Leicester, Leicestershire and Rutland Autism Strategy Group Delivery Action Plan for the Autism Strategy and the Diagnostic and Support Pathway

Transcription

1 Leicester, Leicestershire and Rutland Autism Strategy Group Delivery Action Plan for the Autism Strategy and the Diagnostic and Support Pathway Forward notes This group has evolved from the LLR Asperger Strategy planning group following publication of the National Strategy entitled Fulfilling and Rewarding Lives: The Strategy Group aims to link across the three pathways Children, Transition and Adults and have oversight of the implementation of the Overarching pathway. The local strategy is aligned to the National Strategy and the guidance (extracts below). The Action Plan details the development work with the commissioning intentions and the actions to progress the work. Details of progress are recorded with review dates to ensure outstanding actions are followed up. A resume of the Commissioning Intentions has been compiled for ease of reference. clinical guideline 142 Extract from the Introduction Autism: recognition, referral, diagnosis and management of adults on the autism spectrum. (The local Pathway is linked across Children s and Adult Services) When the diagnostic assessment process works well, professionals, the person with autism and their family, partner or carer(s) communicate right from the start and the person with autism is involved in the decisions relating to their care. This lays the foundation for a longterm understanding between the person with autism, their family, partner or carer(s) and the professionals supporting their needs. However, many adults with suspected autism have difficulties accessing a diagnostic assessment. Even if they manage to obtain a diagnosis they may receive no follow-up support because of the absence of appropriate services or an agreed care pathway. In this guideline 'autism' refers to 'autism spectrum disorders' encompassing autism, Asperger's syndrome and atypical autism (or pervasive developmental disorder not otherwise specified). Page 1 of 17

2 Implementing Fulfilling and Rewarding Lives Structure of the national guidance The Autism Act required that guidance covers the following: 1. the provision of relevant services for the purpose of diagnosing autistic spectrum conditions in adults 2. the identification of adults with autism 3. the assessment of the needs of adults with autism for relevant services 4. planning in relation to the provision of relevant services to people with autism as they move from being children to adults 5. other planning in relation to the provision of relevant services to adults with autism 6. the training of staff who provide relevant services to adults with autism 7. local arrangements for leadership in relation to the provision of relevant services to adults with autism. However, there is no requirement under the Act that these seven areas are covered separately. Therefore, in recognition of the fact that there are important links between some of these areas, this guidance is structured as follows: A. Training of staff who provide services to adults with autism covering item 6 above B. Identification and diagnosis of autism in adults, leading to assessment of needs for relevant services covering items 2, 1 and 3 above C. Planning in relation to the provision of services to people with autism as they move from being children to adults covering item 4 above. D. Local planning and leadership in relation to the provision of services for adults with autism covering items 5 and 7 above This structure helps clarify the links between these areas and simplifies the guidance. It also ensures the guidance is more clearly focused on the outcomes we seek. Page 2 of 17

3 Delivery Action Plan for Autism Strategy 1. Implement the pathway for diagnosis and ensure it is followed by the offer of a personalised needs assessment and appropriate support. 1. Commissioning intention: Ensure sufficient resources are available across the whole pathway in Learning Disabilities and Mental Health (children / transition / adult / older people) for diagnosis and ongoing support. No Delivery Partnership / programme of work The current planning Group to become the Multi-agency Strategy group to oversee the implementation of the Autism Pathway Develop the Mental health side of the Diagnostic and support pathway, & link across to the expertise in LD services Page 3 of Autism Strategy group to develop close links with CCG s. 2. Lead Commissioners to negotiate the commissioning priorities with CCG s, with particular emphasis on the mental health diagnostic and support service 3. Practical Guide for Clinical Commissioning Groups to support health 1. Autism Strategy group meetings planned through Completed 2. LLR mental health & learning Disability Clinical Commissioning Sub-group approved temporary funding for 1.5 days for Diagnostic clinic, and Specification for support service to Aug. meeting. 3. Feedback on 1.Commissioning Intentions to be taken to the Commissioning Boards. 2. to be monitored via Strategy Group meetings The autism strategy group should develop local care pathways that promote access to services for all adults with autism, including: people with coexisting physical and mental disorders (including substance misuse) In each area a specialist community-based multidisciplinary team for adults with autism should be established The autism team should have a 1. Completed January Mar 4 th 3. Completed May 7 th 2013

