North Yorkshire & York Autism Diagnosis Strategic Partnership Group
Tuesday 11 December 2012 - Minutes

Present:

5 Chair

Head of SEND Support and
Outreach NYCC
20

SLT & Paediatric Community
Therapies Service Manager,
Airedale NHS FT
9

Specialist Lead for Autism,
NYCC
25

Specialist Senior EP, North
Yorkshire CYPS
44

Interim Senior Commissioning
Specialist, NY& Humber CSU
17

Interim Commissioning
Specialist, NY& Humber CSU
38

Development Officer (Autism,
Adults) NYCC (HAS)
27

Parent, Lives Unlimited
26

Parent, Lives Unlimited
14

Specialist Nurse ASMPACT
Co-ordinator, HDFT
16

Consultant Paediatrician

Action
1.
Welcome and Introductions:

All were welcomed and a round of introductions took place.

1.1
27 and 26 provided an overview of ‘Lives Unlimited’.

•  A family and user led voluntary service in the York area.

•  Has been established for 7 years

•  Parents with children with a wide range of disabilities /

illnesses

•  Advocates

•  Have an interest in peer support and personal budgets

•  Whilst York mainly - also have some contact with families

outside of York

•

  Have a website http://www.livesunlimited.org.uk/

38 was appointed in September to work on the adult autism
1.2

strategy. 38 is currently doing an online survey. To take part in

the survey go to; https://www.surveymonkey.com/s/NCR3MVZ

11.12.12
Page 1 of 7

44 outlined briefly the changes currently underway in the NHS

1.3
Appendix 1

The group agreed with the sharing of the minutes with all 4

CCG groups in North Yorkshire and York. 20 asked if they could
also be shared with commissioning colleagues in the Bradford

and Airedale localities as there was cross border work. The

group agreed to share with 45 and 40 and hoped that this would
be reciprocal.

2.
Apologies:

29, 24, 46, 39, 36, 22, 31, 13, 47, 28, 48, 10, 23, 49, 6, 50, 51

3.
Minutes of previous meeting:

Amendments to be noted:

P1 – Apologies also received from 31, 47 and 48

P2 – Item 4 Suggested to health that the NICE tool is useful to
use
P3 – Harrogate new service was commissioned in May 2012
P3 – Ham and Rich  See 6.1 below for an update on the
minutes of the August meeting

5 outlined that a NY group of young people are going to
produce a DVD. It will be in a roving reporter style and may be
called ‘Adults don’t understand us’. There will be many uses for
it including peer awareness for staff in schools etc

4.
Strategy for Children and Young People with Autism

Draft implementation plan and time-line:

5 gave a brief history of the group as it currently stands.

•  There was a need identified for an autism strategy for

children in NY. The group supported its development

•  It is a joint strategy with health

•  The strategy is supported by NICE guidelines

•  The strategy can be found at

http://www.northyorks.gov.uk/send

•  People liked that CAF was part of the pathway

•  At the next meeting it was agreed to look at the Terms of  Agenda item
Reference and membership to reflect that the strategy is
for February
now entering its implementation phase
2013

Appendix 2

11.12.12
Page 2 of 7

•  5 has produced a first draft of an implementation plan,

containing different focus areas. Some general

discussions took place around competencies frameworks
and levels of training, raising awareness particularly in

relation to hard to reach groups.

•  Regarding training for trainers. Cygnet for professionals

has just been developed and some NY staff have been

trained. 20 has piloted a module on puberty, sexuality

and relationships which should be released in October

2013

•  Identification, assessment and diagnosis will be health

led

•  Discussion also included communication with parents,

Children’s Centres, improving outcomes and the

gathering of data

•   It was noted that Springwater and Mowbray Schools are
now NAS accredited schools

•  In respect of transitions, there was an identified need to

work with Health and Adult Services to ensure a more

integrated approach and a stronger interface with the aim  Agenda item
of achieving better transition and personalised pathways
for February
•
2013
  In summary the strategy should link up with other

strategies with a provisional time line of 3 years for

implementation. It may be that the implementation of the

strategy would fall within the groups remit to monitor the

progress
•

  44 and 5 agreed to meet to discuss and to bring a paper

to the next meeting
5/44

5.
Post diagnosis information pack:

•  17 provided a summary of the background to the

development of the pack.

