1. Tristan Johnson; Acute liaison nurse LD 07/06/2016 The Autism Act 2009- Implications for GP practices. “Understanding the needs of individuals with Autistic Spectrum Disorder ( ASD) and Aspergers Syndrome and Implications for GP practices.

2. Tristan Johnson; Acute liaison nurse LD What is autism? “ People with autism have said that the world, to them is a mass of people, places and events which they struggle to make sense of and which can cause considerable anxiety” The National Autistic Society

3. Tristan Johnson; Acute liaison nurse LD A life long developmental disorder. May be associated with Learning Disabilities but can also occur in the non- Learning Disabled population as High Functioning Autism or Asperger syndrome Part of the ‘Autistic Spectrum’ Spectrum because:- 3 main areas of difficulty. Affecting each individual differently. - Social communication - Social interaction - Social imagination

4. Tristan Johnson; Acute liaison nurse LD Additional issues Routines Sensory sensitivity- Intensified, dislike noise bright lights etc or under sensitive high pain threshold, extremes of temperature etc. Special interests.

5. Tristan Johnson; Acute liaison nurse LD What is Asperger syndrome? Form of autism. Lifelong disability. Mostly hidden. Like autism people have the same three areas of difficulty.- Social communication, interaction and imagination. Unlike autism fewer problems with verbal speech, often average or above average IQ. Not usual to have accompanying learning disability but may learning difficulties - dyslexia, dyspraxia, attention deficit hyperactivity disorder (ADHD).

6. Tristan Johnson; Acute liaison nurse LD Characteristics “ If you have Aspergers syndrome, understanding conversation is like trying to understand a foreign language” “I have difficulty picking up social cues and knowing what to do when I get things wrong” “ We have trouble working out what other people know and guessing what you are thinking” The National Autistic Society

7. Tristan Johnson; Acute liaison nurse LD Who is affected? Half a million in UK. 1 in 100 All backgrounds and nationalities. More men than women. Cause still being researched- combined factors genetic and environmental. No cure

8. Tristan Johnson; Acute liaison nurse LD Who is covered by the Act/Law? All individuals with diagnosed Autistic spectrum disorder. All people with diagnosed Asperger syndrome. Individuals who professionals identify as having problems or traits related to Autism or Asperger syndrome, who have not had the opportunity to have formal diagnosis.

9. Tristan Johnson; Acute liaison nurse LD Policy Context Disability discrimination act 1995 Disability equality duty Autism Act 2009 Equality act 2010 Implementing “ fulfilling and rewarding lives” Guidance for Local authorities and NHS bodies implementing the autism strategy Dec 2010

10. Tristan Johnson; Acute liaison nurse LD Autism Act 2009 Increased personal autonomy Inclusion Improved quality of life Implementing fulfilling and rewarding lives ( December 2010) Statutory guidance The Law

11. Tristan Johnson; Acute liaison nurse LD The strategies focus is on outcomes, not process targets Its ultimate outcome for adults with autism is that: ‘All adults with autism are able to live fulfilling and rewarding lives within a society that accepts and understands them’.

12. Tristan Johnson; Acute liaison nurse LD Responsibilities under the law. 1. Identification and flagging; Surgeries must be able to identify adults with Autism / Aspergers who use their services. Electronic flag on IT system / Read code. Referrals on to other health services should flag specific needs.

13. Tristan Johnson; Acute liaison nurse LD 2. Training on Autism; All staff in the surgery must have mandatory training to identify people with ASD and understand their specific needs. Different levels of training are required depending on role. Important to identify a lead in the surgery to make sure this happens. Lead must have advanced training to be able to advise colleagues.

14. Tristan Johnson; Acute liaison nurse LD 3. Individualised planning and reasonable adjustments to improved health outcomes Specific policy to help manage the needs of this patient group. Individual plan for the patients consultation; HAP. Needs to cover specific issues; environmental and personal.

15. Tristan Johnson; Acute liaison nurse LD 4. Transition planning. Be aware of issues related to transition. Not just from child to adult services. Move of home, impact of moving to different GP practice etc Admission to acute services. Ensure continuity, liaison is key.

16. Tristan Johnson; Acute liaison nurse LD 5. Assessment and Diagnosis. It is not your responsibility to diagnose. Practitioners must be able to identify the need for a formal assessment. Then be able to sign post to relevant services and to get formal assessments etc.

17. Tristan Johnson; Acute liaison nurse LD Good practice; Surgery needs to develop an action plan. Action PointCurrent situation Action PlanWho and by when. Progress Surgery must be able to identify adults with autism who use their service. No separate code in place; currently registered under LD code Agree suitable electronic read coding system or paper flagging system. Practice manager with IT lead. November 30 th.

18. Tristan Johnson; Acute liaison nurse LD Action Point Current situation Action PlanWho and by when. Progress Staff must have training to recognise and understand the needs of adults with autism. No training provided. Develop training plan. Source provider for training. Include in mandatory training programme. Invest in an e learning pack to support refresher training. Autism lead with Training lead for the surgery.

19. Tristan Johnson; Acute liaison nurse LD Norfolk's referral pathway. Autism diagnosis; If the individual has a known learning disability or you identify them as having an IQ below 70, referral needs to be made to the Norfolk learning disability service. If you require advice on additional support systems for people with autism living in Norfolk you can also contact Autism Anglia 01206 577678.

20. Tristan Johnson; Acute liaison nurse LD Asperger Diagnosis; If you feel the individual has Asperger syndrome or higher functioning autism, you need to make a written referral to the Asperger Service Norfolk Team. Include the individuals name, address, DOB, that you have discussed the referral with the patient and they are happy to go ahead with it, a brief outline of any previous document health needs and previous diagnosis Most importantly you need to clearly outline your current issues of concern and the reason for your referral and the urgency of their input, so they can triage appropriately.

21. Tristan Johnson; Acute liaison nurse LD LD team contact numbers; City 01603 638520 South 01953 450800 North 01263 835200 West 01553 666680 East 01493 841250 Adult social services referral number; 0344 800 8014