Asked by: Jim Shannon (Democratic Unionist Party - Strangford)
Question to the Department for Work and Pensions:
To ask the Secretary of State for Work and Pensions, whether his Department issues guidance to Departments on supporting candidates with autism through job recruitment boards.
Answered by Mims Davies - Minister of State (Department for Work and Pensions)
The Department for Work and Pensions does not issue guidance to other departments on supporting candidates with autism through job recruitment boards. This falls within the remit of the Government People Group, within the Cabinet Office.
All candidates requiring a reasonable adjustment are able to request one during their application. There is also some general information on Reasonable Adjustments on the Civil Service Careers page, including the links to Disability Confidence Scheme and what the Reasonable Adjustment process via CS Jobs will involve.
Asked by: Darren Jones (Labour - Bristol North West)
Question to the Department for Education:
To ask the Secretary of State for Education, what steps her Department is taking to support young people with autism spectrum conditions who have education otherwise than at school plans.
Answered by David Johnston - Parliamentary Under-Secretary (Department for Education)
Local authorities provide support to certain children and young people with special educational needs (SEN) through Education, Health and Care (EHC) plans. A local authority may choose, where statutory criteria are met, to make an ‘Education Otherwise than in School’ arrangement, whereby the child or young person with the EHC plan receives special educational support outside of a school or college.
The department are taking steps to improve the special educational needs and disabilities (SEND) system. There are measures in place for the department to support and challenge local authorities to improve their practice. Ofsted and the Care Quality Commission commenced a strengthened local inspection framework in January 2023. Where local authorities are failing, the department works with them, using a range of improvement programmes and SEND specialist advisers to address weaknesses. Inspections under this new framework will place greater emphasis on the outcomes that are being achieved for children and young people with SEND, including those who are autistic.
More generally, as part of the department’s support for autistic young people, the department worked closely with the Department of Health and Social Care to develop a refreshed cross-government Autism Strategy. This was published in July 2021 and includes children and young people. The strategy recognised the progress that has been made, as well as the challenges and priorities for reducing inequalities, and enabling autistic people of all ages to have the same opportunities as everyone else to lead healthy, happy and fulfilling lives. The national strategy sets out the department’s vision to make life fundamentally better for autistic people, their families and carers by 2026.
Asked by: Caroline Nokes (Conservative - Romsey and Southampton North)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps her Department takes to involve people with learning disabilities in the development and implementation of measures to reduce their health inequalities.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
We recognise the importance of involving people with a learning disability in policy development and implementation to support in reducing the health inequalities they experience. We aim to do this in a range of ways within the Department, some of which are set out below.
Experts by experience are members of governance structures, such as the Oliver McGowan Code of Practice Board. This Board has supported the development of the Oliver McGowan Code of Practice. The Code will guide registered health and care providers to meet their statutory requirement to ensure their staff receive learning disability and autism training appropriate to their role. The Code sets an expectation that training is co-produced and co-delivered by people with a learning disability and autistic people. The draft Code was publicly consulted on, including an easy read version to ensure accessibility.
In developing the Building the Right Support (BtRS) Action Plan, published in July 2022, we sought expertise, advice and challenge from experts by experience. The Plan brings together actions across government and public services to strengthen community support and reduce overall reliance on specialist mental health inpatient care for people with a learning disability and autistic people.
The BtRS Advisory Group was established to improve direct engagement with experts by experience. The Group developed an independent, co-produced report on ‘What Good Looks Like’ in terms of community services. The final report has a specific focus on actions that integrated care systems should take to ensure the best possible community support for people with a learning disability and autistic people.
Additionally, the Department jointly manages the Health and Wellbeing Alliance which is a partnership between representatives in the health and care system and sector. This enables the sector, including people with a learning disability, to share their expertise at a national level with the aim of improving services and policy development.
Integrated care boards are now expected to have an Executive Lead on learning disability and autism. As part of their role, the Executive Lead will support the Board in championing co-production of policies and service delivery and recognising the value of people’s lived experiences. NHS England has published guidance on this role, which is available at the following link:
https://www.england.nhs.uk/long-read/executive-lead-roles-within-integrated-care-boards/
Asked by: Alex Sobel (Labour (Co-op) - Leeds North West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if she will make an assessment of the adequacy of the number of professionals able to offer pre-school autism assessments in Leeds.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
An assessment of the adequacy of the number of professionals able to offer pre-school autism assessments in Leeds is not currently planned. It is the responsibility of integrated care boards (ICBs) to make available appropriate provision to meet the health and care needs of their local population, including autism assessment services, in line with relevant clinical guidelines.