•  The additional pieces of work which the Task and Finish
Group were asked to do i.e. No diagnosis pack,

information for families at point of referral and information
for professional prior to referral, will be completed at a

later stage, although it was noted that the no diagnosis

pack would be developed from the current pilot pack and

the information leaflets are already in first draft format

•  There was a discussion around the inclusion of

recommended services. It was agreed that they are other
forums and word of mouth which can enable this. Within

the local pack section there had been included a phrase

suggesting that families ask others for their experiences

and recommendations for services.   In York PACT run a

‘Good Place to Come’ scheme which highlights and

11.12.12
Page 3 of 7

accredits good services, this award indicates recognition

and recommendation

•  It was agreed that there would be a pilot of the current

draft packs and that feedback would be obtained.

•  20 and 16 volunteered to distribute packs with all

feedback to be returned to 17 in February 2013. The aim

would then be to proceed to a formal print run as soon as
possible following any amendments. Other pilot options

to be explored if required

•  20 to gather further local, cross border information for the
Craven section of the local pack for the pilot.

•  17 will write a letter for parents to accompany the pilot

pack and produce a system for feedback and co-ordinate
the pilot

[Post meeting note: The pilot packs were distributed to 16
16/20
and 20 on 20.12.12. Feedback due by early February in time
for the next strategy meeting]

•  The core packs are likely to cost an average of £1 a pack
and a decision will be taken following the pilot how many

to produce in the first print run. The local information

packs will cost £75 to produce 40 packs. These will be

distributed locally for local centres to copy and distribute

as required

•  It is expected that the core pack and local information

sheets will appear on the internet to assist accessibility

[Post meeting note – 17 to explore any permissions required
in respect of the local information pack being available on
17
line]

6.
Multi-agency assessment and diagnostic teams update:

6.1
Hambleton and Richmondshire – 16

In reference to the minutes of the meeting held in August 2012.

There have been difficulties with CAMHS offering support to the

autism diagnostic forum. The difficulty has been across the

whole range 0-19. This was part of a wider issue because it had

been discovered that psychological input to children with

developmental difficulties had not been part of the service that

TEWV had tendered to deliver. The commissioners are working

actively with TEWV to find a resolution to this. However

educational psychology has supported the forum so the team

have remained compliant with the NICE guidelines and despite

the aforementioned difficulties are still on target to deliver all the
11.12.12
Page 4 of 7

assessments that have been commissioned from them for this

financial year. The number of referrals to the forum is greatly in

excess of the number of assessments that have been

commissioned  and there are ongoing discussions about how

this can be managed. (16)

•  CAMHS no commissioning to any under 5’s

•  By January 2013 will have completed 18

assessments (only commissioned to do 17)

•  The waiting list is proving a challenge

•  Awaiting direction, there is the same number on

the waiting list who all warrant assessment

•  Demand noted to be high though unclear why,

could it be due to there being no service before?

•  CAMHS now passing referrals to the forum

•

  25 was thanked for his support and contribution to

the forum

•

  Going through contract management routes

(TEWV) re clinical psychology

•

  All doing best to address the arising situations

6.2

Scarborough - 14

•

  Continue to get more referrals 25-26 diagnosed

excluding the children and young people who went to

Newcastle for assessment (?16), unclear why, could it be

due to raised awareness? Double in the last year, 49 in

discussions with Scarborough and Ryedale CCG

•

  At least 30 waiting and some waiting for intake

•

  ASCOSS have noticed an increase in activity and impact

•  Discussion around the pathway, panel and Educational

Psychologists feeding in.
25 to have a

discussion
6.3
Airedale - 20

•  Issues around clinical psychology

•  40 plus referrals

•  10 early years assessment

•  JAC issue is now sorted

•  They had a ‘Lean Day’ due to local issues and working

across two different local authorities. There is now a

move to a new way of working

•  Need to speak with to commissioners re the back-log

•  Hope to find out before Christmas if they can change

their way of working. Child will only be accepted when all

information is available e.g. educational and settings

assessment

•  There are some children who have been waiting a year

•  CCG’s have started a review of paediatrics and

community teams. Expected to be completed by March
11.12.12
Page 5 of 7

2014

Harrogate – No rep available so 9 provided comment

•  Team co-ordinator appointed
6.4

Selby/York – No rep available so 25 provided comment

•  Satellite system in Selby but same package as York
6.5

7.
Autism training / awareness raising programme/delivery:

9 outlined the Autism Parent/Carer Support Training

Programme for 2012-2014.

http://www.northyorks.gov.uk/index.aspx?articleid=2997

Appendix 3

From the public consultation it was clear that parents wanted a

range of support on offer and it was hoped that this programme

would fulfil this.

