Improving access to social care for adults with autism

Early intervention and eligibility

Some of the difficulties faced by people with autism could be addressed or reduced if low-level, often relatively inexpensive services were provided promptly (30). This notion of early intervention* is, however, often hampered by what people with autism sometimes experience as inflexible and reactive services. This inflexibility is often linked to people's experience of Fair Access to Care Services (FACS) or DHSSPS 'Care management, provision of care and charging guidance' eligibility criteria (9, 49). FACS criteria measure whether the risk to a person's independence would be at low, moderate, substantial or critical risk if services were not provided (9). Most local authorities only provide services to people whose needs are in the substantial or critical bands (9), which tends to militate against the provision of early intervention services.

However, skilled commissioning of preventative services** and effective use of the provisions within FACS (or the DHSSPS 'Care management, provision of care and charging guidance') that promote preventative support can be used. The revised guidance on applying FACS makes it clear that staff should:

The focus in Fulfilling and Rewarding Lives(10) and the'Autism strategic action plan for Northern Ireland' (24) on diagnosis has an early intervention aspect, as the sooner people are accurately identified as having autism, the sooner appropriate, well-informed support can be provided. The insistence in Fulfilling and Rewarding Livesthat a diagnosis of any form of autism must be a reason to offer an assessment, rather than deny one, does mean that people with high-functioning autism or Asperger's Syndrome have at least overcome one hurdle to getting the support they need, even if they still have to have eligible needs under FACS. The expectations under 'Putting people first' that local areas will provide a universal information and advice service (42) should also mean that people with autism can be pointed in the right direction for accessing help.

* We are taking early intervention here to mean the timely provision of services to people with autism. We do not mean interventions that aim to militate or remove the effects of the condition.

** Again, by preventative, we do not mean services that aim to prevent autism. We mean services that aim to prevent social care needs from escalating.