4 No Delivery Partnership / programme of work 2.1 A new proposed objective for the Action plan - Self Harm which links with evidence of higher figures within the college age group. Consider links with ASD professionals implementing the Adult Autism Strategy Statutory and Guidelines on Diagnostic Services 4. Report to Health & Wellbeing Boards. draft document to Region by May 7 th This evidence comes from Liaison Psychiatry & Samaritans. 4. Reports have been to H&WB following completion of the Self-Assessment Framework City 8/10/13 Rutland 26/11/13 3. MW to bring the audit outcomes from the Suicide Prevention Group to the next meeting. Next update when the new National Strategy is launched key role in the delivery and coordination of: specialist diagnostic & assessment services & specialist care and interventions 4. Completed Oct/Nov Page 4 of 17

5 No Delivery Partnership / programme of work 3. Review and develop the information people receive on: 1.The Pathway 2. When diagnosed 3. Support 4. Carers 5. Training Sources of Information: 1. Leicestershire Autism Information Hub 2. LA s x 3 inc Transitions 3. LPT LD & MH adult, CAMHS and children. 4. Ind. & Vol Sector Link with Service provision and Carers information Communication work stream to draw up a Comms Strategy and work on web links for LPT platform. Link with front line practitioners, users and carers for ongoing feedback. 1. Ensure feedback mechanism via assessment process. 2. to be monitored via Strategy Group meetings Ensure that comprehensive information about the nature of, and interventions and services for, their difficulties is available in an appropriate language or format (including various visual, verbal and aural, easy-read, and different colour and font formats) 1. Mar 3rd 2. Mar 3rd 4. Consider how to develop a Register of people with ASD, to facilitate the mapping and planning of services & link with Winterbourne requirements Liaison between CCG, LA s LPT & LD Register and see if it can redeveloped to include ASD in some way. Suggested base in Primary care linked with Reed coding. Needs to link to ASC & Public Health CCG have indicated an intention to Decommission the current LD register. 1.Evidence required to demonstrate the practical application of the Register alongside. 2. Ongoing work by CCG & LPT with LA & UHL involvement Recommended by the Autism Act and the Winterbourne Concordat. 4. Mar 4 th 2. Increase awareness and understanding of Autism among frontline professionals. Page 5 of 17

6 2. Commissioning intention: Increase in provision of training, the development of training & quality accreditation for the training. No Delivery Partnership / programme of work 5. Review who has received training to date, identify priorities for future training. 6. Review future delivery structure and processes for the local training programme. 7. Commissioned provider to report progress to group after a further six months of service Autism LLR Strategy group, Local Authorities & NHS Statutory learning & development teams All providers to aim for each organisation to promote Autism E- learning as mandatory training for all new staff New training packages nearing completion Tier A Awareness e- learning Assessment e- learning staff whose main focus is Autism Tier B 1 day course front line staff (Inspired) Tier C 2 day course staff whose main work focus is Autism. Contracts to be extended. 1.Good progress reported in SAF 2. Is Accreditation still being sought from LPT Academy? 3. Ensure accessibility to training all areas in voluntary and private sector The autism strategy group should design local care pathways that provide an integrated programme of care across all care settings 1. Mar 4th 2. Mar 4th 3.Nov 4th The ASD training to Page 6 of 17

7 No Delivery Partnership / programme of work 8. Ensure workforce plans/ training plans & contracts include reference to Autism specific training. children s professionals is organised through Lisa Anderson at the Greenwood. Dr Khalid Karim provides that and there bespoke training is provided as requested. CAMHS LD provides some other training and there is training provided to parents by CAMHS as part of the group work programme. We only have the standard resources available in CAMHS to organise this so it is not comprehensive The autism team should have a key role in the delivery of: advice and training to other health and social care professionals on the diagnosis, assessment, care and interventions for adults with autism (as not all may be in the care of a specialist team) Page 7 of 17

