NHS Ayrshire and Arran FOI Request Regarding Autism Provision 2012

See also Autism Provision by NHS Primary Care Trust 2012.

Dear Ms McCulloch,

Thank you for your request.

Q.1 How many adults you have with a diagnosis of autistic spectrum disorder (ASD) (any, although if there are separate statistics for Asperger’s, HFA, LFA, they would be appreciated) in your area;

A.1 There is no local register for gathering this information. We currently use prevalence statistics from other sources.

As we do not hold this information it is classed as an exclusion under section 17 (1) of the Freedom of Information (Scotland) Act 2002.

However, the National Autistic Society carried out a review of ASD research and proposed an approximate prevalence of one person in every 110. This rate has since been adopted by the Scottish Parliament’s Cross Party Group on ASD. Using this source, Ayrshire and Arran have approximately 3,331 people with ASD in a population of 366,393.

There are also no statistics on gender and age, however the ratio that is widely accepted through previous research is four (male) : one (female).

Q.2 How many children.

A.2 Please see our response to question one.

Q.3 What diagnostic services are available to a) adults and b) children;

A.3 The evidence-based tools we routinely use are:

. Autism Diagnostic Observation Schedule (ADOS)

. The Diagnostic Interview for Social and Communication Disorders (DISCO)

. Social Communication Questionnaire (SCQ)

. Developmental, Dimensional and Diagnostic Interview (3Di)

. Gilliam Autism Rating Scale (GARS)

. Gilliam Asperger’s Disorder Scale (GADS)

Please note that an Autism diagnosis is a clinical decision – while they are highly relevant tools for the assessment and diagnostic process the decision is dependent on clinical judgment.

a) Where there is thought to be a co-association with learning disability, referral will be picked up by Community Learning Disability Team for multidisciplinary assessment, with specific diagnostic criteria applied by psychology and psychiatry. Referrals picked up will also be screened for the appropriateness of learning disability label and any associated co-morbidity. Referral may remain with learning disability service or signposted as appropriate.

The Adult Mental Health Community (AMHC) service can provide assessment and treatment to adults presenting with mental health problems and autistic spectrum disorder (ASD). Assessment, including a clinical opinion on diagnosis, is provided by psychiatry and psychology as part of clinical assessment. In addition to psychiatry and psychology, treatment of ASD in the context of complex mental health problems is provided by the wider professional group of the Community Mental Health Team (CMHT). There is no purely diagnostic or specialist treatment service under the AMHC Service and no ASD specific support service. Care needs would be responded to on a multi-agency basis where this was required.

Adult Mental Health (AMH) inpatient services do not provide diagnostic services for this condition. However, the Responsible Medical Officer (RMO) can make a referral to Psychology for diagnostic work

b) Within community paediatrics a number of team members are involved, including: clinical psychology, paediatricians (consultant and staff grade), speech and language therapy and nursing staff.

In the pre-school age-range children are seen in a multi-disciplinary clinic. In the school age-range this is normally led by clinical psychology, but with involvement of the other professionals noted, and also occupational therapy, as required.

Within the Child and Adolescent Mental Health Service (CAMHS) all members of the team (nursing, occupational therapy, psychiatry and psychology) are involved, usually with CAMHS psychology leading the assessment and diagnosis.

Other disciplines outside CAMHS are also often involved including speech and language therapists, paediatricians and educational psychologists.

Q.4 What agencies or teams you have that work with autistic people, provide support/services, strategise, etc.

A.4 Please see our response to question three.

Q.5 An email address/website for each of these agencies or teams where possible.

A.5 We do not provided email addresses for staff below Director level. We have generic enquiries email addresses available from our public website, http://www.nhsaaaa.com whereby members of the public can make contact and their query can be forwarded to the most appropriate recipient.

The majority of NHS departments have generic email contact details for use of members of the public or alternatively we provide phone numbers and postal addresses. Personal emails are provided to staff to assist them in carrying out their daily work and provides an effective way of communicating internally and externally with colleagues and partnership organisations. It is not used as a point of contact for public or patient enquiries.

In not providing you with this information we are relying on exemption section 38 (1) (b) of the Freedom of Information (Scotland) Act 2002 (FOISA). This exemption covers personal information where disclosure would contravene any of the data protection principles as laid down by schedule one of the Data Protection Act 1998 (DPA).

For a full explanation of our use of this exemption, please see the attached document.

There is no generic e-mail address. However, the Learning Disability Service section of the NHS Ayrshire & Arran website has links to the Community Learning Disability Team Leaflets and information about Assessment and Treatment with contact information. Please visit http://www.nhsaaa.net/.

AMHC Service section of the NHS Ayrshire & Arran website provides contact information and guidance on how to seek referral to the service.

Q.6 What the typical process should be for an adult in your area first asking their GP for an assessment for autistic spectrum disorder to receiving a diagnosis/support.

A.6 In the first instance the individual should visit their GP who would refer through the single point of access. All GP practices have a consultant psychiatrist and community mental health nurse who link specifically with them and there are regular liaison opportunities where clinical advice can be sought regarding referral options/pathways. There is no specialist diagnostic service for ASD in the absence of mental illness.

If there is an association or suspected association with learning disability and a specialist health need, then the GP would refer to the learning disability service and referral will be dealt with as in question three.

I trust this is to your satisfaction. However, under the Freedom of Information (Scotland) Act 2002 if you are dissatisfied with our response you are entitled to request a review. A request for a review must be made in writing to Mr John Burns, Chief Executive, NHS Ayrshire & Arran, Eglinton House, Ailsa Hospital, Dalmellington Road, Ayr KA6 6AB, no later than 40 working days from 17 July 2012. You must provide your name, an address for correspondence, details of your original request and say why you want a review. If our decision is unchanged following a review and you remain dissatisfied with this, you then have the right to make a formal appeal to the Scottish Information Commissioner.

Please do not hesitate to contact me should you require any further advice or assistance.

Kind regards,

Ann

Ann Catherine Wilson L.L.B
Freedom of Information Officer

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