Shaping policy and provision for people with intellectual disabilities in England: Change from within

Aim: The last three decades have seen a movement away from exclusive services to those shared by non-disabled citizens, and health care professionals have been at the centre of many of these changes in England as people with intellectual disabilities (ID) moved towards a more inclusive and integrated lifestyle.

Method: Key changes in policy regarding people with ID in England are examined through the experiences of 20 nurses for those with ID elicited via life narrative interviews. Participants describe their roles in assisting clients in moving from segregated, residential accommodation to supported living in community settings.

Results: A consistent theme across all 20 narrative interviews was that of ‘change from within’, where practitioners described themselves seeking to humanise the physical environment, enhance the emotional climate and emancipate their clients by increasing the variety of life choices available to them.

Conclusions: The UK Government White Paper Valuing People (DH 2001) was based on four principles of Rights, Independence, Choice and Inclusion. Despite the sometimes austere financial climate, health care professionals have sought to prompt change, actualise the principles of Valuing People, and support people with intellectual disabilities to live, work and play in a more diverse range of settings in society.