Agenda item

Purpose of the item: To update on progress in developing a 5-year All-Age Autism Strategy across Adult Social Care, Children, Lifelong Learning and Culture, and Health in Surrey.

Witnesses:

Hayley Connor, Director of Children’s Commissioning

Kay Hammond, Chairman of Children, Families, Lifelong Learning and Culture Select Committee

Marisa Heath, Deputy Cabinet Member for People

Steve Hook, Assistant Director of Learning Disabilities, Autism and Transition

Julie Iles, Cabinet Member for All-Age Learning

Mary Lewis, Cabinet Member for Children, Young People and Families

Sinead Mooney, Cabinet Member for Adults and Health

Simon White, Executive Director of Adult Social Care

Key points raised during the discussion:

1.    The Select Committee expressed approval that the new strategy covered all ages. The Deputy Cabinet Member for People stated that the transition between childhood and adulthood was a key part of the new strategy. She acknowledged that the governance of the strategy could seem opaque and so the strategy needed to clarify how it could streamline the governance. Mental health was a high priority and the strategy aimed to see a reduction in mental health issues.

2.    A Member asked what proportion of school-age children with autism attended mainstream schools. The Assistant Director of Learning Disabilities, Autism and Transition replied that in 2020 just over one quarter of young people with autism attended mainstream schools. In 2019, the figure had stood at about 30%. The Director of Children’s Commissioning added that the Council was working with schools to ensure that more children with autism were accommodated in mainstream schools where appropriate.

3.    The Co-Chair of the Surrey Coalition of Disabled People expressed concern at the long waiting times for assessments and asked what the plan was for prioritising workstreams. The Assistant Director of Learning Disabilities, Autism and Transition responded that the service was working closely with the Surrey and Borders Partnership NHS Foundation Trust (SABP) Neurodevelopmental Service to improve adult diagnostics. Also, certain workstreams would be prioritised as necessary. The Director of Children’s Commissioning said that CAMHS (Child and Adolescent Mental Health Services) were being recommissioned and as part of this, changes had been made to the Neurodevelopmental service. Work would be focused on responding more quickly to children’s needs.

4.    A Member expressed concern that Surrey County Council was not providing access to horticultural or animal husbandry activities for people with learning disabilities and autism (LD&A); these activities could be beneficial. The Assistant Director of Learning Disabilities, Autism and Transition replied that the LD&A service did offer a range of day activities for people with LD&A, including horticulture and animal husbandry, which were aimed at furthering employment opportunities. However, feedback suggested that many people with LD&A wanted opportunities to further their education and employability, meaning that alternative activities may be more suitable in order to allow people with LD&A to lead fulfilling, ordinary lives. The Council’s commissioning of horticulture and animal husbandry services was proportionate; some services were commissioned specifically for people who would benefit from working with animals. Unfortunately, these sorts of services had been impacted considerably by the pandemic. The Director of Children’s Commissioning confirmed that children’s LD&A services also worked with young people with autism to build skills and confidence. It was agreed that the Select Committee would receive a briefing note summarising horticulture and animal husbandry services for adults and children with LD&A.

5.    A Member raised concern that intervention was often not occurring early enough for children with mild autism. The Cabinet Member for All-Age Learning responded that there was an Early Learning Fund that early years settings could access in order to provide extra support for very young children (aged five and under). 620 children had been assisted through this programme. The Director of Children’s Commissioning emphasised the importance of diagnosis and of responding to the needs of the child and their family. Work was also ongoing with the voluntary and charitable sector to identify how children and families could be supported before and during diagnosis.