8 3. Improve access to services and support so people can live independently within the community. 3.1 Commissioning intention: The Personalisation processes to reflect the specific needs of people with Autism, to ensure there are good quality, affordable services & support available for people to purchase through personal budgets and self-funding. 3.1 Personalisation - choice and control No Delivery Partnership / Review date Page 8 of 17

9 9. No Delivery Partnership / Review the progress of current providers, who may need to skill up staff & promote appropriate training for new providers and PA s Market Development Team / Right to Control Monitor increased up take of Personal Budgets / service packages via IT systems. New DP pathway completed in City 1. Liaise with Market Development Team / SCPU to promote support mechanisms appropriate for people with Autism (Individual Service Funds) The autism strategy group should design local care pathways that promote a range of evidence-based interventions at each step in the pathway and support adults with autism in their choice of interventions Review date 1. Mar 4th 10. Identify what support people with Autism will require to make best use of personal budgets. Ensure that self-assessment questionnaires and the process for assessment for self-directed support takes into account the needs of adults with Autism Personalisation Programmes Autism LLR Planning Group County to employ Training +Delivery by specialist workers feedback & other training to be cascaded to staff Liaise with Market Development Team / SCPU to promote support mechanisms appropriate for people with Autism (Individual Service Funds) minimise the need for transition between different services or providers 1. Mar 4 th Page 9 of 17

10 No Delivery Partnership / Review date 11. Market development: Availability of appropriate, skilled, good quality, affordable services & support Personalisation Programmes Choose My Support is available for County. From 1/4/14 the City will have an Online Directory of providers. They will no longer contract with Choose my support. The city directory will need to link to the HUB and LPT platform 1. May Page 10 of 17

11 3. Improve access to services and support so people can live independently within the community. 3.2 Commissioning intention: Continue to develop local providers and social landlords to provide quality accommodation & support with an Autism focus. 3.2 Supported living No Delivery Partnership / 12. Ensure the needs of people with Autism are explicit in relevant housing strategies 13. Encourage and develop options to support people locally who are currently in out of area placements 1. Link with Supported Living Strategy 2. NHS & Local Authorities & District Councils 1. Use of Autism specific resources Living in the Community- Housing Design for Adults with Autism Andrew Brand SAF data has shown movement to supported living Small, local communitybased units with well-supported single person accommodation 1. Sept 2nd 2. Sept 2nd Consider support for offenders. 3. Improve access to services and support so people can live independently within the community. Page 11 of 17

12 3.3 Commissioning intention: Continue to support & develop local providers and educational establishments, and social group s with an Autism focus 3.3 Something meaningful to do, leisure, social activities, lifelong learning (excluding employment) No Delivery Partnership / 14. Engage with local Colleges of Further Education and Universities on the needs of people with Autism 15. Need to address the issues for those who wish to access education but may not be able to improve their level of education. Page 12 of 17 Ensure access as required to training for staff Inspire and HUB/NAS providing ongoing training and advice and information to a range of educational institutions. Autism lead to maintain profile of educational needs 1. Student Mental Health group currently undertaking work with Universities across LLR 2. Training completed with Universities Trent, DMU, Leicester, Leicester City College West Leicestershire Mind Remploy Stephenson College - staff & peer 1. Access to college arise if there are significant behavioural challenges. 2. LDPB/MHPB City have reps. from further Ed. Link with Transition work streams from County Monitor & gather evidence of difficulties Encourage adults with autism to participate in self-help or support groups or access oneto-one support, and provide support so that they can attend meetings and engage in the activities. Link with the Leics careers service 1. Jul 1st 1. Mar 4 th

13 3. Improve access to services and support so people can live independently within the community. 3.4 Commissioning intention Continue to support & develop universal providers and ensure they have an understanding of Autism 3.4 Access to universal services No Delivery Partnership / 16. Provision of good accessible information Local Authorities & NHS 1.Review advice & information streams 2. A Communication work-stream is being led by LPT & will develop a Strategy to ensure a wide range of accessible mediums for communication Communication group delayed in action to report in Jan Ensure that comprehensive information about the services for, their difficulties is available in an appropriate language or format 1. Mar 4 th 17. Champions Network LLR All areas HUB is maintaining network links with champions & circulating information 1. Develop & maintain Champions network - review in 6 months 1. Jan 7th Making available training, resources and information Local Authorities & NHS Refreshing information & monitoring progress Page 13 of 17

