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Standards and monitoring
'A working party should be established by the Scottish Executive to develop global standards for lifelong services for those people with autistic spectrum disorders ( ASD) that require it. It should also review current training provision in Scotland.
Thereafter the Scottish Health Advisory Service ( SHAS), or an alternative body, should monitor these standards.
A request is made to the Scottish Intercollegiate Guidelines Network ( SIGN) to develop guidelines for the evidence based approaches to the diagnosis and management of ASDs.
A conference is planned for 2002 and should be used to bring together interested parties to discuss the implication of this document.'
What has happened
The ASD Reference Group fulfils the role of the recommended working party. A list of the group members is in Annex 1.
There are a number of developments that monitor standards and which are relevant to people with ASD. These include NHS Quality Improvement Scotland learning disability quality indicators, national care standards, the SCLD database project, and education quality indicators. The inclusion of ASD in wider developments is indicative of a heightening awareness of the needs of this client group.
The Scottish Commission for the Regulation of Care registers and inspects all regulated care services, including support services, housing support services and care home provision to ensure they are meeting the national care standards.
Her Majesty's Inspectorate of Education ( HMIE) is currently conducting a specific inspection of educational provision for children and young people with autism spectrum disorder across Scotland. The inspection began in April 2005 and is due to conclude at the end of March 2006. The inspection is following an integrated assessment approach using a multi-agency (education, health and social care) team and includes consideration of:
- how far pupils with ASD have access to a broad and relevant curriculum to ensure they are learning
- how far pupils with ASD are included and enabled to engage with more socially equipped peers
- how expertise is used in schools and why certain interventions are chosen
A report on the inspection is due in late summer 2006 and will highlight current good practice, identify any gaps in provision and make recommendations for the way forward.
Joint Inspections of learning disability services, for which a framework is presently being developed, will also include services for people with ASD. These joint inspections will bring together SWIA, NHSQIS, the Care Commission, HMIE and HMIC. The report of a pilot joint inspection taking place in Ayrshire, across 3 local authorities and an NHS board, is due in summer 2006.
NHSQIS conducted a programme of visits to NHS Boards from October 2004 onwards. Information from these visits is available in a national overview report published on 28 th February 2006.
The SIGN Council agreed to the development of a guideline for children and young people up to age 18. The guidelines will cover diagnosis, assessment and clinical interventions and will take into account the views of parents and carers on diagnosis and assessment.
An autism conference was held in 2002. Since then, Ministers and officials have met and corresponded with the Cross Party Group on Autistic Spectrum Disorders to update on developments in relation to the PHIS Report. There have also been a number of other events relating to diagnosis, training and information, to highlight the need for action in line with the Needs Assessment Report.
What still needs to happen
In recognising that progress will take time, the reference group believes there is a need to develop an agreed care pathway, from childhood to adulthood. The Scottish Executive has funded specific developments 1 in adult services in Greater Glasgow and Lothian, and a project developing services for young people on transition from children's to adult services in Highland. Evaluation of these projects will contribute to the development of an agreed care pathway and will also demonstrate good practice on which others can build.
The roll-out of Joint Inspections needs to ensure that the requirements of people with ASD are being addressed across all services.
The broad range of existing care standards and performance measures need to be looked at to identify what further work is needed and where the gaps are in relation to ASD.
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