6.    Expressing concern that long waiting times were causing difficulty to residents, a Member enquired who had oversight of these waiting times for an autism diagnosis and was therefore responsible for bringing about improvements on this. The Assistant Director of Learning Disabilities, Autism and Transition acknowledged that the average waiting time of 370 days was unacceptable. One of the main aims of the new strategy was to identify and solve key problems such as this. Good assessment and early diagnosis were key factors in improving outcomes for people with autism, and the Council was working closely with ASC commissioners to improve resourcing of the SABP Neurodevelopmental service (which conducted diagnoses). SABP was jointly commissioned by Surrey County Council and Surrey Heartlands Integrated Care Partnership, and the Adults and Health Select Committee would have a role in oversight of this issue. The Director of Children’s Commissioning emphasised the importance of reducing the time children had to wait for an autism assessment and there was a weekly meeting chaired by the Deputy Chief Executive of the Council to ensure a focus on this.

7.    A Member emphasised the importance of using autism-friendly processes and language for everyone in the system, not just those with an autism diagnosis, to ensure that the system was friendly to everyone, including those who may be autistic but as yet undiagnosed.

8.    The Assistant Director of Learning Disabilities, Autism and Transition informed the Select Committee that a key part of the new strategy was the awareness of autism in the wider community and working collaboratively with other organisations such as district and borough councils, housing providers and retailers. Even something such as the change in temperature or from light to dark when entering a building could affect people with autism and it was important that suitable adaptations were made. There was a workstream focused on wider community awareness. Moreover, the strategy aimed to work with employers in Surrey to improve employability for people with autism.

9.    The Select Committee expressed concern that the governance structure included in the strategy was unclear, and the Assistant Director of Learning Disabilities, Autism and Transition assured Members that an alternative governance structure was being put together and should be ready by April 2021.

10.  A Member requested that all of the issues raised by service users and quoted in paragraph 17 of the report be included in the strategy and dealt with individually. The Assistant Director of Learning Disabilities, Autism and Transition responded that these comments were fundamental in the formation of the strategy and had been taken into account in its development so far. The Director of Children’s Commissioning added that the service was keen to work with the autistic community to understand the issues they faced.

11.  The Chairman of the Children, Families, Lifelong Learning and Culture Select Committee asked what support plans there would be for high-achievers with autism or those with autism without a learning disability. The Director of Children’s Commissioning stated that taking high-achievers into account was an important feature of the consultation and the Council wanted to foster a system whereby all people with autism were facilitated to reach their ambition.

12.  The Chairman of the Children, Families, Lifelong Learning and Culture Select Committee enquired how the Schools Alliance for Excellence (SAFE), as well as other voluntary and charitable sector organisations, would be included in engagement during the development of the strategy. The Cabinet Member for All-Age Learning replied that Family Voice Surrey had reported improved listening all round by partners and had given positive feedback. Some aspects such as SAFE would be scrutinised by the Children, Families, Lifelong Learning and Culture Select Committee.

13.  The Chairman of the Children, Families, Lifelong Learning and Culture Select Committee requested assurance on the new CAMHS contract and the inclusion of the voluntary sector in the development of the strategy. The Director of Children’s Commissioning said that the new CAMHS contract was an alliance and the Surrey Wellbeing Partnership was a critical part. The voluntary and charitable sector had been involved, and communities’ and system partners’ views had been taken into account.

14.  A Member suggested that Surrey County Council could establish apprenticeships or similar schemes to encourage people to specialise in autism-related fields, in order to tackle the shortage of specialists in autism, mental health and learning disabilities.

Recommendations:

1. The Select Committee endorses the strategic themes and continued development and implementation of the Surrey All-Age Autism Strategy 2021-26 across Adult Social Care; Children, Families, Lifelong Learning and Culture; and Health;
2. The Select Committee acknowledges the resource implications (staff and timelines) for the development and implementation of the Strategy;
3. The Select Committee recommends that officers simplify the Autism Delivery Governance Structure to ensure that governance and oversight is as streamlined as possible;
4. The Select Committee recommends that training is developed to ensure that all officers use autism-appropriate language;
5. The Select Committee requests that a review of the All-Age Autism Strategy is conducted by the Select Committee at an appropriate time following the start of its implementation.

Actions/further information to be provided:

1. Assistant Director of Learning Disabilities, Autism and Transition is to provide the Select Committee with a summary of the services relating to horticulture and animals that Surrey County Council commissions and offers to children and adults with autism.