Expressions of Interest for Autism Services for NHS Herefordshire & Worcestershire Clinical Commissioning Group

The outline service specification is expected to include: a) Initial contact: • The service provider will primarily receive referrals from General Practitioners and Specialist Mental Health Services. A completed Autism Spectrum Quotient or AQ10 must be included with the referral. (NICE CG142 recommends that those adults scoring more than 6 out of 10 should be considered for referral for a diagnostic assessment). • The service provider will be expected to explain the number and purpose of the appointments required to complete the diagnostic assessment pathway. • The service provider will confirm that the outcome of the assessment will be provision of a support plan with distinct outcomes for the service user. • Service users presenting at a time of crisis may have to be referred into the Mental Health Crisis Intervention service. The service provider must have appropriate arrangements with this service to ensure speedy referral into the service. and support the service to enable reasonable adjustments to be made. Data regarding this element will need to be reported on. b) Clinical assessment and diagnosis: • The service provider will complete a comprehensive assessment using a formal assessment tool such as ADOS-G or other NICE recommended tools. • The assessment can lead to a clinical diagnosis which should form part of the support plan. • The service provider will develop a support plan based on the comprehensive assessment, incorporating the risk management plan and including any particular needs (such as adaptations to the social or physical environment), and also taking into account the needs of the family, partner or carer(s). • The support plan will be shared with the service user's GP/clinician (referrer) and the service user c) Initial post-diagnostic support • The service will offer all adults who have received a diagnosis of autism (irrespective of whether they need or have refused further care and support) a follow-up appointment to discuss the implications of the diagnosis, any concerns they have about the diagnosis, and any future care and support they may require. This can be provided through online, telephone call or face-to-face to meet the needs of the individual. • Support for families and carers should be available following diagnosis. It is expected that this will be a single session provided online or face to face as appropriate. • The provider will actively support patients to transition to the autism support service commissioned in Herefordshire and/or Worcestershire. The provider is expected to facilitate a seamless transition between the pathways. The Diagnostic service provider will be expected to provide advice on reasonable adjustments to enable the individual service user to access the support they need. The service provider is expected to adhere to NICE Guideline CG142 general principles of care and offer a multi-disciplinary approach to the diagnostic assessment, and to minimise the length of the pathway from referral to diagnosis, through flexible approach to appointments using face-to-face and digital options to meet the needs of the service user. Please see attachments section for outline specification of this service. Additional information: Contract value is circa. £245,000 per annum. Contract term 2 years with option to extend for further 2 years. The current contract is due to expire in March 2022. Contract commencement is expected to be from 1st April 2022. Current demand for the service is approx 36 accepted referrals each month, or 432 annually. This is an increase on the previous year of 23 per month and 277 annually.

The outline service specification is expected to include: • Psychoeducation to assist people understand and learn cognitive strategies to manage the impact of autism following diagnosis • Psychosocial interventions focused on life skills, including activities of daily living, social interaction and isolation, and anxiety and anger management • Support to access employment, housing and other community services The service delivery model may include: • Self-referral or via a third party • Group work / activities • Individual work, where a person is unable to access or benefit from group work • Episodic support • Signposting where access to a service is supported • Support to family carers The target group will be: • People age 16 and over • Who are registered with a Herefordshire or Worcestershire GP • Who have an autism diagnosis • Who are not currently in receipt of social care or secondary mental health services • Who are not eligible for aftercare services under the section 117 of the MHA • Who are not CHC eligible • Who, in the case of young people, do not have an Education Health and Care Plan (SEND) The standards of the service will include: • An offer which is personalised and makes reasonable adjustments • Differentiated according to age • An appropriate mix of staff knowledge and skills, trained to at least Tier 2 of the Oliver McGowan Mandatory Training / DHSC Core Capabilities Framework for Supporting Autistic People • Compliance with local safeguarding arrangements • Understanding of and application of the Mental Capacity Act • Work collaboratively and in partnership with NHS, social care and other services, including the voluntary sector • Include autistic people in its governance arrangements • Develop services in continuous co-production with autistic people The precise number of autistic people in Herefordshire and Worcestershire is not known as there is no formal ‘register’. However, if it is estimated that 1% of the population is autistic, then there are approximately 9,000 autistic people in Herefordshire and Worcestershire. The service must be equally accessible to people in Herefordshire and Worcestershire and must be responsive to local populations. Please see attachments section for outline specification of this service. Additional information: The value of this lot is £100k in 2022/23, and £290k in 2023/24. Subject to continued NHS funding, the contract would be extended for a further 2 years at £290k per annum. The total potential value of the contract is therefore £970k. Contract commencement is expected to be from 1st April 2022.