The Senior Officer, Strategy, Change and Delivery, NHS Bradford District and Craven Clinical Commissioning Group will submit a report (Document “A”) which provides an update on the current state vis-à-vis adult autism and also provides a synopsis of the work planned to address ‘all age autism’ and therefore, address some of the challenges that are outlined in this paper.

Recommended –

(1)       The challenges regarding adult autism are discussed and noted.

(2)       The development of an ‘all age’ pathway that is prefaced with   stronger prevention and early help is endorsed.

(Ali-Jan Haider - 01274 237290)

The Senior Officer, Strategy, Change and Delivery, NHS Bradford District and Craven Clinical Commissioning Group submitted a report (Document “A”) which provided an update on the current state regarding adult autism and also provided a synopsis of the work planned to address ‘all age autism’ and address some of the challenges that were outlined in the report. 

Members were reminded that the issue had been discussed previously, in October 2019 when assurances had been provided that the Bradford/Airedale Neurodevelopmental Service (BANDS) list would be reopened and the backlog of people waiting for assessment would be cleared.  It was confirmed that the BANDS list had reopened and whilst challenges had been experienced due to the pandemic the service had responded in an agile manner and continued to provide the services needed.  Alternative software had been utilised to accelerate the assessment process and self-referral pathway.  Recruitments had also been made to the BANDS team.  Bradford District Care Trust and the Clinical Commissioning Group were working together to improve services.

It was reported that, in response to feedback, and to familiarise General Practitioners (GPs) with the dynamics of autism, a top tips leaflet had been developed.  It was explained that demand for assessment and diagnoses continued to rise both locally and nationally and a national all age autism strategy had been developed.

A dedicated manager had been recruited to investigate funding from existing models locally and across West Yorkshire and beyond.  Initiatives to address the issue alternatively to augment what was already in place were reported. 

Following a detailed presentation Members raised grave concerns that the situation had not improved since the report had been presented previously.  It did not appear, despite previous assurances, that additional funding had been provided and the extensive backlog of people waiting for assessment had been cleared.

Assurances that people waiting for diagnosis would be able to access the benefits that a diagnosis would provide were of no comfort as it was felt that without assistance someone with a less visible condition may be unable to comply with the specifics required and would lose that funding.

It was questioned if any lessons had been learned from the acute distress of people who had been unable to access the waiting list for assessment and what had happened to funding invested in a firm contracted to address the back log on the waiting list. 

Members queried when the service had re-opened the waiting list; what extent had the GPs involvement had on the 359 referrals on the waiting list; what would a ‘normal’ rate of referral be and what was the conversation rate from referral to a diagnosis.

It was stated that of the issues raised by constituents mental health was raised the most.  Autism was raised most frequently and residents, concerned that their GPs had been unable to help, had asked ward councillors for help. 

A Member stated his unease when he heard additional administrative arrangements were being developed and stressed that people were needed to deal with the problems and not additional administrators.

A co-opted Member referred to the National Autistic Society’s view that people would still be eligible for benefits without a formal diagnosis and reported incidents of people who had been assessed and awarded a lifetime award, many years ago, losing their benefits when Personal Independence Payments had been introduced.  Those people had lost everything and were in a state of panic when having to access places such as Job Centres.  It was acknowledged that some organisations were autism friendly but the Department of Work and Pensions and job centres were not.  It was suggested that pressure be applied on those organisations to provide autism awareness training.

A Member with considerable experience of the issues being discussed found it difficult to see any progress had been made and expressed concern that young people with a diagnosis fell off the radar when they reached adulthood as there were currently no services to them.

In response the Senior Officer, Strategy, Change and Delivery, apologised that he had articulated incorrectly.  He explained that a backlog on the waiting list had been cleared and those now waiting for assessment were new.  A sum of £125,000 had been invested and assessments had been completed as promised. The list had re-opened in 2020 and since that time demand had increased.

Additional administrative arrangements would not delay assessments but would find out more about adult autism and assess if the best systems were in place.  They would also help the service learn lessons and make improvements. 

He maintained that the difficulties children faced whilst transitioning to adulthood had been recognised and a strong business case had been presented to the Partnership Board.  That case would be considered along with other priorities.  It had been a challenge to recruit the right staff and colleagues in Social Care had provided assurances that services would be provided to people if needed regardless of formal diagnosis.

A co-opted Member referred to previous presentations to the committee and intentions to fast track to a shorter assessment process.  She questioned if that had occurred and why, when it was known that referrals would flood in, staffing resources had not been put in place It was also queried if the waiting list remained open at the current time.

In response it was reported that an analysis of the assessment process had been conducted and it had been found that a ‘gold’ standard was provided whilst a ‘silver’ would be effective.  Staff issues had occurred when Care Trust employees had left and the service was taken on by a new team.

Resource issues had prevented additional staff being put in place, however, a plan had been developed to address the waiting list and future demand.  The presentation to follow would discuss the work of the creation of the Mental Health, Learning Disabilities and Autism Board. 

Following additional questions, it was explained that there were two professionals in each of the autism and ADHD assessment teams.  The demand did not immediately increase on reopening of the assessments but there had been a significant increase across neurodiversity corresponding to the lockdown. 

Resolved –

That an update report, to include case studies illustrating people moving through the autism pathway, be presented to the Committee in six months.

Action: Senior Officer, Change and Delivery