What is standard care for people with learning disabilities and behaviour that challenges and what does it cost? all authors: Valentina Iemmi Martin Knapp Nick Gore Vivien Cooper Freddy Jackson Brown Caroline Reid Maria Saville BC Delphi Group Amritpal Rehill Peter McGill Paul McWade Catherine Sholl Gemma Biles Karola Dillenburger Jennie Duprey Simon Jones Bron Roberts Dora Whittuck

Background: We describe current care arrangements in England for children, young people and adults with learning disabilities and behaviour that challenges, and estimate their comparative costs.Materials and Methods: A two-round Delphi exercise was performed in March and April 2014, followed by a costing exercise.Results: The study finds a mixed picture: participants reported that 60–87% of children, 66–88% of young people and 34–47% of adults were like ly to be living within the community. Annual cost of care would range between £39 612 and £74876 for children, between £35 235 and £52 832 for young people and between £81 478 and £94 799 for adults.Conclusion: While residential-based care may continue to be necessary for respite or for individuals with particular needs, community-based care may be an economically attractive alternative, supporting the inclusion of people with learning disabilities and behaviour that challenges within their communities, potentially at a lower cost.