Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps she is taking to incorporate research on (a) masking and (b) internalised behaviours into (i) autism diagnostic pathways and (ii) training for healthcare professionals.

Integrated care boards (ICBs) and health professionals should have due regard to National Institute for Health and Care Excellence (NICE) guidelines when commissioning and providing health care services, including autism assessment services. NICE guidelines are developed by experts based on a thorough assessment of the available evidence and through extensive engagement with stakeholders. In June 2024, NICE’s prioritisation board decided to prioritise updating the current NICE guidelines on autism assessment and diagnosis, namely Autism spectrum disorder in adults: diagnosis and management, and Autism spectrum disorder in under 19s: recognition, referral and diagnosis. Both guidelines are available, respectively, at the following two links:

https://www.nice.org.uk/guidance/cg142

https://www.nice.org.uk/guidance/cg128

Although NICE has committed to updating these guidelines, this work has not yet been scheduled into NICE’s work programme.

Under the Health and Care Act 2022, providers registered with the Care Quality Commission are required to ensure their staff receive specific training on learning disability and autism, appropriate to their role. To support this, we have been rolling out the Oliver McGowan Mandatory Training on Learning Disability and Autism to the health and adult social care workforce. The first part of this training has now been completed by over three million people. Staff with responsibility for providing care, support, or healthcare, including social care and other professionals with a high degree of autonomy, are expected to complete Tier 2 of Oliver’s Training, which includes content on avoiding diagnostic overshadowing. Oliver's Training has been developed with reference to the Core Capabilities Frameworks on Learning Disability and Autism, co-produced alongside people with a learning disability and autistic people, and based on learning from the independently evaluated trials of the training in 2021. A long-term evaluation is now underway.

In addition, 5,000 trainers have been trained as part of the National Autism Trainer Programme, which covers autism presentation in women and girls. These trainers will cascade their training to teams across mental health services. NHS England has also published guidance on meeting the needs of autistic adults in mental health services, which makes specific references to the possible role of masking.