9 has looked at modifying and trialling the Cygnet course for

parents of children who attend special schools. 9 is in

discussions with 43 at Barnados

There is a question around the promised funding i.e. 6 sessions

of 6 hours which was coming from Health.  44 agreed to look

into this and feedback to 9

43
It was also noted that if diagnosis rates increase that there
would be a need to review the funding planned.

[Post meeting note – confirmation that cygnet/early bird training
funding has been transferred to Harrogate, Hambleton &
Richmondshire. Finance colleagues are checking whether
Airedale funding was transferred]

8.
AOB:

World Autism Day 2.4.13

•  NYCC DVD If produced in time,  could be released to

coincide with the day
NYCC
•  The awareness of the patient information pack could be

made on 2.4.13. This could take the form of a news
    17
release. 17 to consider further

•  43, Cygnet co-ordinator has previously held events days.
9 agreed to find out what works well
    9
11.12.12
Page 6 of 7

•  No decision was made about the format of such a day
and it may be that this would evolve into locally driven
events, with displays/posters in schools, libraries and
Children’s Centres etc.

9.
Date of Next meeting:

Monday 11th February 2013 13.45-15.45
The Boardroom, NHS North Yorkshire and York, Station Road
Business Park Station Road
Thirsk YO7 1PZ

Monday 15th July 2013 13.45-15.45
The Boardroom, NHS North Yorkshire and York, Station Road
Business Park Station Road
Thirsk YO7 1PZ

Monday 14th October 2013 13.45-15.45
The Boardroom, NHS North Yorkshire and York, Sovereign
House, York.

A 0800 conference call facility will be available for all

meetings and details will be sent with the agendas.

Appendix 4

Parking available in Tesco’s for 3 hours

Appendix 5

11.12.12
Page 7 of 7

Appendix 1

Local NHS Changes Update
December 2012

1.0
Purpose of Paper
1.1
This report is to provide an update position on the current local health changes.

2.0
Recommendations
2.1
The partnership is asked to note the current progress.

3.0
Background
3.1
Following Royal Assent of the Health and Social Care Bill earlier this year, the

proposed NHS changes wil  be formalised fully from 1 April 2013 when Primary Care

Trusts (PCTs) will cease to exist and new organisations will be fully established to

undertake the relevant roles. There is however, a transition phase currently

underway locally and nationally to move towards the new infrastructure.

3.2
PCT responsibilities will transfer to various new functions but mainly to the NHS

Commissioning Board (NHSCB) and the Clinical Commissioning Groups (CCGs)

which is where the focus of this paper is aimed. The partnership will, however be

aware that some functions are transferring to Local Authorities with Public Health in

April 2013 and the transition process for this is currently underway.

3.3
This paper provides an update on the local situation in relation to these changes

including recent appointments and timeframes.

4.0
Local NHS Changes Progress
4.1
The NHSCB has remits, nationally, regionally and locally. There are four regions

being established and the one for this area is the North of England.  Local Area

Teams are being established and in future North Yorkshire and York will be part of

the North Yorkshire and Humber Local Area Team (LAT).

4.2
# has been appointed as the Local Area Team Director of the North

Yorkshire and Humber LAT and very recently the appointments listed below have

been made. Work is now ongoing to recruit to the wider LAT structures. It is

expected that this wil  be completed by the end of December 2012. There are

national guidelines for structures, portfolios and human resources processes.
• Finance Director
• Commissioning Director
• Medical Director
• Assurance and Operations Director
• Nursing and Quality Director

4.3
Clinical Commissioning Groups will be the organisations that will become

accountable for the future commissioning of local services. Members will be aware

that the CCGs in North Yorkshire and York are already established in shadow form

and the four main North Yorkshire and York CCGs are listed overleaf. GP Practices in

the Craven district have joined with the Airedale and Wharfedale Alliance and

formed the Airedale, Wharfedale and Craven Clinical Commissioning Group

(currently being overseen by NHS Bradford and Airedale) with the exception of

Bentham which is hoping to be part of the South Lakes Clinical Commissioning

Group.
• Vale of York
•Harrogate and Rural District
•Scarborough and Ryedale
•Hambleton, Richmondshire and Whitby

4.4
Currently the CCGs are working in shadow form and are developing structures and

agreeing what they will do themselves, what they will share across the system and

what they will buy from the Commissioning Support Unit (CSU). All the CCGs have

been included in wave 3 of the formal authorisation process led by the NHSCB in

October 2012. The PCT Cluster has established a programme of assurance meetings

to ensure the CCG are discharging their responsibilities in a safe and effective

manner. These meetings are monthly and are called Business Delivery Meetings and

cover the wide range of functions to be managed by the CCGs following

authorisation.

