Service Provision - UK John Lawson & Nicki Holland Oxford Brookes University

Outline: 1)Overview of UK service provision 2)The “I Exist” report 3)The Adult Autism Act

Nastja trtnik Service Provision in UK: 1)Relative to many countries both diagnostic and support services generally good 2)Highly variable throughout UK – historically controlled by regional NHS funding groups e.g. South Eastern England has much better diagnostic service provision than the North-West

Service Provision in UK: 3) Situation with specialist schools varies hugely – a) National Autistic Society – Runs 6 schools / 500 children (4 in Southern England) with a clear policy on teaching etc.. b) Many other ‘independents’ with varying approaches e.g. Treehouse (N London) – very big on ABA, Garden School (Lonsdale) – more varied approach

The “I Exist” Report: )NAS Report voicing concerns & needs of people on ASC 2) Contained survey data (from ASC individuals, families / carers, Local Authorities & Primary Care Trusts 3) Contained in-depth interviews

The “I Exist” Report: ) Responses a) 2,600 individuals b) 770 parents carers c) 53 LA (35%) d) 24 PCT (16%) 5) Key Findings?

The “I Exist” Report: 2008 – Key Findings 1)Understanding & record keeping needs to be better a) 67% of LA and 77% of PCT - no records of how many ASC adults live in their area b) 65% of LA do not know how many adults with autism they actually support

The “I Exist” Report: 2008 – Key Findings 2) Significant barriers to social care & health services- a) Only 42% of ASC adults (who responded) had received an adult needs assessment from their LA b) 45% of LA surveyed do not have a process in place to address the needs of people with ASC who do not fulfil the criteria of the learning disability or mental health team

The “I Exist” Report: 2008 – Key Findings 3) Needs & local service provision a) 63% of adults who responded - not have enough support to meet their needs b) Of those, 70% - could live more independently with right support Discrepancy indicated between the types of services that people receive and what they want

The “I Exist” Report: 2008 – Key Findings 4) More training for social care staff- a) 63% of LA who completed the questionnaire - support workers are insufficiently trained in ASC b) 56% said that ongoing professional development training was also inadequate All of the above fundamental in achieving …….

The Autism Act – 2009/2010 1) Put a duty in legislation on the UK Government to produce a strategy by April strategy development underpinned by legislation 2) Put a duty on Government to produce statutory guidance for health and social care bodies by December 2010 The Act covers services for adults with autism and young people at transition

Strategy for England Five main areas of focus – 1)Awareness and understanding 2)Diagnosis 3)Access to services and support 4)Helping adults into work 5) Service development

Strategy for England )Awareness and understanding – ASC to be included in the core training curricula for doctors, nurses and other clinicians ASC training to be part of training for staff carrying out community care assessments ASC training for staff in the criminal justice system ASC awareness training for all working in the public sector £500,000 to fund the development of training programs to improve understanding of autism among frontline professionals in health and social care Training in autism for all Disability Employment Advisors (DEAs)

Strategy for England ) Diagnosis– Local appointment of a lead professional to develop a local diagnostic and assessment services for adults with ASC National Institute of Clinical Excellence (NICE) to develop model care pathways to form the foundation of local referral and care pathways A diagnosis of autism will trigger a community care assessment and a carer’s assessment Statutory guidance to set out the type of information that should be provided to adults with ASC and their parents/carers once they have been diagnosed

Strategy for England ) Improving Access To Services– Dep.Health to develop guidance for mental health and learning disability services on “reasonable adjustments” for adults with autism Local authorities to work with the third sector to support development of advocacy and buddying schemes Travel training to be made available nationwide for all adults with autism Work to ensure transition planning gives people with autism the right start in adult life Clarification of types of support that students with autism can pay for with Disabled Students Allowance

Strategy for England ) Helping Adults Into Work– ASC training for all Disability Employment Advisors (DEAs) Many of the measures in Valuing Employment Now are designed to meet people with autism even when they don’t have a learning disability New actions and initiatives from Work, Recovery and Inclusion to be available to support adults with autism Work to increase employer awareness

Strategy for England ) Service Development – Each local area to develop a local commissioning plan DH work with regional partners to develop regional delivery plans Local authorities to appoint a lead with responsibility for autism Recommendation for local planning groups Recommendation for local autism teams Involvement of adults with autism and parents/carers DH to develop “protocol” on recording and sharing information Homes and Communities Agency include autism in forthcoming guidance on housing standards

Summary: 1)Many advances over the last few years 2)Many changes / improvements due to come on-line soon 3)UK Government changes may endanger this