Improving access to social care for adults with autism
Specialist autism services
There is an argument that if mainstream services improved their ability to meet the needs of people with autism, then specialist services wouldn't be needed. Fulfilling and Rewarding Lives(10) and its attendant guidance (11) (and the DHSSPS action plan for Northern Ireland (24)), with their focus on raising awareness across services, aim to make all services better for people with autism. But there needs to be a balance, and offering mainstream services must not be done simply to reduce costs (14). Autism is a complex condition, and sometimes people will be well served only by people with well-developed expertise.
Whether specialist services are in place, be that a care management service or provision such as day care or supported living, will depend ultimately on local need and commissioning priorities. But Fulfilling and Rewarding Lives, despite the emphasis on awareness raising and generalised improvement, stresses that specialist services have a 'pivotal role' (10) in improving outcomes for people with autism, despite the current patchiness of their provision. Specialist services, especially multi-disciplinary ones, do seem to hold out the promise of better outcomes (6), and Fulfilling and Rewarding Livespromotes autism-specific bodies for the delivery of services, such as specialist autism teams and autism partnership boards (10). This message is also stressed in the DHSSPS action plan for Northern Ireland (24).
When we spoke to people, the message was clear that specialist autism services are more accessible than general social care provision (7). The National Audit Office study, 'Supporting adults with autism through adulthood' (23), goes further: specialist teams can improve outcomes, and have the potential to save significant sums of money. This is looked at in more detail in the Early intervention and prevention section.
One example is the Prospects employment service, run by the National Autistic Society. It costs Prospects more per head to place someone in work than it costs general disability employment services (23), but the jobs last longer, carry greater satisfaction for employer and employee and lead to long-lasting benefits to people's incomes and sense of self-worth (23).
It is worth noting that if no specialist autism care management team is in place, then it is for each local social services area to provide clarity as to which team will take on the support for people with autism who have no attendant learning disability or mental health problem.