Contents
Introduction
Context to the Strategy
National and Local Drivers for Change
Where are we now?
Consultation: Who have we listened to in developing this plan?
Our alignment to Trust Values, Objectives and Strategies
Delivering the Strategy
Three-year Objectives
Indicators of Success
Introduction
The aim of this document is to set out a 3-year plan (2024–2027) to support patients who are autistic throughout their journey of care in Lancashire Teaching Hospitals NHS Foundation Trust (LTHTR). The Autism Strategy considers care within the Emergency Departments, Inpatient and Outpatient areas and covers all ages (children, young people and adults).
At LTHTR we are committed to providing outstanding, patient-centred, and individualised care. It is crucial that our patients feel safe, listened to and have confidence in the knowledge and skills of our staff. The strategy aims to ensure positive experiences and involvement of families and carers who play a pivotal role in their loved ones / patient’s journey. This Autism Strategy builds on the work that has been completed over recent years. It provides a clear commitment for continuing this progress and aims to ensure continued development, drive to reduce health inequalities and co-production with autistic people and experts by experience (families/carers).
The Trust recognises and welcomes the opportunity to work in partnership with our multi-agency partners including health, social care, voluntary agencies, our Integrated Care Board/System colleagues (responsible for planning and ensuring provision of health services) and patient / user involvement groups. Through working in partnership, we will ensure our collaborative efforts contribute to improving the health and outcomes of autistic people.
This strategy will be made available in an accessible version.
Context to the Strategy
The Autism Strategy recognises that the terms Neurodiverse, Autistic people, Autism, Autistic Spectrum Condition and Autistic Spectrum Disorder may be preferred by people. This strategy focuses on individual strengths and needs, although recognises and respects that our patients may prefer ‘autistic, neurodivergent or a person with autism’ throughout their journey of care.
Autism :
- Autism affects the way a person communicates and how they experience the world around them. Autism is a spectrum condition which can vary in how it impacts on somebody and the level of support that may be needed across a person’s life. Ambitious about Autism
- Some autistic people have average or above average intelligence. NHS ‘What is Autism 2024’
- However, research indicates that many more people may be undiagnosed: In 2018 0.82% of the English population was diagnosed and up to 1.2 million (or 2.12%) of the population may be autistic and undiagnosed. (Lancet, 2003) NHS Digital estimates that 1.1–1.2% of the population are undiagnosed for autism.
NHS England, NHS Improvement ‘People with a learning disability, autism or both Liaison and Diversion resources’ (2019) noted that Autistic Spectrum Conditions are not classed as a learning disability. However, 20–30% of people with a learning disability also have autism and people with autism are more likely to experience mental health problems.
The difference between a Learning Disability and Autism is recognised and therefore a separate Learning Disability Plan and Autism Strategy has been developed. However, following a number of consultation events with people with a lived experience we have recognised that there are overlapping priorities in the action plan for services delivering care for people with either a Learning Disability or Autism (or both). These include - data collated for the NHS England and NHS Improvement (NHSEI) Learning Disability Benchmarking Standards to include autistic people, improvement within the agendas of Special Education Needs and/or Disabilities (SEND) and Learning from lives and deaths – people with a learning disability and autistic people (LeDeR).
The Five-year NHS Autism Research Strategy for England recognises that autistic people have greater difficulties accessing health care. The Equality Act 2010 ensures that all people accessing healthcare have equal opportunities to care and to treatment. Equality for people with disabilities may require the organisation to make reasonable adjustments to its service to accommodate specific or additional support needs of those with disabilities. As a Trust we are committed to ensure that all patients have equal rights, feel listened to have the opportunity for involvement in improvement programmes with an aim of co-production.
The Autism Strategy has been led by patient, family, carer and staff feedback.
Special Education Needs and/or Disability (SEND)
The Autism Strategy ensures a shared vision in the implementation of reasonable adjustments, aims to reduce health inequality, and is committed to ensuring that autistic patients aged 0–25 years and SEND have a positive experience from a skilled workforce.
Special Educational Needs and/or Disabilities (SEND) forms Part 3 of the Children and Families Act (2014) and covers the age range of 0–25 years.
Schools are funded to meet the majority of Special Educational Needs (SEN) and support and adjustments will be arranged to meet the child or young person’s needs – set out in a SEND support plan.
