Health, Housing, and Adult Social Care Scrutiny Committee.	6 November 2024
Report of the Director of Public Health Update on the York Autism and ADHD Health Needs Assessment, and progress towards a York Autism and ADHD strategy.

Summary

1. This paper introduces the draft Autism and ADHD health needs assessment (HNA) and sets out a proposed three phase plan for developing a strategy on the same topic.

2. The HNA has been drafted by the public health team. It is not the final published version of the HNA and is supplied to scrutiny members at this meeting for comment and for shaping the final output. It is a provisional full draft being circulated now to support planning of future strategy.

3. Following the HNA being finalised, the CYC Public Health team will also be coordinating the development of a new Autism and ADHD strategy for York, in conjunction with many partners and with public involvement. Publishing an autism strategy is a statutory duty which falls on both health and council partners, and falls across children’s and adults services. Public health is leading the strategy development approach and are holding oversight of the engagement and coproduction, but will not be the sole authors; for the strategy to be impactful and robust it is essential that it must be jointly authored by all key stakeholders, and be coproduced by those whose lives are affected by this key issue.

Background

Developing the health needs assessment

4. The provisional full draft of the health needs assessment is attached as an annex. The purpose of this needs assessment is to consider the current and emerging Autism and ADHD needs of residents who live in York.

5. The HNA looks at people of all ages who live in York who have a diagnosis of Autism or ADHD, who believe they have Autism or ADHD, or who would like to receive a diagnostic assessment for these conditions.

6. This HNA looks at many local data sources to understand the local autism and ADHD population.

· Local authority services: SEND team, adult social care

· Health services: neurodiversity diagnostic and support services, GP data, hospital data, addiction recovery services, mental health services, children’s social care data

· Other sources: Employment data, criminal justice and police data, large scale research studies

7. This HNA also looks at national and international research for a wider understanding of the health and wellbeing needs of people with autism and ADHD. This can be particularly helpful when local data is incomplete, out of date, hard to access, or does not clearly contain information about Autism/ADHD.

8. The HNA also includes a what works guide. This is a selection of guidance and best practice documents which describe ways of working that can be helpful and inclusive to people with Autism and ADHD.

9. This needs assessment does not make specific recommendations. It identifies topics and needs that should be considered for inclusion in the development of the York Autism and ADHD strategy.

Developing the strategy

10. The all age autism strategy (2017-2021) has now lapsed. The council alongside the ICB have a joint strategy duty to have an Autism Strategy. It has been agreed that this should be, for York, an all-age Autism and ADHD strategy.

11. Subsequent to the production of a need assessment, there is a three-phase plan to developing the Autism and ADHD strategy.

Phase One: Conversation and Consultation (2-3 months)

12. Using the provisional health needs assessment as a basis, we have developed three ‘conversation starters’ which we will ask our statutory and voluntary sector partners to capture feedback on:

a. Enabling society: what needs to change in wider society to make York a better place to be autistic or have ADHD?

b. Assessment and diagnosis: What can we do to improve the assessment and diagnosis journey for autism and ADHD?

c. Support and wellbeing: What should support for health and wellbeing look like for those who are neurodiverse, whether with a diagnosis or not?

13. Members of the strategy partnership group are asked to host these conversations with existing public groups and networks.

Phase Two: Codesigning the strategy (3-4 months)

14. Using learning from the conversations we will co-write the strategy. There will be opportunity to continue to feedback through public groups and networks as well opportunity for individuals to share comments.

Phase Three: Formal consultation on the draft strategy (1-2 months)

15. A full final draft of the strategy and HNA will be published for formal consultation.

Timeframes

16. It is important to allow sufficient time to engage on, reflect, and coproduce this strategy. We intend to publish the final strategy within 2025.

Consultation

17. The three-phase approach outlines the emphasis on engagement and conversation as well as formal consultation that will be employed in developing the Autism and ADHD strategy.

Analysis

18. Approximately 1% of the population are Autistic and approximately 3-4% of the population have ADHD. Autism and ADHD are associated with an increased risk of physical and mental ill health, of economic disadvantage, and of social exclusion. It is important that we recognise and respond to the different needs of people who are neurodiverse who live in York.

Council Plan

19. Health is one of the four commitments of the council plan. The council is committed “to improving health and wellbeing and reducing health inequalities’ and ‘taking a health in all policies approach’. It also commits to ‘co-produce and publish our approach to supporting people with Learning difficulties, mental health, autism and delivery of adult social care’

20. Additionally the joint health and wellbeing strategy states that; “We take a strengths-based approach which sees people as valuable, not vulnerable, and recognises that everyone has gifts, talents and skills…” We will be taking this same approach of using peoples experience, knowledge and talents to help build our strategy.

Implications

Implications are discussed in relation to the work done so far in development the health needs assessment and in the proposed three phase plan for the Autism and ADHD strategy. Further implications may be identified as the strategy is developed.

· Financial There is no budget allocated to the development of the health needs assessment or the strategy.

· Human Resources (HR) There are no HR implications of this report, however autistic people and people with ADHD often face barriers within the workplace, including within local government, as the HNA demonstrates, and there are likely to be recommendations for employers and workp[laces emerging through the strategy development

· Equalities Autistic people and people with ADHD experience poorer health and wellbeing outcomes, including physical health, mental health, social stigma, and economic wellbeing. This is explored in the health needs assessment. In addition, many autistic people and people with ADHD should be considered within policy as having a protected characteristic, and equalities act 2010 should be borne in mind.

· Legal The development of an Autism and ADHD strategy will support the fulfilment of the duties on local authorities and NHS bodies set out in the Autism Act 2009.

· Crime and Disorder There are no crime and disorder implications identified at this time.

· Information Technology (IT) There are no IT implications.

· Property There are no property implications.

Risk Management

21. The current Autism strategy has lapsed. The council has a duty to have an Autism Strategy under the Autism Act 2009.

Recommendations

Health Scrutiny are asked to:

· provide comment on the provisional health needs assessment presented in the annex. Members are welcomed to meet with public health separately to this meeting if they would value the opportunity to provide detailed feedback.

· comment on and approve the three phase approach to developing the Autism and ADHD strategy for York.

· comment on and approve the proposed timeframes for developing the Autism and ADHD strategy for York.

Contact Details

Author:	Chief Officer Responsible for the report:
Jennifer Irving Public Health Specialist Practitioner	Peter Roderick Director of Public Health
	Report Approved  √	Date	24/10/2024
Wards Affected:  List wards or tick box to indicate all				All	√
For further information please contact the author of the report

Background Papers:

Annexes

Annex A:  Autism and ADHD in York - A Health Needs Assessment 2024 (Provisional Draft)

Abbreviations

ADHD        Attention Deficit Hyperactivity Disorder

ICB             Integrated Care Board

HWBB        Health and Wellbeing Board

HHASC      Health, Housing, and Adult Social Care Scrutiny Committee

HNA           Health Need Assessment

SEND        Special Educational Needs and Disabilities