, 21% had a diagnosed mental health need, but 49% were prescribed antipsychotic medication.