At times an Education, Health, and Care Plan (EHCP) is needed to ensure health, social care and education work together to meet these needs. The Trust is committed into their statutory obligation for SEND, the EHCP process and ensuring our services are identified in the SEND Local Offer (which describes the services offered by agencies).
Learning from Lives and Deaths - People with a Learning Disability and Autistic People (LeDeR)
The LeDeR programme aims to improve health and social care for people with a learning disability and autistic people, to reduce health inequalities and to stop people from dying too soon by making care better.
A LeDeR review will look at a person’s life as well as how the person died, this helps to identify good practice, improvements for care (health and social) and agencies work together to understand any lessons learned. We as a Trust are committed to learning and being part of the LeDeR process.
National and Local Drivers for Change
The LTHTR Autism strategy sets the Trust’s commitment in line with local and national strategies including –
The National Strategy for autistic children, young people and adults (2021–2026) which for the Trust specifically relates to -
- Improving understanding and acceptance of autism within society.
- Supporting positive transition into adulthood
- Tackling health and care inequalities for autistic people.
- Building the right support in the community and supporting people in inpatient care (LTHTR specifically supporting pathways and multi-agency discharge planning to support our autistic patients).
- The NHS Long Term Plan (2019) ensuring that NHS commissioned services provide good quality healthcare and treatment to autistic people, that NHS staff make reasonable adjustments to ensure equal access, experience and outcomes and that the NHS has an aware of the needs of people with autism.
- The Learning from lives and deaths – People with a learning disability and autistic people (LeDeR) policy (2021)
- Lancashire SEND Plan 2021–2025
- Safeguarding statutory requirements and Mental Capacity Act (2005)
- The Lancashire & South Cumbria Strategy (2022) All-Age System Strategy for Autism
- Think Autism (2014)
- Autism Act (2009)
- NHS England National Framework to deliver improved outcomes in all-age autism assessment pathways: guidance for integrated care boards (2023)
Where are we now
- The Trust has invested in a Matron for Mental Health, Learning Disabilities, Autism and Dementia and a Learning Disability and Autism Specialist Practitioner/Nurse who support patients, families and specialist teams to consider reasonable adjustments, to deliver person centred care and to work closely with multi-agency partners including the Local Authority, Mental Health Trust, Community Learning Disability services, other Acute Hospitals, local community Trusts and the Integrated Care Board.
- The completion of the annual NHSE/NHSI Learning Disability Benchmarking Standards for 4 years and submission for the 5th year – providing data analysis to the standards, patient feedback and staff feedback. Data includes care for our autistic patients.
- A Reasonable Adjustment flag for autism (and other visual or hidden disabilities) on electronic patient records which allows us to ensure staff are aware of the changes (adjustments) that are needed to support care – for example, adjusted times and length of appointments, changes to support sensory needs or communication aids. This flag has been developed with autistic patients.
- Continuous Improvement within the Community Neurodevelopmental Paediatrics Team including review and development of the community neurodevelopmental pathways, development of the autism spectrum disorder (ASD) Programme Co-ordinator and ASD Pathway Navigator, reviewing and streamlining of service provision, data collection and post diagnostic support for the parents of pre-school and school age children.
- A Special Care Dentistry service which is focused on ensuring our patients with a Learning Disability, autism or mental health difficulty are supported to access dental care, have reasonable adjustments ensured, close working with families and carers and a dedication to reducing anxiety by using different methods (for example: written or video social stories). And, Special Care Dentistry working on transition clinics, so children with complex needs have a transition plan is developed from starting High School/age 11 years.
- The development of resources for both staff and patients including - a staff Intranet with helpful tools (e.g. Communication books), the development of Easy Read information specific to individual patients or patient leaflets (for example, PALS leaflet) and personalised Social Stories (booklets or videos) to help understanding of the planned appointment, medical intervention, or pictures of multidisciplinary team to reduce anxiety about accessing healthcare.
- Bespoke training sessions with our Learning Disability and Autism Champions and specialist teams often co-delivered with people with lived experience. Sourced training days
- from the National Autistic Society pre-COVID-19.
- The development of a mandatory e-learning module on Learning Disabilities and Neurodiversity, co-working between the LTHTR Learning Disability/Autism Team and Trust Neurodiversity Lead to include Oliver McGowan training.
- Established Learning Disability and Autism Champions who provide the ward with increased knowledge, receive training including by people with a learning disability and / or autism are the link to positive patient experience on the wards and departments.
