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Commissioning person-centred services for people with autism spectrum disorder
Commissioners need good quality, shared information about current and future demand for support across the wide range of abilities in the autism spectrum. Following the national audit of services for people with autism spectrum disorder in 2003, localities should have robust systems for the collection and dissemination of information about the needs of people with autism spectrum disorder.
Any good commissioning process should understand the needs of service users as well as their carers in identifying gaps in services and trying to fill them. A good way of doing this is through aggregating person centred plans to reveal any key or recurring themes. In this way, even people with the most profound disabilities can be included.
All council services, not just social work should be accessible to the general public as a whole. This is a central tenet of the Disability Discrimination Act and disability equality duty. Commissioning needs to include low level preventative services and support to reduce the need for expensive crisis services.
Joint working with Health and the independent sector will ensure that service provision leaves no gaps and avoids duplication. Health authorities and other partners can pool resources to work across geographical boundaries to create local and affordable autism-specific services, where these are required.
Joint commissioning and influencing across council departments and good prevention or early intervention work, especially with NHS partners, may mean that those on the autism spectrum need fewer specialist services and so will be better socially included. The cost burden of providing these is spread more evenly and each department can record meaningful results on inclusiveness. An example where this works well is in the provision of changing facilities for profoundly disabled people in town centres through planning and building departments, on the advice of social work. The result is that people can remain in the community for longer, rather than having to return to segregated or clinical settings for personal care.
Self-directed support allows for individual need be targeted in a way that block purchasing could seldom achieve. The government intend to increase the uptake of self-directed support and to look at a framework for enabling its development across Scotland. Evidence from England currently suggests that the aggregate costs to local authorities of providing services in this way has fallen by around 18% (source: 'In Control England').
A range of tools and guidelines to support commissioners in identifying appropriate services are set out in Annex B.
Services should be based on full citizenship rights, enable people to make choices about their lives and lifestyles and promote independence and inclusion in ways that are important to them. A number of examples of models of support from across Scotland are outlined in Annex D.
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