The advantages of specialist autism teams

The autism strategy suggests councils need only consider developing specialist teams. But some argue the evidence is there to roll them out nationally, writes Jeremy Dunning

When the autism strategy was published in March it failed to make the establishment of specialist autism teams a requirement for all local authorities.

It acknowledged that, in most areas, services for autistic adults were provided by learning disability or mental health teams but excluded many people with autism from support. But the strategy, Fulfilled and Rewarding Lives, merely asked councils to consider setting up specialist teams, of which examples exist in every government region, to help build capacity locally in autism services.

This was despite a widespread clamour, including from the National Autistic Society, for their establishment everywhere.

Evidence cited included a National Audit Office report last June, which found that specialist teams improved outcomes and, over time, saved money.

Dimensions, the UK’s biggest adult autism support provider, was disappointed and still believes the strategy will be less successful without teams being a requirement.

Lisa Hopkins, director of specialist development, says: “Each local area needs to do what’s right for them. Each area has its own demographics and priorities, but the NAO report says there is a pretty decent business case to be made for the cost-effectiveness of local teams.

“Many local authorities will address this in the right way, but in other areas nothing will happen, nothing will change.”

The strategy will remain intact whoever wins this week’s general election.

An autism strategy is a requirement under the Autism Act 2009, which received cross-party support, while the new government is also mandated to produce statutory guidance on it by the end of this year.

The strategy did not deny the merits of teams and referenced the work of some of them as examples of good practice.

However, it said there was a lack of evidence about the most effective models because services had been developed to reflect local needs and priorities.

Instead, it said the Department of Health would continue to identify best practice and promote effective service models in the forthcoming statutory guidance.

Phil Hope, care services minister, says: “We want to be sure there are good diagnostic services for people with autism across the areas, that people are accessing services where they currently aren’t and where providers and frontline professionals understand the problems people with autism face.”

However, he says that introducing specialist teams is not the whole answer. The National Autistic Society supports the current direction being taken by government, in terms of encouraging – though not mandating – the setting up of teams.

Policy officer Sarah Lambert says: “There’s clear direction from the Department of Health that teams do deliver results.”

Laura Hickman, Asperger’s syndrome sufferer: ‘I can phone my case worker if I’m having a crisis ‘

Laura Hickman appears to be like any other 18-year-old. She has her dreams of a fulfilling and absorbing life and is in the foundation year of an NVQ in business administration at Ashfield School in Kirkby-in-Ashfield, Nottinghamshire.

In other respects, she is different from other teenagers. Diagnosed with Asperger’s syndrome, she finds it difficult to make sense of the world and has problems with communication and social interaction.

At times she struggles to explain herself to others, which can lead to serious misunderstandings or crises.

It has also been difficult for her to adapt to the transfer from Bracken Hill, a special state-funded school in Nottingham, to mainstream education.

And this is where Nottinghamshire’s specialist adults with Asperger’s team and her case worker, Cheryl Mason, have been vital to both her and her mother, Tracy, since last autumn.

Tracy contacted the team to discuss support options when Laura, who also has diabetes, was still 17 and about to transfer from children’s to adults’ services.

Since then a strong bond has been forged between the three. Laura feels she can phone Mason for help whenever she is in the middle of a crisis and Tracy phones fortnightly to generally “let steam off”.

Without the team, which consists of five full-time staff and manager Chris Mitchell, it is unlikely Laura would have made such progress.

Laura says: “It’s provided help and support and it’s a good service and I think there should be more of them because you don’t get a lot of help if you’ve got Asperger’s. Cheryl’s been there for me from day one. She’s sorted out a plan.

“She’s worked with members of the family and she’s supported me and other people who work with me. I see her whenever I want to. I can phone her if I’m having a crisis and if she’s free she will come up and see me and if it’s urgent she will come up and see me straight away.”

Laura adds: “She’s helped me to say to myself what to do, when to socialise, and how to socialise and she knows how intimidating it can be when I don’t know how to.”

For example, Laura was provided with information about a social group for 16- to 25-year-olds with learning disabilities that she attends once a week.

Now she says she wants to be an ambassador for other people with Asperger’s and speak out for more help for sufferers.

The team sees on average three referrals a week and Laura is one of more than 175 people on its varied caseload.

Support ranges from advice and assistance in getting a diagnosis, to community care assessments and help with benefits.

It also focuses on quality of life issues, such as help with finding suitable accommodation and related support, advice and help with using leisure facilities and information about self-help groups, social groups and groups for carers.

Nottinghamshire is also unusual among specialist teams in being social care-led and considers people’s needs in an holistic way based on a person-centred assessment.

Team member John Stronach says: “We are able to put in support packages, which are having a positive effect on the person’s life whether you are putting in more support hours to develop their independent skills or to have more social interaction, which helps build their confidence.”

There are plans to expand the service. The council is about to advertise for two employment advisers who will work closely with the team. It is also waiting for a further commitment from Nottinghamshire Primary Care Trust on whether it will fund clinical professionals to work as part of an integrated care team.

An online Asperger’s directory – essentially a one-stop shop of available services – has also been launched as a result of a collaborative effort between the team and the Nottingham Regional Society for Adults and Children with Autism.

Other autism teams

Windsor and Maidenhead adult autistic spectrum disorder team

● Consists of team manager, care manager and assistant care manager.

● Helps clients access meaningful activities, employment and housing, providing one-to-one and group work.

● Deals with about 50 adults at once.

 More on the Windsor team

Somerset Asperger syndrome consultancy service

● Consists of team manager, social worker, community nurse and two clinical psychologists.

● Provides diagnosis and training for other professionals.

● Has dealt with 300 referrals since its establishment in 2005, typically from community mental health teams.

More on the Somerset service

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