- A ‘Health Day’ event in 2023, restarted post COVID-19, to inform the Learning Disability and autistic community about different health needs, screening in relation to health and aimed to ensure access and reduce health inequality.
- Involvement in the Integrated Care Board (ICB) task and finish groups including the Autism Partnership Board Health and Social Care Group - Ensuring learning into action for service development.
- Engagement with the LeDeR (Learning from lives and deaths-people with a learning disability and autistic people) Steering Group. Active involvement, and implementation of lessons learned and learning from patient experiences, and internal processes to ensure LeDeR notifications are submitted.
- The development and implementation of LTHTR Hospital Passports, and education around their use and improvements for patient care for autistic people or patients with a learning disability. (See image below)
- Involvement in Lancashire & South Cumbria SEND Partnership - including a SEND clinical lead and SEND Champion, working with the SEND Designated Clinical Officer into the completion of Educational Care Health Care Plans (EHCP)
- Established a SEND Improvement group share the message of SEND, ensure service improvements are aligned to the SEND priorities and the Trust are driving forward SEND (for example Transition, data capturing and Neurodevelopmental pathways)
- Improved systems to understand patient experience and incidents – changes made to the Trust incident reporting system to include Learning Disability and Autism (as per NHSE/NHSI Standards) which can capture compliments, concerns and complaints of patients, families and carers. Close working with the patient experience team.
- It is recognised that although we have had a journey of improvement, our progress has been significantly stalled as a result of COVID-19 and much of the work commenced is being re-started or continued.Size
Image Description
The hospital passport has a green top border with a graphic representation of a pair of hands in the top left hand corner. The hands form together to make a heart shape hole. The right hind of the border features thela Lancashire Teaching Hospital Logo.
The main body of the image features a white background with a border of blue. Along the top of the image there are four icons in blue. One of a hospital, one representing an ambulance, one of a first aid kit and one of a hospital H road sign.
Then follows text on the image.
The title 'Hospital Passport' in black capitals on a light blue band.
This is followed by the paragraph text in blue 'when you come into hospital we want to make sure tthat we care for you really well. This passport gices hospital staff important information about YOU and a brief account of any additional needs you may have that the staff taking acre of you may not know.'
The text in black follows ' Please take it with you if you have to go into hospital. Make sure that all the staff who need to know about the information read it.
ALL NURSES and MEDICAL STAFF MUST READ THIS INFORMATION
I have some one who supports me, their name is:'
The blue text sentences follow:
'Their telephione number is:
Please involve them 9see page 2)
Date completed:
Completed by:
Relationship/Designation:
Consent: Are you happy for us to share your information? please tick a box'
There are then two tick boxes yes and no. Each tick box has a graphic of a smiley in a speech bubble next to it. The yes tickbox has green square style speech bubble with happy face smiley.
The no tickbox has red square style speech bubble with sad face smiley.
Along the bottom border of the image has the words 'Adapted from the original produced by Gloucestershire Partnership NHS Trust'
Consultation: Who have we listened to in developing this strategy
Consultation with people with lived experience (autistic people, a learning disability or both), experts by
experience (families and carers) and multi-agency consultation has been key for the development of this
Autism Strategy.
Key people have included:
- Two consultation events including autistic people, families, and carers.
- Local advocacy groups.
- Lancashire Teaching Hospitals NHS Foundation Trust Patient Experience and Involvement Group
- Lancashire Teaching Hospitals NHS Foundation Trust Learning Disability and Autism Champions
- Lancashire Teaching Hospitals NHS Foundation Trust Specialist Teams including the Community Neurodevelopmental Paediatrics team and SEND Clinical Lead.
- Lancashire Teaching Hospitals NHS Foundation Trust Patient Experience and Patient Advisory Liaison
- Service (PALS) teams.
- Lancashire Teaching Hospitals NHS Foundation Trust Governors.
- Multi-agency partners across the Integrated Care Board including leads / members from SEND and LeDeR groups.
- Lancashire Teaching Hospitals NHS Foundation Trust SEND Improvement Group.
