The report of the Senior Officer, Strategy, Change and Delivery, NHS Bradford District and Craven Clinical Commissioning Group (Document “U”) describes the Adult Autism pathway, shares experiences of patients through case studies, and summarises the position in relation to improvements to the assessment and diagnosis of autism spectrum disorder (ASD) in adults in Bradford, District and Craven.

In particular, the report details the plan agreed at the MH, LD and ND Programme Board and progress on implementation. The Adult Autism Plan, as focusses on 3 key areas:

1.    Continue to strengthen the Autism Assessment Pathway (adults) through expanding existing BANDS service to increase capacity and patient throughput

2.    Engage with NHS and independent providers for rapid, short term, expansion in capacity for clinical assessments

3.    Engage with ICS to explore system approaches to ASD assessment and diagnosis

Recommended –

Members are asked to support Option 1, to allow BDCFT/BANDS a reasonable period to strengthen the staff team, increase activity and improve outcomes.  Waiting times will also be reduced through outsourcing.

(Ali-Jan Haider – 01274 256083)

The report of the Senior Officer, Strategy, Change and Delivery, NHS Bradford District and Craven Clinical Commissioning Group (Document “U”) described the Adult Autism pathway, the shared experiences of patients through case studies, and summarised the position in relation to improvements to the assessment and diagnosis of autism spectrum disorder (ASD) in adults in Bradford, District and Craven.

In particular, the report detailed the plan agreed at the MH, LD and ND Programme Board and progress on implementation. The Adult Autism Plan, as focusses on 3 key areas:

• Continue to strengthen the Autism Assessment Pathway (adults) through expanding existing BANDS service to increase capacity and patient throughput;
• Engage with NHS and independent providers for rapid, short term, expansion in capacity for clinical assessments; and,
• Engage with ICS to explore system approaches to ASD assessment and diagnosis.

The Strategic Director, Keeping Well at Home was present and joined with the invitation of the Chair, gave a monologue of the report to the committee. He stated that autism was a lifelong neurodevelopmental condition, the core features of which were persistent difficulties in social interaction and communication and the presence of stereotypic (rigid and repetitive) behaviours, resistance to change or restricted interests. The way that autism was expressed in individual people differed at different stages of life, in response to interventions, and with the presence of coexisting conditions such as learning disabilities (also called 'intellectual disabilities'). People with autism also commonly experienced difficulty with cognitive and behavioural flexibility, altered sensory sensitivity, sensory processing difficulties and emotional regulation difficulties. The features of autism ranged from mild to severe and possibly fluctuated over time or in response to changes in circumstances.

In reference to the demand of service, in particular, provisions were put in place to provide assessment, diagnosis and support for those with Autistic Spectrum Disorder. To provide support to other organisations to identify and meet the needs of adults with ASD. The service had reduced the central intake in order to improve access to service for the reduction of waiting lists and times for people to access services for the purpose of expansion and strengthening provisions since the announcement. The service had presented to the Medical Health Learning Disability and Neuro Diversity Programme Awards to reduce expenses in the autism assessment pathway for adults, through expanding the existing demand services to increase capacity and secondly, to engage independent providers for rapid short term expansion of capacity for clinical assessments. To fully reduce the waste in this short period of time as possible, and thirdly, to engage with the integrated system to explore system approaches to ASD assessment and diagnosis. Attention was focused on best practice and opportunities from a system perspective.

The actions were based on the comments, questions, suggestions and the challenges that had been brought to the service following examination and identifying sources of additional Family Support Service. Therefore, further financial sources of funding had been identified, (a) £374,000 NHSE Transformation Fund Allocation, over 2 years b; (b) £100,000 CCG non-recurring funds to outsource 100 assessments to SWYFT; and, (c) £100,000 BDCFT non-recurring funds to outsource assessments to independent sector.

A Recruitment Plan with explicit timelines was being followed that entailed, (a) 1x band 8b Psychology post (1 WTE); (b) 1 x Consultant Psychiatrist (.2 WTE); (c) 1x Band 4 Support worker (1 WTE); (d) 1x band 3 Admin/Support (.5 WTE); and, (e) The recruitment would create an MDT in Bradford to diagnose as per best practice. Staff to be in post by July 2022.

A question and answer session ensued:

·         Were the Lead Autism and the Assistant Autism Clinical, both expert clinicians who had specialist knowledge and training in Autism, now permanent members of the Autism Clinical Team?

o   Yes, they were part of the core members of permanent staff;

·         What was the purpose of the Carers’ Resources Service? 

o   This service provided support for carers who were defined as people who, without payment, provided help and support to a friend, neighbour or relative who could not manage otherwise owing to frailty, illness or disability; and,

·         Was the implementation of transformation of services in response to past experiences with people with autism?

o   Yes, this was part of the process for transformation of vital services. The prevalence data contained in the 2019 Public Health report, Learning Disability and Autism in Bradford - A Health Needs Assessment would be used to help understand potential demand for adult diagnosis services and could contextualise something of the challenge faced by commissioners and providers of services to support adults with needs linked to ASD.

o   Further to conversations with the Bradford District’s Autism Board in relation to the review of its work on key priorities, it was identified to work in consultation with partners across West Yorkshire in order to provide a positive and joint collaborative services to communities.

The Chair concluded the discussion on the item by stating that it was paramount for professionals to work in collaboration with elected members due to councillors being acquainted with their respective ward constituents and the services required for the community.

The committee expressed its appreciation for the detailed report as it set out clear explanations on work streams and thanked officers for their attendances.

Resolved: -

(1)  That Commissioners be requested to report back to this Committee in 12 months with the expectation that 80% (256) of the projected number of assessments will have been delivered.

(2)  That the report includes a plan to ensure the sustainability and continued improvement of the service.

Action: Senior Officer, Strategy, Change and Delivery, NHS Bradford District and Craven Clinical Commissioning Group