Agenda item

The Joint Overview and Scrutiny Committee is asked to consider and endorse the joint All Age Autism Strategy for Coventry and Warwickshire 2021-26.

The joint overview and scrutiny committee received a copy of the report considered and approved at Cabinet on 7 December. The report was introduced by Ali Cole, Joint Commissioner for Learning and Autism. She outlined the various bodies which had considered and approved or were due to consider this strategy.

She reminded of the helpful feedback received from this joint committee in October 2020, which had assisted in formulating the strategy, also speaking about the new national Autism strategy, which this strategy aligned with. She picked up the points from earlier debate around a focus on support and the strategy made a commitment that people could access support with or without a diagnosis. There had been a clear message from autistic people and their families that diagnosis was important to helping people understand themselves and their identity. Many autistic people lived independently without support. Further points raised that this was an all-age strategy, touching on the issues for adults with Autism, about how society could become more Autism friendly and inclusive. This strategy took a broad approach to creating inclusive communities, beyond health education and social services; the national strategy did likewise. There was no additional recurrent funding, but reference was made to the business case raised under the CWPT item.

Questions and comments were submitted with responses provided as indicated:

• Councillor Beetham spoke about working with employers and the need for reasonable adjustments to be made for autistic people. He asked how this was achieved if there wasn’t a diagnosis.  He referred to a section of the report on prevalence of Autism. The data for the Warwick and Nuneaton areas were similar despite Nuneaton having a much larger population and he sought an explanation of the reasons for this. The report stated there would be reduced demand if access to support was available. Ali Cole responded that a diagnosis would make employers aware that they might need to make adjustments. Feedback from autistic people consulted as part of the strategy showed that a diagnosis did not make enough of a difference. Autism was a spectrum condition with individual needs. The need for a public awareness raising campaign was stated, drawing comparison to that undertaken for dementia. A particular area referenced was the County Council and NHS organisations setting a good example as employers. On the point about prevalence, this was a topic both nationally and locally with the rates being higher than the 1.1% identified via a commissioning tool. There were a number of contributors why an Autism diagnosis was not captured reliably. Capturing data and building an evidence base were a priority within the strategy. A key priority was looking at the diagnostic pathway having regard to recent referral data.
• Councillor Humphreys spoke of the mislabelling of undiagnosed children as naughty. This could lead to a social stigma and additional problems, both for the child and their family. A recent case was used to highlight this. Ali Cole agreed that this demonstrated the need for awareness raising and the case outlined was not unique. When people received a diagnosis, it gave a deep understanding of how their child was thinking and sometimes making small adjustments helped significantly. The education role was a significant piece of work. Ali Cole spoke of the additional difficulties for autistic people in crisis due to a lack of social interaction, friendships or activities. It was important though that diagnostic waiting times were reduced.
• Councillor O’Donnell spoke about the transition from primary to secondary school, the potential for children to be cruel, the data on prevalence and the proportion of girls with Autism who masked it and were not detected for some time. Quicker diagnosis was needed, and she spoke of parents reaching crisis points whilst waiting for a diagnosis. Earlier diagnosis would enable adjustments in turn addressing disruptive behaviours. The sensory assessment work was welcomed.
• Councillor O’Donnell referred to the gaps in specialist services, asking how these were going to be addressed, given the lack of additional funding. She asked about the financial incentive for having an autism diagnosis. Finally, she asked about the priority four actions, specifically in regard to responsibility for care coordination between health and social care, to ensure that some people did not fall between services.
• Ali Cole responded to the points raised. On children’s cruel behaviour this showed the need to educate early and for a public awareness raising campaign to be more accepting of difference. There were initiatives focussed on girls masking their Autism and how to improve identification, including a pilot across Warwickshire, Solihull and Birmingham. Locally the diagnostic rates for males and females were broadly even which differed from the position in other areas. Reference to the business case looking at diagnosis and post diagnostic support, which included funding for speech and language therapy. There were some sources of non-recurrent funding, but no extra long-term funding from central government. Many autistic people may require high-cost services. A need to make a case, having signed up to the national strategy to move funding into earlier interventions. However, such funding was competing with many other health and care priorities. In terms of the financial incentives, a need to address myths and reliance on getting a diagnosis as part of the eligibility criteria. On the point about health and care responsibility, it was not just about funding, but also who had the relevant expertise. Amongst professionals, a concern about lack of skills, but between services agreeing who would support and ensuring they were equipped.
• Councillor Baxter-Payne asked if the new strategy would address the questions raised by residents previously at a meeting in Nuneaton and Bedworth, on their journey through the diagnostic pathway. Ali Cole considered that this strategy, coupled with the planned changes to the SEND programme would make a difference. Another area outside the scope of this strategy which needed addressing was the Tourette’s diagnostic pathway.
• Chris Bain of Healthwatch provided an overview of the feedback they had received and the challenges autistic people were facing. These concerned pressured care environments, with examples of several NHS services where autistic people found themselves in difficulty. People with multiple conditions had additional challenges and did not feel they were dealt with as a whole person, but with clinicians responding to individual conditions. The final area raised was autistic people with protected characteristics and/or with a physical disability, who had found it difficult to be understood and properly responded to.
• Councillor Beetham asked how the awareness raising would be undertaken, given that every person’s autism was different. The suggestion about training in schools was a good long-term strategy. Some people might not realise they were autistic. He also spoke about the employment aspects and support for those who were not in employment. Ali Cole responded about awareness raising, echoing the message about individualism. Some people thought differently, and society needed to be more accepting of difference. She thought that national awareness was starting to be seen, with an example being supermarkets offering a quiet time shopping experience.
• Reference to employment opportunities for people with Autism and/or learning disabilities. Many people on the Autism spectrum did not have a learning disability. They could undertake very responsible and high skill level professions with engineering roles referenced as an example and they had a lot to offer to employers. Where people also had a learning disability this could be more difficult. Reference to the employment support offer and helping employers to think of the small adjustments needed. There was not a need to create specific employment opportunities for people with Autism.
• Councillor Mills commented on the value of this session.

The Chair brought the item to a close speaking about the creation of an Autism friendly community, but it did not need a ‘badge’ to do this.

Resolved

That the Joint Overview and Scrutiny Committee endorses the joint All Age Autism Strategy for Coventry and Warwickshire 2021-26.