You said in the consultation:
What should be our first 3 priorities be for the Autism Strategy?
training for staff
better understanding
sensory friendly
more resources
sensory profiling
hospital passports
resonable adjustments
commissioning
autism pathway development
easy read information
resource to make change
resource to make changes
change in attitude
increase understanding
understanding individuals
involve patient and carer
flexability
burnout
inclusion
prior planning for care
hidden disability
y p support
listening to carers
support for carers
ward activities
thinking outside the box
easier points of contact
non judgmental care
Ideas for Co-production
expert by experience
easy read information
feedback in easy read
better feedback
include patients
video messages
discharge paperwork
better signage
care planning
improved communicaton
new forums
focus groups
more link nurses
accessible information
attend anywhere
send
transition clinic
info in waiting rooms
learning from leder
circulate briefings
ward activities
teams meetings
link with special schools
engaging with bame
communication campaign
Examples of Positive Practice
mdt meetings
films to support access
the ld team involment
apls
being proactive
pre planning
key contacts
reasonable adjustments
follow up of information
use of communication aids
good communication
building on existing care
quality of resources
de sensitisation
seeking to understand
sharing postive stories
health days
hospital passports
involing key parties
vanguard theatre
fast track options
early reponse
directory of resources
using real stories
consistency
using social stories
The Trust is committed to ensuring actions from learning and the strategy has been developed considering patient's family or carers experience and feedback.
Our Alignment to Trust Values, Objectives and Strategies
Our values
This Autism strategy aligns with the Trust mission, ambitions, and values. Our values were designed by our staff and patients and are embedded in the way we work on a day to day basis, are at the core of everything we do and are embedded to guide high quality, patient-centered care:
Compassionate
A culture where we treat patients and colleagues with compassion, understanding and with kindness.
Respectful
A culture where all roles or backgrounds are valued and equal, ideas are welcomed, we feel respected and supported.
Empowered
A culture where we are empowered and enabled to act to the full remit of our roles, we understand what we can do and feel able to act without permission.
Collaborative
A culture where we recognise we are part of a bigger team, willing to work across boundaries to support others to achieve their aims.
Performance Focussed
A culture which is performance focussed, we strive to be the best. We are happy to be held and hold others to account in a positive, supportive manner, we are reflective and do not seek to blame.
Alignment to Trust Objectives
The objectives defined in this plan are framed on the Trust’s core objectives which are:
To provide sustainable and outstanding healthcare to our local communities
To offer a range of high-quality services to patients in Lancashire and South Cumbria
To drive health innovation through world class education, training, and research
These objectives are translated into key deliverables founded on four ambitions:
Consistently deliver excellent care
Improve outcomes and prevent harm
Get it right first time
Work in partnership to deliver a positve patient experience
Ensure a safe, caring environment
A great place to work
Promote health and wellbeing
Inform, listen and involve
Value each other
Develop people
Deliver value for money
Spend well
Spend wisely
Spend less
Fit for the future
System working
Place based partnership
Strategy and transformation
The Autism Strategy is closely aligned to other Lancashire Teaching Hospital (LTHTR) strategies including:
The Learning Disability Plan 2023–2026
The Mental Health Strategy 2021–2024
The Patient Experience and Involvement Strategy 2022–2025
The Equality, Diversity, and Inclusion Strategy 2022–2025
As previously highlighted our patients may have a mental health difficulty or learning disability and therefore alignment at times may be appropriate. It has also been key to align this strategy with ‘The Patient Experience and Involvement strategy,’ and the ‘Equality, Diversity and Inclusion strategy’. These strategies similarly provide a clear plan to improve patient experience at LTHTR through the Trust ambition to ‘Consistently deliver excellent care’ and the aim for co-production with a more meaningful level of involvement and equal footing for
decision-making.
Delivering the strategy
The delivery and success of the Autism Strategy will be governed through a number of established groups within
Lancashire Teaching Hospitals including –
- The SEND Improvement Group for the SEND specific focused improvement and action planning.
- The Patient Experience and Involvement Group, a sub-committee of the Safety and Quality Committee with specific focus on patient experience and quality
- The LTHTR Safeguarding Board within which the mental health, learning disabilities, autism and dementia team report into.
- The Trust Mortality Committee where LTHTR LeDeR annual feedback will be ensured and an annual report benchmarking against the national annual report in context of learning will be completed.
The Autism Strategy recognises the need for patient involvement and a drive to achieve co-production. Further opportunities for review of the Trust Strategy will be achieved with our local autistic advocacy groups.
