The Government has published its National Autism Strategy for autistic children, young people and adults for 2021-2026.
For the first time the new strategy covers autistic children and young people with a key focus on training for teachers, employers and healthcare professionals.
Each priority area has been given a measure of success so that progress can be monitored each year to ensure that by the end of the strategy, life is “fundamentally better” and lives are transformed for autistic people, their families and carers.
In his introduction, Sajid Javid, Secretary of State for Health and Social Care, said: “As a society, we’ve come a long way since the landmark 2009 Autism Act. We’ve never had a greater public awareness of hidden disabilities like autism. Although we’ve come so far over the last decade, there must be no limit to the ambitions of autistic people; they should have the same opportunities as everyone else in society.
“For me, our goal must be nothing less than making sure autistic people from all backgrounds, ethnicities, genders, sexualities and ages – in all parts of the country – get the support they need to live full and happy lives.”
The strategy sets out six key areas in which to make improvements for autistic people. These are:
- Improving understanding and acceptance of autism within society
- Improving autistic children and young people’s access to education and supporting positive transitions into adulthood
- Supporting more autistic people into employment
- Tackling health and care inequalities for autistic people
- Building the right support in the community and supporting people in inpatient care
- Improving support within the criminal and youth justice systems
Background to the National Autism Strategy
The Autism Act (2009), which only applies to adults, was enacted over 10 years ago with the aim of addressing the multiple social disadvantages and health and care inequalities autistic adults faced. Since then, two more adult autism strategies have been published.
The strategy builds on and replaces the preceding adult autism strategy, Think Autism, which was published in April 2014. It extends the scope of the strategy to children and young people for the first time.
The focus of this new strategy and implementation plan have been informed by the government’s call for evidence on the review of Think Autism, which received over 2,700 responses from autistic people, their families and carers and organisations.
In addition, the strategy has been informed by independent research commissioned by the Policy Innovation Research Unit to undertake into the impact of the COVID-19 pandemic on autistic people and their families.
The government also commissioned Skills for Care, the National Development Team for Inclusion and the National Autistic Society to produce a guide to help commissioners to identify local demand and develop the right services and support for autistic people, which is published alongside this strategy.
In a joint foreword, Helen Whately MP, Minister of State for Social Care and Vicky Ford MP, Parliamentary Under-Secretary of State for Children and Families said that since the last autism strategy was published, new challenges have also emerged for autistic people, as has the understanding of the barriers people face across their lives.
They added: “We have seen the number of people identified as being autistic in inpatient mental health services increase, and now know more about the scale of the life expectancy gap for autistic people, which is we know is approximately 16 years compared to the general population.
“Over the next five years, we want to create a society that truly understands and includes autistic people in all aspects of life. This is our vision to make life fundamentally better for autistic people, their families and carers by 2026 and we are determined to make it happen.”
Improving understanding and acceptance of autism within society
This priority area aims to significantly improve the public’s understanding and acceptance of autism and how autism can affect people differently, including the difference in how autistic women and girls present.
It also aims to help more organisations, businesses and public sector services to become autism-inclusive, so that autistic people can engage in their communities, just like everyone else. This will mean taking part in initiatives like Autism Hour, the Autism Friendly Award or taking other steps to become more autism-aware.
The Government also says it is also taking a number of steps to improve the accessibility of transport for autistic people as the country moves out of the Covid-19 pandemic and plans to resume the ‘it’s everyone’s journey’ campaign to create a more inclusive and supportive public transport environment for disabled people.
Improving autistic children and young people’s access to education
The report says the Government is taking a number of steps to improve understanding of autism among educational professionals, including providing £600,000 of funding for staff autism training and professional development in schools and colleges.
It will also work with training partners to develop materials and resources and will consider the issue of identification and support for autistic girls within this.
Improvements to the support autistic people get in their transitions into adulthood are also included in this priority area so that more autistic people can live in the community, find work or higher education or other opportunities. This is to help prevent more young people from avoidably reaching crisis point or being admitted into inpatient mental health services.
Included in the commitments for the first year are plans to consult and publish the SEND review as soon as possible and conduct a new anti-bullying programme in schools, to improve the wellbeing of children and young people in schools, including those who are autistic.
Supporting more autistic people into employment
The aim of this priority is to close the employment gap for autistic people, ensuring that more people who are able and want to work can do so and that those who have found a job are less likely to fall out of work.
By 2026, it wants to show that employers have become more confident in hiring and supporting autistic people, and that autistic people’s experience of being in work has improved.
The strategy includes making sure that existing services and work programmes are more autism-inclusive and better able to help autistic people find the right employment opportunity for them.
For autistic people who are unable to work, improved welfare support aims to help them get the support they need to live well in their communities. The Department for Work and Pensions’ (DWP) forthcoming health and disability support green paper will consider how the welfare system can better meet the needs of disabled people, including autistic people, and how the DWP can improve the service it provides.
Tackling health and care inequalities for autistic people
Health and care inequality was exposed further by the Covid-19 pandemic. The report acknowledges that autistic people often need adjustments to their healthcare for this to meet their needs, but that currently professionals cannot always identify that people are autistic or the adjustments they may require.
