The National Institute for Health and Care Excellence’s (NICE) new quality standard for autism sets out expectations for standardising care across the country – but its implementation that will be key to any improvement in overall service.
Where you live in the country can be crucial to people with autism’s chances of receiving effective diagnosis, care and support.
As Jonathan Green, Professor of child and adolescent psychiatry at the University of Manchester, and member of NICE’s autism quality standard committee, admitted recently: “Across England, there is real variation in the type and quality of care people with autism receive, which can have lasting effects on both the person and their families and carers.”
Like many other aspects of learning disability and autism services, there are some great examples of good practice out there, but these are mirrored by those that are sub-standard. It’s just a matter of luck for someone with autism whether the services where they live are of a high quality, or not.
But NICE’s quality standard, which is for children, young people and adults with autism, contains 8 statements, against which practice can be measured, and that taken together, it is hoped, will improve the quality and consistency of care for people with the condition.
The statements include the expectation that people with possible autism who are referred to an autism team for a diagnostic assessment will have the assessment started within 3 months of referral. As part of that diagnostic process, any mental or physical health issues should also be investigated.
In addition, the standard calls for personalised plans for all, and the allocation of a named key worker to coordinate the care and support detailed in the plan.
Furthermore, the standard expects that people with autism will not be prescribed medication to address the condition.
All of these targets are welcome and, if implemented, will make a real difference to the standard of autism care and support in England. But the keyword is ‘if’.
The targets will be a challenge for commissioners, local authorities and the NHS alike, but it is one they must meet head-on.
Funding, as always, will be an issue here. But there are areas that have great autism services and they face the same problems as every other local authority or NHS Trust, so there is no reason why, with a bit of creative thinking – and learning from best practice – that the standards cannot be successfully implemented across the country.
It is now up to the NHS and local authorities to ensure the standard is properly applied. The standard should make autism more of a priority, and it should also make it easier for commissioners to gauge the effectiveness of services, but real change will come down to the willingness and drive, of those in power, to build up the necessary services.