Three Year Objectives
The Trust’s three-year plan to deliver the strategy is based upon the national standards developed by NHSEI and is set out below.
Strategic Priorities Commitment: Respecting and Protecting Rights
Aim:
1. We will demonstrate the ability to isolate and disaggregate specific outcome data for patients with a Learning Disability as per NHSEI Learning Disability Standards
2. We will demonstrate reasonable adjustments to care pathways to ensure patients can access highly personalised care and achieve equality of outcomes.
3. Patient feedback and experience will indicate a culture of reasonable adjustments and positive, high quality care.
4. Children, Young People and Adults with a Learning Disability will have their rights protected in line with the mental capacity act and least restrictive practice
Year 1 |
Year 2 |
Year 3 |
Consistently deliver excellent care |
A great place to work |
Deliver value for money |
Fit for the future |
NHS |
Outcome |
Outcome |
Outcome |
✓ |
✓ |
✓ |
✓ |
✓ |
| We will work alongside the Patient Experience team to increase the knowledge, use and understanding of the Reasonable Adjustments tab on electronic patient records (Harris). | We will routinely capture the number of patients with a Reasonable Adjustment tab through Business Intelligence evidencing improvement of Trust knowledge and implementation. | There will be evidence that the Reasonable Adjustment flag is routinely highlighting our autistic patients either with consent or in best interest and this has improved patient care. The Trust to consider feedback forms. | ✓ | ✓ | ✓ | ||
| The Reasonable Adjustment tab will have the function to ‘be pulled’ from electronic patient records onto Outpatient whiteboards, Emergency Department whiteboard and Inpatient Safety Surveillance Boards to guide individualised care. We will be able to ‘run reports’ for forthcoming outpatient clinics and be able to identify patients with reasonable adjustment needs prior to the appointment so the appropriate support and adjustments can be planned |
All outpatient clinics will have function to use the Reasonable Adjustment tab to inform adaptations for autistic people accessing outpatient clinics. Patient feedback to be collated and Compliments, concerns and complaints will be analysed to consider impact on experience. We will audit whether any outpatient areas intermittently contact children, young people, or adults on waiting lists to see if presentation has changed. |
As a reasonable adjustment we will have processes in place to intermittently contact children, young people and adults with autism on waiting times to see if their presentation has changed and if existing timeframes require reviewing. | ✓ | ✓ |
✓
|
Year 1 |
Year 2 |
Year 3 |
Consistently deliver excellent care |
A great place to work |
Deliver value for money |
Fit for the future |
NHS |
Outcome |
Outcome |
Outcome |
✓ |
✓ |
✓ |
✓ |
✓ |
| Joint working with Business Intelligence will occur to scope accurate data collection for our autistic patients – admissions and waiting lists. | We will capture autistic patients and be able to disaggregate waiting times and reemergency admissions for autistic children, young people, and adults. | We will analyse the data for waiting times, re-emergency rates for autistic people | ✓ | ✓ | ✓ | ||
| The use of the Hospital passport will continue to be pivotal as a tool to inform staff about Reasonable Adjustments and individual needs - the Hospital Passport will be emphasised at the re-established ‘Health Day’, via the Autism Partnership Board Health and Social Care group and by ensuring we ask patients for a Hospital Passport (for example at the Emergency Department and on admission) | We will review the Hospital Passport with Community advocacy groups for autistic people to ensure sensory needs are better highlighted. We will continue to work alongside multi-agency partners and the Integrated Care Board groups to embed Hospital Passports in the community, primary care and within families, carers, and providers. | The monthly STAR audit into the use of the hospital passport will be reviewed and analysed to consider improvement opportunities. Audit will indicate increased use of Hospital Passports across LTHTR for autistic patients. | ✓ | ✓ |
✓
|
||
| The Internet will be updated with a page on the Learning Disability and Autism Team and key documents such as the Hospital Passport and information on the Reasonable Adjustment flag. | Specialist Teams (i.e. PALS) will ensure patients, families, carers, and providers are aware of the Intranet page for contacting the LTHTR Learning Disability and Autism Matron/ practitioner and resources. | Review of compliments, concerns and complaints will indicate whether the intranet can be improved/has supported family and carers. | ✓ | ✓ | ✓ | ||
| A new annual report will be completed to benchmark the national LeDeR findings to LTHTR lessons learned and show evidence of learning into action. | The annual LTHTR LeDeR benchmarking report against national findings will be completed to provide assurance and action planning. | We will continue to complete the annual LTHTR LeDeR benchmarking report against the national report to provide assurance and action planning. | ✓ | ✓ | ✓ |
Year 1 |
Year 2 |
Year 3 |
Consistently deliver excellent care |
A great place to work |
Deliver value for money |
Fit for the future |
NHS |
Outcome |
Outcome |
Outcome |
✓ |
✓ |
✓ |
✓ |
✓ |
