Health and Social Care Bill

Memorandum submitted by TreeHouse (HS 30)

Health and Social Care Bill and autism education

TreeHouse is the national charity for autism education. We have an interest in the Heath and Social Care Bill, as it is vital that all health providers are equipped to ensure good outcomes for children and young people with autism.

In the committee stage of the Bill’s legislative journey, TreeHouse continues to have concerns relating to:

· T he expertise of commissioners of working with children with autism

· H ow Health watch will engage parents and carers of children with autism

· T he co-ordinated commissioning of specialist services for children with complex and low-prevalence needs

· T he role of schools in local H ealth and W ellbeing boards

The Expertise of Commissioners

Studies have shown that GPs often lack experience or training in working with children and young people with autism. Four out of five GPs (80%) indicate that they require additional guidance and training to identify and manage patients with autism more effectively [1] . We therefore have serious concerns about whether GP consortia will have the necessary expertise in autism to effectively commission services for children and young people with autism.

Recommendation TreeHouse suggests that steps are taken to ensure expertise on autism is reflected in the commissioning process. One way of doing this may be to ensure the participation of the local authority autism lead and the autism partnership boards in the Health and Wellbeing boards or in GP consortia; this should be listed in part 5 chapter 2.

Healthwatch & Participation

Healthwatch groups must ensure that there is provision for the participation of children with autism and their families. TreeHouse knows that children and young people with autism and their families find it difficult to engage positively with the services on which they rely.

TreeHouse endorsed the Health White Paper’s dictum that there should be no decision about me without me and believe that this is particularly relevant for young people with autism and other disabilities, who all too often have been seen as ‘passive’ rather than ‘active’ service users.

Recommendation: We suggest that HealthWatch be given a specific remit to

advocate on behalf of children with disabilities and their families, as they are likely to be core users of these services.

Co-ordinated Services

Children with autism often require input from a large number of health professionals, for example GPs, speech and language therapists, occupational therapists, and educational psychologists. TreeHouse is concerned that whilst at present there is a single body responsible for the provision of each of these services (PCTs), consortia could fail to commission and co-ordinate all of these services effectively.

Recommendation: TreeHouse ask that Part 1 Section 9, ‘Duties to Consortia as to Commissioning Certain Services’, include a clause that requires boards to commission specialist support services for disabled children and ensure that provision is co-ordinated.

The Role of Schools

The co-ordination and partnership of education and health services is essential for children and young people with autism, who may see a range of professionals from across education and health on a weekly basis. In order to ensure the effective sharing of information, use of resources, and minimal disruption for children and families, it is essential that all providers who support children work closely together.

At present schools are represented on Children’s Trusts. TreeHouse understands that the new Health and Wellbeing boards will take on many of the responsibilities of Children’s Trusts but there is no mention of how schools might be represented. With the opening of academies and free schools it is essential that there is a co-ordinated approach as these schools may need help in accessing specialist services such as speech and language therapists.

Recommendation: TreeHouse ask that Part Five of the Bill includes a requirement for an education representative to sit on Health and Wellbeing Boards, or that the boards are required to ensure regular liaison with local schools.

February 2011

[1] National Audit Office, ‘ Survey of General Practitioners in England on the subject of autism’ (2008)