Agenda item

Joint report

Members of the Education and Children’s Scrutiny Board (2) have been invited to the meeting for the consideration of this item along with Councillors P Seaman and B Gittins, Cabinet Member and Deputy Cabinet Member for Children and Young People, Councillor K Maton, Cabinet Member for Education and Skills, and Councillors K Caan and R Ali, Cabinet Member and Deputy Cabinet Member for Public Health and Sport.

The following representatives have also been invited to attend:

Ali Cole – Senior Joint Commissioner for Disabilities and Autism, Coventry City Council, Warwickshire County Council, Coventry and Rugby CCG, South Warwickshire CCG, and Warwickshire North CCG

Jamie Soden – Director of Nursing and Clinical Transformation, Coventry and Rugby CCG

Jeanette Essex – Head of SEND and Specialist Services, Coventry City Council

Rob Spencer – Associate Director of Operations (Neurodevelopmental), Coventry and Warwickshire Partnership Trust (CWPT)

The Board considered a joint briefing note which provided an overview of national policy and strategy relating to children with Autistic Spectrum Condition (ASC), local services and local governance; an update on what was working well and areas of concern; and detailed the next steps and plans. Ali Cole, Coventry and Warwickshire Councils and the three Clinical Commissioning Groups (CCGs), Gemma Cartwright and Rob Spencer, Coventry and Warwickshire Partnership Trust (CWPT) and Jamie Soden, Coventry and Rugby CCG attended the meeting for the consideration of this item. Councillors P Seaman and B Gittins, Cabinet Member and Deputy Cabinet Member for Education and Young People also attended along with Councillors J Blundell and K Sandhu and S Hanson and K Jones, all Members of the Education and Children’s Scrutiny Board (2). Councillor Brown, Chair of Scrutiny Co-ordination Committee, was also in attendance.

The briefing note provided an explanation of autism and set out the requirements of legislation on Local Authorities and CCGs for supporting children and young people with special educational needs or disabilities including autism. Reference was made to the national plan, Building the Right Support and to the local initiative – the Transforming Care Programme. The NHS Long Term Plan included a specific focus on autism and learning disabilities although there was no clarity on how much funding would be available to support delivery of the plan. A key deliverable was a reduction in numbers of children and young people with a learning disability and/ or autism being admitted to a mental health hospital. 

The Coventry and Warwickshire Learning Disability and Autism Transformation Board was responsible for the delivery of the NHS Long Term Plan objectives in relation to autism and learning disabilities, and in addition for overseeing the development and delivery of the joint all age autism strategy.

Members were informed that nationally and locally there was no register of people with autism recorded so the true prevalence in Coventry and Warwickshire was not known. Based on the national prevalence, it was estimated there were around 3,090 people living with autism in Coventry of which there were around 673 children living with autism, during 2019.

Reference was made to the wide range of services available in Coventry for parents and carers, children and young people, and schools to support children and young people who are on the waiting list or have received a diagnosis of autism. Details of these services were set out in an appendix to the briefing note. As part of the CAMHS offer, Coventry and Warwickshire Partnership Trust (CWPT) provided a specialist Neurodevelopmental Service, across Coventry and Warwickshire. In Coventry, the services provided pre-assessment, assessment and post diagnostic support to pre-school and school age children. The briefing note detailed what the service delivered. In addition CWPT delivered a children’s intensive support service. The multidisciplinary teams, work alongside CAMHS where required, and the support provided was outlined.

Vibes (autism social club), was a service delivered by Coventry and Warwickshire Mind, who provided support to children and young people with autism by helping to develop confidence, social skills, self-esteem, and understanding of their own emotional health. The briefing note also set out the provision provided by Schools and Education to support children with autism.

The briefing note highlighted the increased demand for autism assessments which were anticipated to rise to by 33% by the end of 2019/20. Locally demand was significantly outstripping capacity across children’s diagnostic pathways. The number of early year’s children presenting with highly complex communication needs was increasing, which had placed a strain on specialist providers within the city. Also, the demand for specialist provision commissioned for autistic people was outstripped by capacity. The number of pre-school and school aged children on the waiting list for autism assessments remained high. January 2020 data shows 172 pre-school aged children and 940 school aged children were on the waiting list for assessment (1,112 combined). Further details were set out in a second appendix to the briefing note.

The briefing note highlighted waiting time for diagnosis, with pre-school aged children waiting on average 78 weeks for an initial assessment and school aged children waiting on average 110 weeks. Young people were being diagnosed with autism while inpatients in mental health hospitals. The options being implemented by commissioners and CWPT to reduce waiting times were set out but weren’t having an impact on the waiting list and waiting times due to increased demand. Also, the national workforce shortages in specialist roles relating to autism were acknowledged. 

Information was provided on what was working well – the joint all age autism strategy; the new services for children pre and post diagnosis; the autism awareness training for the children’s workforce; the support for children at risk of mental health hospital admission; and the joint commissioning. The next steps were also detailed.

Members questioned the representatives and officers on a number of issues and responses were provided, matters raised included:

·  Concerns about the length of the waiting lists and waiting times

·  Concerns about the gap in provision when moving from childhood to adulthood while waiting for a diagnosis for autism, with a request to strengthen support in this area

·  Further details about staff shortages and resources

·  The links with the two local universities to try to reduce employee vacancies

·  The importance of early intervention at a young age for a child with autism, also providing support for families

·  Clarification about autism and the need to support people’s differences

·  The importance of raising awareness of autism

·  The chances of being able to reduce the numbers of children and young people with autism being admitted to mental health units

·  An emphasis on awareness raising with other school pupils 

·  Why were the numbers significantly higher in Coventry compared to other areas

·  What happens when elderly adult parents can no longer cope with their autistic adult children

·  The implications for families of the long wait for a diagnosis

·  Further information on the ongoing work to reduce waiting lists and waiting times

·  Further details about the pilot scheme in schools and why were only three schools involved at the current time

·  An acknowledgement that awareness raised expectations

·  Support for Coventry becoming an Autism Friendly City and for having an Autism Awareness Day in Coventry

·  An acknowledgement that a diagnosis of autism was integral to providing families with an equitable life, with particular reference to PIP payments.

·  Support for all the work being undertaken in the city in help children and adults with autism and their families

·  A suggestion that autism awareness training be provided for both Councillors and officers

·  A request for the draft All Age Autism Strategy to be submitted to a future Board meeting

·  A suggestion that a letter be sent to the city’s three MPs asking them to request more resources for Coventry and Warwickshire to support the ongoing work with autism.

RESOLVED that:

(1) The progress to date on services to support children be noted and the plans to further progress the Autism Spectrum Condition (ASC) support available to children and young people living in Coventry who are on the waiting list and who have been diagnosed (pre and post diagnosis support) be endorsed.

(2) Support be given to:

i) Coventry becoming an Autism Friendly City

ii) Holding an Autism Awareness Week in the summer 2020.

(3) The draft All Age Autism Strategy be submitted to a future meeting of the Board along with further information on the Autistic Spectrum Condition pathway and the waiting lists for initial assessment.

(4) Consideration to be given to establishing Autism Awareness training for Councillors and officers.

(5) The Chair, Councillor Clifford, supported by Councillor Sandhu, to send a letter to the City’s 3 MPs requesting that they pursue the options for more resources being provided for Coventry and Warwickshire to enhance the current partnership work being undertaken to support children and young people with autism and their families.