Developing operational guidelines for the multidisciplinary assessment of young people aged with possible autistic spectrum disorder.

Transcription

1 Developing operational guidelines for the multidisciplinary assessment of young people aged with possible autistic spectrum disorder.

2 Yorkshire and the Humber CAMHS Developing Operational Guidelines for the Multi- Disciplinary assessment of young people aged with possible autistic spectrum disorder Leadership Course Simon Eltringham Wakefield CAMHS

3 Stated aim. Why this service improvement? To formalise current local practice in written guidelines, for the assessment of possible ASD in year olds. Indirect goal. To use the guidelines as a lever to devolving ASD assessments for the year old age group to locality CAMHS Teams.

4 The service context: Reasons for the service improvement High Impact Changes: 2 and 8. Long waits for access to an ASD assessment has meant that a full understanding regarding a young person s s presentation, to inform care packages, could not be provided in a timely manner. High Impact Changes: 4 The service has been challenged to provide the same level of access to mental health services for the year old age group awaiting an ASD assessment, in comparison to younger children. For example waiting time, access to range of professionals with the knowledge and skills to undertake an ASD assessment.

5 Operational Guidelines for ASD Potential benefits. By producing formal guidelines, expectations regarding ASD assessments in this age group are made explicit, helping to maintain clinical standards. Knowledge, skills and experience regarding ASD diagnostic assessment will be better devolved throughout the service. Service users will be able to access ASD assessments quicker and packages of care/intervention will be better informed.

6 Produced a draft guideline. What happened? Literature review. Information from other ASD diagnostic provisions. Discussed specific clinical issues with relevant clinicians and disciplines (e.g. psychiatry, speech and language therapists, educational psychology service). Included a referral/care pathway, taking into account CAPA.

7 Circulated draft document to: Clinicians within the MDA Teams for younger children. CAMHS Psychiatrists. Virtual Policy Group for WDPCT. Presented document at CAMHS Clinical Management Group. Discussed devolution of assessments at a Clinical Psychology Professional Meeting.

8 Set a timescale for the implementation of the guidelines across locality CAMHS teams. As an on-going process, delivering training on, and encouraging shadowing of, ASD assessments particularly for CAMHS psychologists.

9 Actions still required. To submit guidelines for consideration by the Local ASD Coordinating Group. Negotiate recent challenges to the draft guidelines. Full implementation.

10 Operational Guidelines for ASD Challenges and developing leadership skills. Prioritizing the time to produce the document: Clinical Lead vs. jobbing clinician. As an unanticipated challenge managing opposition to aspects of the guidelines external to CAMHS. Personality and Leadership. Collaborative but could I have been more collaborative with more disciplines/departments and at an earlier stage? Compromising but vulnerable to being too compromising?

11 Operational guidelines for ASD What might I have done differently? Earlier benchmarking information. To have foreseen challenges to the guidelines at an earlier stage.? May have developed the guidelines within a much wider review of o referral guidelines/pathways for the entire age range. Lessons learned. The importance of service user flow in planning and devising services / pathways.

12 What is the service like now? The content of the guidelines and the principal of devolving assessments seem to have largely been accepted... The project however remains work in progress and its impact at this stage untested.