Agenda item

-       Steve Mulligan, Principal Educational Psychologist

Further to Minute No. 19 of the meeting of the Health Select Commission held on 11^th July, 2013, Steve Mulligan (Principal Educational Psychologist) gave a presentation about the progress of the implementation of the actions arising from the scrutiny review of autistic spectrum disorder (ASD). The various issues highlighted were:-

Scrutiny Review: September-November, 2012

Objectives of the Review

-          The reasons for the higher diagnosis rates

-          Services required at diagnosis stage and after

-          16plus (pupils leaving school) support and transition

-          Budget implications

Final Recommendations

-          That the Autism Communication Team (ACT) continue to co-ordinate the monitoring and intelligence of ASD rates of diagnosis in Rotherham and partner agencies be requested to share information to facilitate this being done accurately. ACT should also ensure that partner agencies have access to this compiled information;

Local and regional data continued to be collected and shared across Education and Health.  CAMHS and the Local Authority have improved their dialogue via regular meetings during the past four months.  The most recent figures, collated to October, 2013, were:-

Mainstream                    1,015

Special                               192

Total                                1,207

-          That the Rotherham Child Development Centre (CDC) and the Child and Adolescent Mental Health Services (CAMHS) bring forward proposals to streamline their assessment processes and reduce waiting lists.  In particular, transition referrals at age 5 years should be the subject of a clearly documented care plan that is shared with all partners and the family

CDC/CAMHS are physically located in the same building and complied with Diagnostic and Statistical Manual version5.  Waiting times are being reviewed and both CDC/CAMHS were examining pathways for the Autism Spectrum conditions, working with the Education Psychology Service.

-          That the Special Educational Needs reform project group is being asked to implement a pilot project for the development of Education, Health and Care plans for children with a diagnosis of ASD with a view to ensuring that in the future all children with a diagnosis will have a multi-agency care plan with a lead worker allocated

Education, Health and Care plans were being developed by the Local Authority group looking at Support and Aspiration under strategic leadership within the Council.  Pilot Education, Health and Care plans were being formulated in compliance with the new Code of Practice and the Children and Families Bill 2013

-          That proposals are brought forward to develop more wrap around family support to assist with the transition between different services (particularly post-5) and at different life stages.  This Service should recognise the vital role that parents and carers need to play in working with and influencing Service providers and should be developed in line with the commitments in the Partner and Child Charter

Continued work regarding the development and understanding of multi-element planning.  The principles of the Parent and Child Charter continue to be implemented and rolled out.  Development of the Early Years Charter

-          That the hierarchy of support within a mainstream setting with ACT and Educational Psychology concentrating on children with more complex needs, be formalised and further developed, including exploring the potential role of special schools to support mainstream schools with support for children with less complex needs

The ACT Team has been aligned to the Learning Support Service.  The funding of all the targeted Services was under a four-way review – High Needs Block, Learners First Review, Development of Integrated Pupil Services and Service Transformation;  proposal to appoint a staff member to build capacity as part of Service Transformation and a commissioning process to meet need, should enable progress to be made quickly.

-          That the Joint Strategic Needs Assessment include a detailed and thorough assessment of the needs of children and adults with autism including the identification of any gap in services

The ASC Scrutiny report would form the basis of the JSNA around autism.  Discussions at CAMHS planning meetings and a meeting to discuss joint commissioning on 19^th December, 2013.

-          In line with the JSNA, that commissioners consider the commissioning of Rotherham-based service for young people (16+) with ASD over the next 5 years, building on the good practice that already exists.  This would result in a reduction of out-of-authority placements

Continued work regarding post-16 provision included building capacity at local college, bespoke packages and joint venture partnerships with independent service providers.  The Director of Safeguarding was leading on work regarding out-of-authority placements

-          That a local care pathway for the management of ASD in adults should be developed in line with appropriate NICE guidelines

Discussions had taken place with Adult Services regarding Autism with Adults paper/pathways linked to the ASC Strategy Group

-          That RMBC identifies a ‘senior leader’ for the autism agenda who is able to challenge provision and raise the status of the condition.  The work should then be channelled through the Autism Strategy Group

Appropriate senior staff of the Council now fulfil these roles.

-          That commissioners should look at how a pathway of care can be resourced effectively and the CCG specifically whether a single diagnostic route would be more appropriate

Children and young people were diagnosed at different stages of their development. All systems must be NICE compliant.  Joint work EPS/CAMHS continued around pathways to reduce “noise” in the system.

As a consequence of the scrutiny review and the work of the local Autism Society, there is now greater awareness in Rotherham, improved communications and increased confidence in schools and services.

After the presentation, Members asked questions about the following matters:-

: the impact of CAMHS services (Members requested additional information about this matter);

: post-diagnosis treatment;

: 5 to 7 years age group;

: post-diagnostic support for families – the Rotherham Clinical Commissioning Group will ultimately be asked to provide funding for such support services;

: support for pupils with high functioning Asperger syndrome in schools.

Resolved:- (1) That the report be received and its contents noted.

(2) That a further progress report explaining the implementation of the actions arising from the scrutiny review of autistic spectrum disorder be submitted to a meeting of this Select Commission in six months’ time.