4.5
Commissioning support services for CCGs will come from a small number of directly
employed staff but much wil  be purchased from CSUs. A North Yorkshire and
Humber CSU has been established and they are almost ful y recruited to now.
Discussions are on-going between the CSU and individual CCGs as to what services
they wish to purchase and how this is undertaken local y.

4.6
To support the transition, it has been agreed that Children’s Safeguarding will be

lead by Scarborough and Ryedale CCG on behalf of all the North Yorkshire and York

CCGs. In addition, clinical leads for children’s services have been identified within

each of the CCGs and are detailed below:
•Vale of York
•Scarborough and Ryedale
•Harrogate and Rural District
•Hambleton, Richmondshire and Whitby

4.7
In respect of children’s commissioning (including maternity), the following

organisations are responsible in shadow form for commissioning services from

October 2012:
•  NHSCB (via the LATs) - Public Health services for children aged 0-5 years (Healthy
Child Programme)
•  Public Health/Local Authority – Public Health services for children aged 5-19
years (Healthy Child Programme)
•  Maternity, specialist services for children with complex needs, health
assessments for looked after children. The commissioning arrangements are to
be confirmed

4.7
The Partnership will be kept informed of progress.

Report prepared by:
Interim Senior Commissioning Specialist
North Yorkshire and Humber Commissioning Support Unit

29.11.12 and adapted from a report written by Executive Director of Nursing, to the North
Yorkshire Children’s Trust Board, November 2012.

Updated on 20.12.12

Appendix 2

NHS North Yorkshire

Autism Strategic Partnership Group

Terms of Reference

1.  Aim

The remit of the group will be to monitor and steer developments around
autism provision and include this work as part of strategic planning, with
responsibilities to include;
•  Strategic planning of need and provision
•  Monitoring performance against delivery of the strategy
•  Local referral pathways
•  Training

In line with NICE guidelines (September 2011), the aims of the autism
strategy group should include;
•  Improving early recognition of autism by raising awareness of the
signs and symptoms of autism through multi-agency training
•  Make sure the relevant professionals are aware of the local autism
pathway and how to access diagnostic services
•  Support the smooth transition to adult services for young people
going through the diagnostic pathway
•  Ensure data collection and audit of the pathway takes place

The Autism Strategic Partnership Group members will engage and act as
champions within their own organisations and forums to support the aims and
objectives of the group, ensuring they are able to be reflective of the wider
perspectives when participating in the group.

2.  Objectives

The Autism Strategic Partnership Group will:

•  Be the local multi-agency co-ordinating group to review, consider and
oversee the development of local area autism services in line with local
and national guidelines
•  Oversee the development of a clear pathway to diagnosis, assessment
and support following assessment
•  Map local needs, resources and identify gaps to inform joint strategic
needs assessment (JSNA) and commissioning future services
•  Identify local commissioning priorities, develop and implement an
action plan with clear objectives and milestones for delivery in line with
local and national autism strategies
Appendix 2

Page1 of 3

Appendix 2

•  Support and advise all stakeholders on the implementation of local
autism strategies
•  Regularly review the action plan to ensure that it reflects the needs and
aspirations of all stakeholders
•  Evaluate the impact of the local and national autism strategies
•  Promote joint working to share resource and expertise and exchange
local and national information of good practice
•  Improve multi-agency working, with particular attention to boundary
management issues
•  Provide a strategic steer for key voluntary, public and community
organisations offering services to people with autism
•  Raise awareness and understanding of issues affecting people with
autism
•  Maintain links with other groups to ensure that there is no duplication of
effort and services for all people with autism and their carers meet their
needs and are well co-ordinated
•  To monitor trends in prevalence, provision of services, effectiveness of
local identification, diagnosis and intervention services
•  To ensure the voice and influence of service users in service planning
and review
•  Improve transition into adult services by raising the awareness of the
importance of the effective management of transitions at all stages of
the lives of children and young people with autism. To gather and
disseminate good practice re the management of transitions
•  To convene and participate in sub groups to assist the Strategy Group
on specific pieces of work as and when required
•  To facilitate communication with partner organisations

3.  Principles

The Autism Strategic Partnership Group will:

•  Facilitate co-operative and partnership working between and among
professionals, voluntary and statutory agencies, users and the local
community.
•  Be transparent and open in conducting its business.
•  Respect the confidentiality of matters discussed.
•  Share relevant data and information from their organisations and
localities in order to enable the objectives to be met, whilst abiding by
information governance guidelines.