The West Yorkshire ICB advises that pre-school autism assessments in Leeds were temporarily stopped due to a shortage of professionals. The service remains suspended as it needs one full time equivalent clinical psychologist. The post has recently been recruited, and plans are in place for the service to reopen by the end of June 2024.
Nationally, we are taking steps to improve autism assessment services. NHS England published a national framework and operational guidance for autism assessment services on 5 April 2023. These documents are intended to help the National Health Service improve autism assessment services, and improve the experience for adults and children who are going through an autism assessment. They also set out what support should be available before an assessment, and what support should follow a recent diagnosis of autism.
Asked by: Robert Buckland (Conservative - South Swindon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment her Department has made of the effectiveness of NHS England’s Dynamic Support Register policy.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
NHS England published updated policy and guidance on Dynamic Support Registers (DSRs) and Care (Education) and Treatment Reviews (C(E)TRs) on 25 January 2023, for implementation from 1 May 2023. The purpose of the updated policy and guidance is to help ensure that people with a learning disability and autistic people get the right support, to stay well in their communities.
NHS England produced the updated policy and guidance following a process of reviewing the learning since the inception of DSRs and C(E)TRs, including consultation and engagement with people with lived experience. This process included drawing on the findings of the Norfolk Safeguarding Adults Board’s review of the deaths of Joanna, Jon, and Ben at Cawston Park in Norfolk, and the subsequent safe and wellbeing reviews for all people with a learning disability and autistic people in mental health hospitals.
Asked by: Mark Hendrick (Labour (Co-op) - Preston)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what plans her Department has to (a) expand and (b) improve autism services in (i) Lancashire and (ii) Preston for (A) adults and (B) children.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
It is the responsibility of integrated care boards (ICBs) to make available appropriate provision to meet the health and care needs of their local population, including services to support autistic people, in line with relevant National Institute for Health and Care Excellence guidelines.
Lancashire and South Cumbria ICB advises that it is currently reviewing its all-age autism pathway, and is in the initial stages of completing consultations with system partners and stakeholders. The ICB is aiming to complete the review, and proposals for a future pathway for 2025/26, by the end of this calendar year. In addition to this work, the ICB is reviewing the service specifications in place for the keyworker team, specialist autism team, and forensic autism team with the local provider, to ensure that the commissioned offer reflects the current needs of their population.
Nationally, we are taking steps to improve autism services. NHS England published a national framework and operational guidance for autism assessment services on 5 April 2023. These documents are intended to help the National Health Service improve autism assessment services, and improve the experience for adults and children who are going through an autism assessment. They also set out what support should be available before an assessment, and what support should follow a recent diagnosis of autism.
We are currently updating the Autism Act Statutory Guidance to support the NHS and local authorities to deliver improved outcomes for autistic people. This will include setting out what NHS organisations and local authorities must and should be doing to support autistic people.
Asked by: Mark Hendrick (Labour (Co-op) - Preston)
Question to the Department for Education:
To ask the Secretary of State for Education, what recent steps her Department has taken to increase the number of places for (a) children with autism and (b) children with special needs in schools.
Answered by David Johnston - Parliamentary Under-Secretary (Department for Education)
In March 2024, the department announced trusts to run 30 new special free schools, which included 17 designated to cater for pupils with autism. The Spring Budget announced funding for 15 special free schools. The department will announce the location of these new schools in May.
In March the department also published just under £850 million of High Needs Provision Capital Allocations for the 2023/24 and 2024/25 financial years. This funding forms part of our transformational investment of £2.6 billion in new high needs provision between 2022 and 2025. Local authorities can use the funding to deliver new places in mainstream and special schools, as well as other specialist settings, and to improve the suitability and accessibility of existing buildings.