| We will continue to ensure the principles of Mental Capacity Assessment (MCA) and Best Interest decision making is followed. We will ensure a referral to an Independent Mental Capacity Advocate (IMCA) where indicated for any patient known to the LTHTR Learning Disability and Autism Nurse/Matron. | Learning from internal MCA audit or outcomes from LeDeR in relation to MCA will be actioned for our autistic patients. | We will continue to action any learning from internal MCA audit or outcomes from LeDeR in relation to MCA will be actioned for our autistic patients. | ✓ | ✓ | ✓ | ||
| We will work to establish the fixed term role of the ASD Programme Coordinator and ASD Pathway Navigator. Data / business intelligence will be utilised to continue to understand referral and waiting times and provided to the ICB and / or nationally as required. | Review of Service Provision across our Community Neurodevelopmental Paediatric Teams will continue, in line with the ICB Neurodevelopmental Pathways. Software to be reviewed and consideration of link into the Integrated Care Board (ICB) to be completed. | The Community Neurodevelopmental Paediatrics will continue to ensure wider data and develop this working with business intelligence and IT systems. | ✓ | ✓ |
✓
|
Strategic Priorities Commitment: Inclusion and Engagement
Aim:
1. To ensure inclusion and engagement with autistic children, young people and adults, their families, and carers
2. To aim to a partnership of co-production
3. To ensure accessibility to healthcare and a positive patient experience
Year 1 |
Year 2 |
Year 3 |
Consistently deliver excellent care |
A great place to work |
Deliver value for money |
Fit for the future |
NHS |
Outcome |
Outcome |
Outcome |
✓ |
✓ |
✓ |
✓ |
✓ |
| We will review the feedback from our ‘Health Day’ in June 2023 which was established to increase knowledge of specialist teams and interventions, reduce anxieties, increase access to healthcare and reduce health inequalities. We will consider the feedback in relation to our autistic patients and whether the event and environment met their needs. Our Health Day to be planned with people with a lived experience for 2024. | Our Health Day to be planned with people with a lived experience for 2025 – feedback from attendee’s to be reviewed to improve or learn from the event. | Our Health Day will be planned with people with a lived experience for 2026 and will ensure that any learning from LeDeR, national strategies and feedback from previous events will be considered. | ✓ | ✓ | ✓ | ✓ | |
| The LTHTR Learning Disability and Autism team will work alongside partners for the Autism Partnership board Health and Social Care group to ensure improvement will influence patient experience in LTHTR and reduce health inequality. | We will collate and audit the information provided for autistic patients, their families, and carers in waiting areas to ensure resources are highlighted including Hospital Passports, Learning Disability and Autism Champions, activities and Reasonable Adjustments. Learning from the Health and Social Care Group will be embedded. | We will have a catalogue of social stories and videos accessible on the Internet and Intranet for families and teams to support the patient journey. A standardised format for Easy read will be developed for specialist teams to use and will be ratified by the Trust Patient Experience and Involvement Group. | ✓ | ✓ |
✓
|
||
| We will work alongside colleagues in the New Hospitals Programme to ensure feedback from autistic patients, their families and carers is heard to influence the environment (for example quieter waiting areas). | We will continue to work with colleagues for the New Hospitals Programme and environmental issues/ improvements for autistic patients. | We will continue to work with colleagues for the New Hospitals Programme and environmental issues/ improvements for autistic patients. | ✓ | ✓ | ✓ | ✓ |
Year 1 |
Year 2 |
Year 3 |
Consistently deliver excellent care |
A great place to work |
Deliver value for money |
Fit for the future |
NHS |
Outcome |
Outcome |
Outcome |
✓ |
✓ |
✓ |
✓ |
✓ |
| The Community Neurodevelopmental Paediatrics Team currently provide an information pack if autism is diagnosed. Digital options of information packs to be considered, with co-production with parents. | Option for digital information packs will have been discussed with parents, and information to be provided will be agreed. | Review parent feedback into the information packs. | ✓ | ✓ | ✓ | ||
| Feedback to be sought from parents of children on the Neurodevelopmental Assessment Pathway, consider trends and themes for positive practice or improvement. | Continue to collate feedback from parents of children on the Neurodevelopmental Assessment Pathway, consider trends and themes for positive practice or improvement. Analysis of learning, trends and themes to be available for service review. | Continue to collate feedback from parents of children on the Neurodevelopmental Assessment Pathway, consider trends and themes for positive practice or improvement. Analysis of learning, trends and themes to be available for service review | ✓ | ✓ |
✓
|
||
| We will continue to improve patient experience through use of activities In addition to the Intranet resources, we will continue to increase activities for individual patients – i.e., Charitable bid for fidget toys, IPAD use with apps embedded by IT. | Patient experience will be sought in the use of activities and resources to consider impact and further developments. | We will continue to seek patient feedback and consider the use of activities for engagement and as strategies to reduce boredom or distress or provide routine. | ✓ | ✓ | ✓ |
Strategic Priorities Commitment: Workforce
Aim:
1. To increase and maintain the knowledge and skills of our workforce in delivering high quality care for autistic patients.
