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Service framework

People with autism spectrum disorder have a right to the information, equipment, assistance and support services necessary to live a fully productive life with dignity and independence. This requires a range of services beyond health and social care to take account of the needs of this group. This guidance however, seeks a specific response from commissioners of health and social care services.

Many adults with autism find that the way local services are structured and organised discriminates against them. This can result in their near exclusion from services, particularly if they have Asperger Syndrome or high-functioning autism.

Community care services for people with autism spectrum disorder should be embedded within joint partnership service planning, commissioning and delivery, including implementation of Single Shared Assessment ( SSA). The development and implementation of Single Outcome Agreements provides an opportunity for performance measures and targets to be developed locally for people with autism spectrum disorder.

Community Health Partnerships ( CHPs) and their partners should ensure integration between primary care and specialist services and with social care. These partnerships also have a role in reducing inequalities in access to information by providing targeted and coherent health messages particularly aimed at excluded or disadvantaged groups, including people with autism spectrum disorder. Guidance on the development of CHPs was issued in 2004.

There are a number of legislative and policy requirements which either have a specific focus or are applicable to people with autism spectrum disorder. Action to meet these existing requirements should mean that local authorities identify people with autism spectrum disorder who require support, and provide appropriate services:

• Integrated Children's Service Planning, which should assist in identifying those young people with additional support needs who have an ASD. Planning for transition between children's and adult services should ensure local authorities have a record of those who are likely to need community care services. Approaches to transition should be individualised and advance planning is crucial.
• The Education (Additional Support for Learning) (Scotland) Act 2004 places duties on education authorities to make adequate and efficient provisions for the additional support needs of every child and young person for whom they are responsible and who requires additional support for learning. Education authorities must identify, support and review the needs of all children with additional support needs including ASD. The 2004 Act places a greater emphasis on much better multi-agency working.
• More Choices More Chances is an action plan to reduce the proportion of young people not in education employment or training in Scotland. The Scottish Government believes in a partnership approach in aiding the transition of all young people from school, recognising that it often takes a wide range of support to enable some young people to progress. Opportunities are to be delivered in a way that makes them accessible to all young people, including those hardest to engage.
• The Community Care & Health (Scotland) Act 2002 significantly extends the rights of many carers in Scotland to have their needs as a carer assessed. The Act also requires local authorities and the NHS to advise carers of their rights. Local authorities are also required to recognise the care being provided by a carer and to take into account the views of a carer in deciding what services to offer to the person they care for. This requirement seeks to ensure that carers are regarded and treated as key partners in the provision of care.
• NHS Quality Improvement Scotland's Learning Disability Quality Indicators set out criteria to evidence assessment and monitoring of specific health needs.
• Delivering for Mental Health aims to raise awareness of mental health and to support mainstream services to be aware of the needs of their clients with mental health problems and provide interventions that address these specific needs.
• The Disability Equality Duty, which from December 2006 places a duty on public authorities to promote equality and demonstrate involvement of disabled people.
• National Care Standards have been developed and published by Scottish Ministers for a range of care services. The standards aim to improve quality of life by raising the level of care and support provided.
• The Scottish Social Services Council Codes of Practice set out the standard of conduct and practice for social service workers and their employers. Everyone who registers will have to agree to abide by the codes. The codes are intended to reflect existing good practice and it is anticipated that workers and employers will recognise in the codes the shared standards to which they already aspire.
• Changing Lives, the 21st Century Social Work review reinforced the need for a preventative approach to delivering social work services.

This guidance sets out the key outcomes for people with autism spectrum disorder. People with autism spectrum disorder may also have a learning disability or other co-morbid conditions. It is important that services and support take account and consider suitable arrangements for those with autism spectrum disorder and dual diagnosis/multiple impairment, including those with mental health issues or learning disability. Equally, people with autism spectrum disorder sometimes have health care needs that are not addressed. Health care services need to identify and treat the conditions which are often associated with autism spectrum disorder appropriately and address the wide range of health needs of people on the autism spectrum. To support this, NHS Education for Scotland have developed an autism spectrum disorder learning resource for GPs and primary care practitioners www.nes.scot.nhs.uk.autism spectrum disorder.

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