Background

In July 2016 Islington Clinical Commissioning Group contacted the National Autistic Society to review the two local autism diagnostic pathways for children 0-18 years, via the Social Communication Team and the CAMHS Neurodevelopmental Team.

The review was triggered by an increase over the past five years in autism assessment referral rates, which had impacted on professional capacity and the timely support of children and their families.

This resulted in lengthy waiting times that far exceeded NICE guidelines. While the assessment rates have increased, there is still a backlog. The numbers referred are within expected prevalence rates for Islington, meaning that they are not expected to decrease going forwards, particularly with a rising local population.

What we did

We were appointed to review and explore current services and support, identify areas for potential development and provide recommendations based on national good practice and guidelines (for example offering a variety of post-diagnostic support and ensuring assessment and diagnosis happens within recommended NICE guidelines).

While the review was to focus on the diagnostic provision, it also needed to look at other services across education, health and social care that link into diagnosis.

The review took place between July and October 2016. This took the form of:

• over 40 hours of telephone, email and face-to-face meetings with professionals
• parent carer consultation (led by parent carers) through two meetings and an online survey
• a consultation meeting with autistic young people
• assessment of a wide range of documents and data.

Outcome

The review identified particular areas of good practice that could be built upon to inspire more service development locally and in neighbouring areas. There were also a number of recommendations made, to encourage further developments.

By bringing in the National Autistic Society to carry out the review, Islington gained fresh insight into 
gaps in services and areas of strength. This enabled them to identify areas for potential development, with suggestions for transformation according to national and regional best practice. Islington was able to reflect on ongoing challenges, but also have reassurance in its ability to deliver with creative oversight. 

There is some excellent practice evidenced in Islington, and the commitment, skills and passion of staff translates into services that are effective and have a strong positive impact on local children and families.