Post on 18-Dec-2015
Service Provision – UK
Outline:
1)Overview of UK service
provision
2)The “I Exist” report - 2008
3)The Adult Autism Act - 2010
Service Provision
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 ProvisionService 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
Service ProvisionThe “I Exist” Report: 2008
1) 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
Service ProvisionThe “I Exist” Report: 2008
4) Responsesa) 2,600 individualsb) 770 parents carersc) 53 LA (35%)d) 24 PCT (16%)
5) Key Findings?
Service ProvisionThe “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
Service ProvisionThe “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
Service ProvisionThe “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
Service ProvisionThe “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 …….
Service ProvisionThe Autism Act – 2009/2010
1) Put a duty in legislation on the UK Government to produce a strategy by April 2010 - 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
Service ProvisionStrategy for England - 2010
Five main areas of focus –
1) Awareness and understanding 2) Diagnosis 3) Access to services and support 4) Helping adults into work5) Service development
Service ProvisionStrategy for England - 2010
1)Awareness and understanding –
ASC to be included in the core training curricula for doctors, nurses and other cliniciansASC training to be part of training for staff involved with a) community care assessmentsb) criminal justice systemc) all disability employment advisors (DEAs)
Service ProvisionStrategy for England - 2010
2) 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 pathwaysDiagnosis will trigger a community care assessmentStatutory 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
Service ProvisionStrategy for England - 2010
3) Improving Access To Services–
a) Dep.Health to develop guidance for mental health and learning disability services on “reasonable adjustments” for adults with autismb) Local authorities to work with the third sector to support development of advocacy and buddying schemesc) Clarification of types of support that students with autism can pay for with Disabled Students Allowance
Service ProvisionStrategy for England - 2010
4) Helping Adults Into Work–
a) ASC training for all Disability Employment Advisors (DEAs)b) Many of the measures in Valuing Employment Now are new actions and initiatives from Work, Recovery and Inclusion to be available to support adults with autismd) Work to increase employer awareness
Service ProvisionStrategy for England - 2010
5) Service Development –
a) Each local area to develop a local commissioning plan b) DH work with regional partners to develop regional delivery plansc) Local authorities to appoint a lead with responsibility for autismd) DH to develop “protocol” on recording and sharing information