14 No Delivery Partnership / for universal providers 19. Involving people with Autism, partners, parents and carers in identifying what makes an accessible service Local Authorities Partnership Boards & Transition work streams. 1. Develop information streams. User and carer feedback within the SAF To collate comments & feed into the ongoing development of the Autism Pathway There should be a single point of referral for adults with autism. 1. Mar 3rd 3. Improve access to services and support so people can live independently within the community. 3.5 Commissioning Intention Help people into work and support them at work. 3.5 Access to work No Delivery Partnership / actions 20. Raise awareness /provide guidance on making reasonable adjustments under Disability Discrimination Act specific to people with Autism LLR mental health employment group Local employment service providers are familiar with the draft standards for supported employment. Data included in the SAF. Review with providers For adults with autism without a learning disability or with a mild 1. Mar 4 th Page 14 of 17

15 21. Raising awareness with employers & ensure workers have a good understanding of the needs of people with Autism 22. Health & Social Care as exemplar employers 23. Raise awareness with Voluntary groups to encourage those with Autism to volunteer Champions network Engage with providers for information & training City Link with Right to Control. Link with Transitions work stream. Local Authorities & NHS LLR mental health employment group Champions network Those linked to the employment group have been made aware of the standards. All schools doing Person Centred Transition Reviews including employment. learning disability, who are having difficulty obtaining or maintaining employment, consider an individual supported employment programme Encourage adults with autism to participate in self-help or support groups or access oneto-one support, and provide support so that they can attend meetings and engage in the activities. Page 15 of 17

16 4. Consider the role of family carers and the support they need 4. Commissioning Intention Support carers as identified in the Pathway in their caring role No Delivery Partnership / actions Ensure identification of carers & an increase numbers of Carers offered an assessment, automatic offer when people are diagnosed with Autism Ensuring staff carrying out carer assessments have undertaken Autism training 26. Ensuring Carers have access to good information about support and services, including advice regarding health & wellbeing 27. Ensuring Carers are able to access support services when they need it. 28. Offering annual health checks to Carers Local Authorities & NHS Local Authorities Local Authorities & NHS (link with action 3) Local Authorities & NHS Pilot in the County 1.Refresh of LLR Carers Strategy Completed Appointed a Care project worker in Leicester to progress 3. ASD Carer Support group established, based in City meeting bi-monthly. Supported by ASC Commissioning and The carer s Centre 4. Carer forum established in City fed into SAF. 5. Developing a Carer Health Check Service awaiting audit information Refresh to begin towards end All health and social care professionals providing care and support for adults with autism and their families, partners and carers should ensure that they are: familiar with recognised local and national sources of information and/or support for people with autism 1. Nov 2. Nov 3. Completed December Mar 4 th 5. Mar 4th 2013 Page 16 of 17

17 5. Work with local partners to plan and develop appropriate services for adults with autism to meet identified needs and priorities. No Delivery Partnership / Review date 29. Refresh the Joint Strategic Needs Assessment - make explicit all types of disability including Autism from JSpNA Local Authorities & NHS, with Public Health (and for City Dr. Jane Bethea) JSpNA in progress in the city. County? Rutland? 1.Planned into JSNA & JSpNA work programme with Public Health 1.Mar 4th 30 Undertake further research identifying people in criminal justice system Local Authorities & NHS & Regional Autism group CJS conference in October 13 Completed Out reach services funding a post 1 day a week in CJS. ASD Training completed in Leic. Prison 1.Planned into JSNA work programme with Public Health In progress. Further liaison planned with Police. Some may have contact with the criminal justice system, as either victims of crime or offenders, and it is important that their needs are recognised 1.May 31. Complete annual Self- Assessment Local Authorities & NHS Planning in progress SAF documents submitted end of Sept Complet ed Page 17 of 17