2. To ensure or families and carers caring for loved ones/patients with autism are supported, involved in decisions where appropriate and resilience of the family / carer is recognised as key.
Year 1 |
Year 2 |
Year 3 |
Consistently deliver excellent care |
A great place to work |
Deliver value for money |
Fit for the future |
NHS |
Outcome |
Outcome |
Outcome |
✓ |
✓ |
✓ |
✓ |
✓ |
| Compliance into the mandated Learning Disability and Neurodiversity- Core E-learning module will be monitored (which references the Oliver McGowan training) | We will monitor compliance of the mandatory Learning Disability and Neurodiversity training through the Safeguarding Board and workforce. Impact on patient experience/ staff confidence will be sought. | Audit of compliments, complaints and concerns / patient experience will consider the correlation of the mandated core module and if patient experience has bene improved. | ✓ | ✓ | ✓ | ✓ | |
| We will review our Learning Disability and Autism Champion events to ensure it includes a Patient Story from the LeDeR reviews as a standard agenda to consider learning, how to implement learning into action. | We will work to extend our co-delivery of training to include the experience of families and carers. | We will source external speakers and training for our Learning Disability and Autism Champions to ensure learning continues and positive patient experience is enhanced. | ✓ | ✓ | ✓ |
✓
|
|
| A training package for SEND will be available as an e-learning module. | We will work to develop the SEND training package to make it bespoke for LTHTR to include case scenarios for children, young people and adults on the wards to ensure information and knowledge to transfer to practice | We will have the numbers of the staff that have completed the SEND awareness module. THE SEND Improvement Group will indicate an increased awareness across the Trust. | ✓ | ✓ | ✓ | ✓ | |
| We will review our training (e-learning and development of face to face) to increase knowledge of Autism highlighting the Carers Charter, importance of involving carers, communication aids, reasonable adjustments, individualised sensory needs and opportunities for activities and improved patient experience. | Tier 2 face to face training will be available to include Oliver McGowan training. | Tier 2 face to face training will be available to include Oliver McGowan training. | ✓ | ✓ | ✓ | ✓ |
Year 1 |
Year 2 |
Year 3 |
Consistently deliver excellent care |
A great place to work |
Deliver value for money |
Fit for the future |
NHS |
Outcome |
Outcome |
Outcome |
✓ |
✓ |
✓ |
✓ |
✓ |
| We will work with our pharmacy team and Consultants to highlight STOMP/ STAMP. A focus in the Community Neurodiversity Teams, Paediatrics, and medical teams. (Although STOMP/ STAMP does not apply as LTHTR do not often prescribe psychotropic medication (antidepressants, anxiety medication and antipsychotic) we may have prescribing requests from specialist teams i.e., mental health or following admissions and liaison with Learning Disability teams). | STOMP/STAMP will be highlighted through a number of education opportunities – Champion meetings, the Intranet and will be considered within MDT individual meetings or joint working. | STOMP/STAMP will be noted within policy and understood by specialist teams | ✓ | ✓ | ✓ | ✓ | |
| We will continue to embed post diagnostic support / contact for parents of children in pre-school and school aged neurodevelopmental assessment pathway, considering reasonable adjustments. We will continue to review service provision and support during the Neurodevelopmental assessment period i.e. advice on sleep. | We will have reviewed service provision in context of the continued ASD Pathway Navigator and ASD Support Secretary. | Roles within the Neurodevelopmental Assessment Pathway and provision will continue to be assessed and developed | ✓ | ✓ | ✓ |
✓
|
Strategic Priorities Commitment: Special Educational Needs and Disabilities (SEND)
Aim:
1. To improve the outcomes for children, young people and young adults with SEND
2. To improve communication for children, young people and young adults with SEND
3. To improve the SEND journey