Asked by: Caroline Nokes (Conservative - Romsey and Southampton North)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how much her Department spent on autism assessments in each of the last five years; how much funding her Department has allocated to autism assessments in each of the next three years; and what recent assessment her Department has made of the adequacy of that funding in meeting the target waiting time for such an assessment.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
Information on the total spend on autism assessments is not held centrally. NHS England is responsible for funding allocations to integrated care boards (ICBs), which are responsible for commissioning services using these core allocations to meet the needs of their local populations, including autism assessment services. The following table shows the total baseline expenditure in ICBs for learning disability and autism services over the last five years, disaggregated for autism services where possible:
| Learning disability | Autism services | Unseparated learning disability and autism services | Total |
2019/20 | N/A | N/A | £1,809,200,000 | £1,809,200,000 |
2020/21 | N/A | N/A | £2,285,600,000 | £2,285,600,000 |
2021/22 | £85,800,000 | £3,700,000 | £2,268,300,000 | £2,357,900,000 |
2022/23 | £625,800,000 | £27,100,000 | £1,928,800,000 | £2,581,700,000 |
2023/24 | £926,000,000 | £47,100,000 | £1,928,800,000 | £2,904,600,000 |
In addition, specific funding has been allocated to ICBs in 2023/4 and 2024/25 from the Service Development Funding, to improve autism assessment waiting lists and pathways. The following table shows information on the additional national funding allocated to ICBs by NHS England, over each of the last five years, to improve autism assessment waiting lists and pathways:
| Service Development Funding via the NHS Long Term Plan Transformation Funding | Spending Review 2021 via the COVID-19 Recovery Fund | Total funding for autism assessment pathways |
2019/20 | N/A | N/A | N/A |
2020/21 | N/A | N/A | N/A |
2021/22 | £2,500,000 | £14,500,000 | £17,000,000 |
2022/23 | £5,000,000 | N/A | £5,000,000 |
2023/24 | £4,200,000 | N/A | £4,200,000 |
2024/25 | £4,300,000 | N/A | £4,300,000 |
Notes:
The NHS Operational and Planning Guidance 2024/25 asks local systems to improve autism assessment pathways, through implementation of the NHS England autism assessment national framework. Allocations from 2025/26 onwards are subject to future decisions on spending. Further information on the operational and planning guidance and national framework is available respectively at the following links:
https://www.england.nhs.uk/publication/autism-diagnosis-and-operational-guidance/
A specific assessment of the adequacy of funding in meeting the National Institute for Health and Care Excellence’s waiting time standard for autism assessments has not been made. However, autism waiting times statistics are published on a quarterly basis. The total number of people with an open referral, where the diagnosis not yet completed, for suspected autism has increased by 47%, from 117,032 in December 2022 to 172,022 in December 2023. In December 2023, it was estimated that only 5.9% of patients whose referrals have been open in the system for at least 13 weeks received their first contact appointment within 13 weeks.
Asked by: Caroline Nokes (Conservative - Romsey and Southampton North)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if she will make an estimate of the number of health and adult social care staff that will undertake the second part of tier (a) one and (b) two of the Oliver McGowan Mandatory Training on Learning Disability and Autism in the next three years.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
We have provided estimates of the number of health and adult social care staff that would undertake Tier 1 and Tier 2 of the Oliver McGowan Mandatory Training in our consultation stage impact assessment. This assessment was published as part of the public consultation on the Oliver McGowan Code of Practice. The impact assessment and wider public consultation are available, respectively, at the following two links:
For healthcare, we estimated that over the first three years of training roll-out, 1,036,000 staff would be trained at Tier 1 level, and 1,186,000 staff would be trained at Tier 2 level. For adult social care, over the same period, we estimated that 840,000 staff would be trained at Tier 1 level, and 492,000 staff would be trained at Tier 2 level. In addition, over 1.7 million people have already completed the first part of Oliver McGowan Mandatory Training on Learning Disability and Autism, an e-learning package.
The final stage impact assessment incorporates additional evidence on the number of staff expected to undertake training, which was provided by organisations through the public consultation. The final assessment will be published in due course.
Asked by: Fabian Hamilton (Labour - Leeds North East)
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 increase access to NHS assessments for Autism Spectrum Conditions for children.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
I refer the hon. Member to the answer I gave to the hon. Member for St Ives on 22 March 2024, to Question 18917.