Pathway Overview Document

Transcription

1 Leicester, Leicestershire and Rutland Autism Pathway Pathway Overview Document Information for Services 1

2 Why an Autism Pathway? Autism is a lifelong Developmental Disability. People with Autism have significant levels of unmet need. There are currently notable service gaps, especially for adults who do not qualify for Learning Disability Services. Transition between Child and Adult Services remains challenging. Key recent policy drivers in this area o Autism Act (2009) o National Autism Strategy (2010) o NICE Guidance on Autism for Children and Young People CG128 (2011) and Adults CG142 (2012) Commissioning focus. Local Picture Locally, the LLR Autism Strategy Group has overall responsibility for steering the Direction of travel of services for people with Autism. Membership includes Social Care, Leicestershire Partnership NHS Trust, Primary Care, Commissioners, Education, Voluntary Sector Organisations, Users and Carers. The Group s remit is as follows: Establish a clear and effective system autism diagnosis. Establish a system for comprehensive needs assessment involving the individual with autism as well as the family. Ensure that good information about the support that is available to people. Ensure access to community opportunities and universal services as any other citizen. Ensuring that universal services know how to make reasonable adjustments for people with autism Access to personalised support if needed An effective response from providers of services and support To raise awareness of the condition Training for front-line services in how best to support people who have the condition. Development of the LLR Autism Pathway Following on from the above, a Pathway Group led by LPT and involving all interested parties was established. The overarching structure of the Pathway process is illustrated on the next page. 2

3 Pathway Overview 3

4 Within the umbrella of the LLR Pathway, separate work streams have produced Child, Transition and Adult Pathway Processes, designed to meet the needs of their particular populations while still following the overall process illustrated above. Regular meetings have been held to iron out process and interface issues, and to ensure clarity around transition points. The Pathway aims to standardise and align practice across disciplines and agencies, provide clarity on the roles of the different professionals and agencies involved, and ensure a multiagency approach. Key to this process has been two strategies: 1. Mapping Skills to Standards. 2. Multiagency Stepped Care Model. Mapping Skills to Standards A list of all key skills needed to work with people with Autism throughout the Pathway process was identified from current Guidelines. All agencies and professional groups involved in the Pathway were then consulted to determine for each skill: (a) who needed the skill, (b) the level of specialism of the skill and (c) any training available or required. Through this process, gaps in service provision were clearly identified, which could be brought to Commissioners attention. A Skills Grid was created to summarise this information, as in the example here: S.No Guideline Recommendation (NICE, SIGN, Adult Autism Strategy) Staff involved Staff skills required Training available/ required 1. Basic understanding of autism, its impact on social, educational and occupational functioning and the impact of environment on autism Primary and secondary care staff, Social care services Probation and Criminal Justice services Education and support services e.g. Leicestershire Student MH Network Generic Ability to consider the presence of autism, its complexity and diverse presentation and ability to refer cases that need further specialist diagnostic assessment / input Basic Awareness Training though an e-learning package. Package currently available for social care staff and to be made available for health staff as well. 4

5 Multiagency Stepped Care Model This approach is key to ensuring integration between agencies and, indeed, professionals within these agencies. Each professional group was tasked with defining its role(s) at each level or Tier of care and this information collated, allowing clarity of roles between professionals, and highlighting any overlaps in skill sets which could be reviewed to ensure best fit of care and maximise use of skills and resources. For example, relationship work for adults with LD and Autism could be undertaken by Community LD Nurses independently in simple cases, with support or joint working from LD Psychologists in more complex cases, while in those cases with higher levels of complexity / risk, the work would be led by the Psychologist. 4b: Forensic / out of area placement 4a: Intensive outpatient / inpatient care Management by generic services Self-guided / carer supported care Voluntary sector led Routine Outpatient care Measuring Outcomes The Pathway will only be successful if it meets the needs of the Service Users it serves. Measuring outcomes is an important part of monitoring the quality of services provided. Two overarching outcome measures have been integrated into the Pathway process, the Autism Outcome Star and the locally created LD PROM. 5

6 LD PROM Name of Service User: NHS Number: Outcome measures were agreed with (tick): service user carer (Name and relationship): What are the issues that we have agreed to work on? Issue/Problem Description Record the question you have asked about rating the issue here: Outcome measures are commenced at the Assessment of Need stage, as part of the conversation between the professional and service user / carer(s) around setting goals for intervention. The measure is then repeated during and at the end of the intervention process, to help ascertain progress made and need for further input. Commonly Asked Questions Q) When will the Pathway be complete? A) The Pathway is an on-going process, which will continue to change and develop over time. Accessing the online documentation will ensure you have the most up-to-date version at your fingertips. Q) Where can I find out more? A) The Pathway will be accessible through your local health and social care intranet facilities. More information can also be obtained through contacting the Leicestershire Autism Information Hub, Tel & 6