4. To ensure preparation for adulthood and transition pathways
5. To improve access to services
Year 1 |
Year 2 |
Year 3 |
Consistently deliver excellent care |
A great place to work |
Deliver value for money |
Fit for the future |
NHS |
Outcome |
Outcome |
Outcome |
✓ |
✓ |
✓ |
✓ |
✓ |
| We will develop a LTHTR SEND Action Plan which reflects and compliments the Lancashire SEND Plan (2021-2025), although specific to health. The LTHTR SEND Action plan will be based on a SEND self-assessment. | The LTHTR SEND Action Plan will be analysed for evidence of completed actions, further improvement opportunities and action planning. | The LTHTR SEND Action Plan will be reviewed in line with any new SEND Plan for Lancashire. The SEND Improvement Group will consider whether the LTHTR Action Plan requires new focus. | ✓ | ✓ | ✓ | ||
| We will reach an understanding of the SEND data to be captured in line with the Integrated Care Board . | A SEND Data Dashboard will be established and used for review in Divisional Governance meetings and the SEND Improvement Group | Work will continue on the SEND data dashboard in line with ability to capture number of children, young people and adults with a Learning Disability. We will analyse the data and consider opportunities to capture patients with SEND. | ✓ | ✓ |
✓
|
||
| We will identify areas of good practice for Transition. | We will raise the awareness of Transition across the Adult services and share areas of good practice. | We will be able to able to evidence impact and implementation of Transition – for example use of Transition tools and documented conversation. | ✓ | ✓ | ✓ | ||
| We will work closely with the ICB Designated Clinical Officers (DCO’s) to understand compliance with Education Health and Care Plan (EHCP) statutory processes/ returns of health advice. We will highlight Quality Assurance training for EHCP’s across the Trust. | We will consider the process of EHCP’s, monitoring in relation to a Trust hub for administration. We will understand any Quality Assurance challenges within the Trust and work with the DCO’s if improvement is necessary | A hub model for administration will be in place, and returns will be monitored through the SEND data dashboard. | ✓ | ✓ | ✓ |
Indicators of Success
This Autism Strategy for Children, Young People and Adults provides a clear direction for continuous improvement for Lancashire Teaching Hospitals NHS Foundation Trust for the period of 2024 - 2027.
Our plan is aligned to NICE guidance and developments within the Lancashire and Cumbria Integrated Care Board (ICB).
Lancashire Teaching Hospitals NHS Foundation Trust is committed to ensuring that as an organisation we make this reality through our own value system, strong leadership, the development of our workforce and seeking to involve experts by experience, families, carers and multi-agency partners in everything we do.
The progress of this plan will be driven and monitored through a newly established forum for people with a Learning Disability and their families and carers. This plan will also be delivered through our SEND Improvement Group and Patient Experience and Involvement Group. Assurance will be provided to the Trust Safeguarding Board, Mortality Committee and Safety and Quality Committee.
Indicators of success will include-
- Positive Patient, family, and carer experience.
- The continued alignment to the ICB, multi-agency working and drive to ensure access to health care.
- Progress for co-production and co-delivery of the Autism Strategy.
- The evidence of increased Reasonable Adjustments recorded on electronic patient records.
- Data collation/dashboard for SEND and business intelligence into the Community Neurodevelopmental Pathways.
- A workforce who feel confident and knowledgeable to use communication aids, ensure the use of Hospital Passports and are engaged in the Learning Disability and Autism Champion events.
- Quarterly and annual reports which highlight continuous improvement, established processes and outcomes of audit.
- The increased availability of a catalogue of Social Stories and Easy Read leaflets in relation to health and LTHTR Specialist Teams