That is why NHS England and Improvement are developing ‘digital flags’ in patient records so healthcare professionals across the NHS are aware that someone is autistic and can tailor the support they provide accordingly. They will work with 12 early adopter sites across regions to test this reasonable adjustment flag this year.
The Government says they are investing £13 million to begin reducing diagnosis waiting times for children and young people. Of this, £3.5 million will be invested to prevent children and young people from reaching crisis point while they are waiting for an autism diagnosis and stop them from being avoidably admitted into inpatient mental health settings.
Local systems will begin proactively identifying children and young people on waiting lists (as well as those on waiting lists for mental health support) who might be at risk of crisis so they can get the support they need.
It will also invest £2.5 million of funding to improve the quality of adult diagnostic and post-diagnostic pathways, and help to address the impact of the Covid-19 pandemic on waiting lists. This will be essential as the report also highlighted Autistica’s Happier, Healthier, Longer Lives briefings that have identified that autistic people have poorer physical health outcomes and a lower life expectancy than the general population.
It also said subject to evaluation, it will move forward with our commitment to develop Oliver McGowan Mandatory Training for all health and care staff and will improve commissioners’ and social workers’ capability so they develop the right services and provide the support autistic people need.
Building the right support in the community
The report references the targets set out in the NHS Long Term Plan to reduce the number of autistic people and people with a learning disability being admitted into inpatient mental health services. It says it is a priority to improve the treatment of autistic people in mental health legislation to prevent people from being avoidably admitted to inpatient care and improving the provision of community mental health and crisis support.
It also aims to improve the suitability and availability of housing support and social care. In addition, for people who do need to be in inpatient mental health settings, the quality of care will be better and more tailored to their individual needs and people will be discharged back into their communities as soon as they are well enough to leave.
In the first year, the key commitments will be to:
- provide £25 million of funding to improve the capacity and capability of 7-day specialist multidisciplinary learning disability services and crisis support for each local area, and £15 million of funding to put in place keyworkers for children and young people with complex needs, including those who are autistic
- provide £18.35 million to prevent crises and avoidable admissions into inpatient care, improve the quality of care for autistic people in inpatient mental health services and facilitate discharges back into the community
- review the results of proposals to improve the treatment of autistic people under the Mental Health Act with the Government response recently published
- provide £21 million funding to local authorities through the Community Discharge Grant, to accelerate discharges.
Improving support within the criminal and youth justice systems
This priority area aims to develop a clearer understanding of how autistic people come into contact with the criminal and youth justice systems, and the type of support they may need across court, prison and under probation supervision.
The Government says it wants to improve the police and wider criminal and youth justice system staff’s understanding of autism so that autistic people are more able to receive the right support, adjusted to their needs, as well as ensuring that different parts of the justice system – from prisons to courts – become more autism-inclusive.
First year commitments include the development of a toolkit to educate frontline staff about neurodiversity, and the additional support people might need and conduct research as part of a 3-year programme which will provide insight about how police use out-of-court disposal to support adults with vulnerabilities.
Response so far to the strategy
The National Autistic Society has published Five things you need to know about the Government’s new autism strategy for England and highlights that although this strategy has more money than any of the other previous strategies, it really needs social care to be fixed too.
In addition, although the strategy is supposed to cover five years, the commitments in this new strategy only take us up to 2022. This is because there is a Spending Review scheduled for autumn.
It added: "All the commitments total almost £75 million and represent the biggest investment in England’s autistic people ever. However, they only account for the first year of the strategy – we are expecting further financial commitments for 2022-26 when the Government sets out its long-term spending promises later this year.
"We’re really pleased that the Government has recognised many of these inequalities and committed to tackle them with some concrete proposals and funding. These could start to make a real difference to autistic people and their families. However, we know that true change will take more than one year and cannot happen without fixing social care, which the Prime Minister promised on his first day in the job – we will keep campaigning hard for this to happen."
Ambitious about Autism said that even before Covid-19, autistic children and young people were too often denied basic and fundamental rights, such as the right to a decent education, to high quality healthcare and the opportunity to live and work in a community of their choice.
Jolanta Lasota, Chief Executive, said: “Early intervention and support are also critical to the success of autistic children and young people and so we’re very pleased to see investment in reducing autism diagnosis waiting times. It’s vital that young people from all backgrounds have equal access to this timely diagnostic support.
“As the strategy gets underway we will continue to monitor its progress and hold decision makers to account, to ensure it makes the maximum impact in transforming the prospects of autistic children and young people.”
National autism research charity Autistica said that although they welcome the new Autism Strategy, it is what happens next that matters.
It said: “This was the easy part. Perpetual abuses and systemic neglect cannot be wished away. There are no shortcuts to resolving entrenched health inequalities or widespread underemployment. The government's last two Autism Strategies promised much and delivered little.
“Now comes the hard work. To make breakthroughs, we need to pinpoint precisely why bad things keep happening and start properly testing solutions to see if they work. We've guessed away autistic people's lives for far too long. It’s past time we started learning how to succeed.
“The next Spending Review will test the government's commitment to this strategy. The initial implementation plan is welcome, but it is a one-year plan for a five-year strategy. Most of the funding discussed today is already inside NHS budgets. Serious investments in years two and three of the strategy will be required if the government is to truly “level up” its commitment to autistic people.”