4.  Accountability

Members of the Autism Strategic Partnership Group will be expected to liaise
with colleagues in their organisations/departments. This will include regular
reporting on the activities of Autism Strategic Partnership Group and providing
informed feedback to the group.

Appendix 2

Page2 of 3

Appendix 2

A representative from each provider and stakeholder group will be required
wherever possible. If core members cannot attend a meeting, apologies will
be expected and if possible a suitable deputy should represent the service.

5.  Governance

The Autism Strategic Partnership Group will be accountable to the North
Yorkshire Children’s Trust Board via the North Yorkshire SEND Board.
The group will link into the following forums:
•  The emerging Clinical Commissioning Groups for Health
Commissioning

6.  Membership

The group will be co chaired by Senior Commissioning Manager – Children’s
(Health) and Head of Access and Inclusion (Local Authority) on behalf of
North Yorkshire.

Core members will consist of :
•  Commissioners
•  Local clinical leads
•  Relevant local authority and NHS service managers
•  Family members/carers
•  Representation from people with autism
•  Voluntary sector representatives
•  Representatives from local children and young people’s services
and/or local authority and primary care trust representatives with
responsibility for transition
•  GP representative

7.  Meeting Arrangements

Meetings will be held every 3 months. Additional meetings will be held if
necessary.
Appendix 2

Page3 of 3

Appendix 3

AUTISM PARENT/CARER SUPPORT AND TRAINING PROGRAMME 2012 - 2014

September 2012 – July 2013
Autumn Term
Spring Term
Summer Term

Early Bird
West

South Central

Early Bird +
West

West

Cygnet
Selby
Craven
North Central

East
South Central
East

Special Schools Cygnet
Mowbray
Woodlands
Brooklands

Cygnet (siblings)

West

September 2013 – July 2014
Autumn Term
Spring Term
Summer Term
Early Bird
West

East
Early Bird +
West

West
Cygnet
East
East
Selby
North Central
West
South Central
Cygnet (siblings)
South Central
North Central
East
Cygnet (puberty)
Selby
South Central
North Central
Special Schools Cygnet
Forest (tbc)
Springhead (tbc)
Springwater (tbc)
ASCEND
Selby (Asperger group)
Selby (Asperger group)  The Gill CRC (tbc)
Selby (autism group)
Nidderdale CRC (tbc)
Morton on Swale CRC (tbc)
Seminars for families
West
North Central
East

* This programme is subject to change –
For confirmation of courses running in your area please contact #
Issued December 2012
Version 1

Thirsk Location Map

Station Road Business Park,
YO7 1PZ
Appendix 5

A19 Southbound

Station
If travelling
Road
from A19
southbound
will enter

Thirsk here
If travelling
from A1
southbound
will enter
Thirsk here
PCT HQ

Tesco

If travelling from A168 /A1

Northbound will enter Thirsk

here

Directions

From the A1 Southbound

Leave the A1 signposted ‘Masham, Thirsk B6267’.

Follow signs for Thirsk.

Drive through outskirts of Thirsk until you reach the mini-roundabout
near Tesco supermarket. Thirsk racecourse will be on your left.

Turn right at the mini-roundabout and park in Tesco car park.  Parking is
free of charge.

From the A1 (Northbound)

Leave A1(M) at the A168 (signed A19 Teesside and Thirsk).

Follow signs for Thirsk. Leave the A168 at the B1448 signed ‘Thirsk,
Sowerby’. Follow this road for approximately 3½ miles.

At the mini-roundabout bear left (signed A61 Ripon). You will
immediately see Tesco supermarket on your left.

Turn left at the mini-roundabout and into Tesco car park. Parking is free
of charge.

From the A19 (Southbound)

Leave the A19 following signs for Thirsk town centre.  At town centre
follow signs for Ripon (A61). Once outside the town centre turn right at
the mini-roundabout onto Station Road (A61). You will see Tesco
supermarket on your left. Park in Tesco car park.

PCT HQ is the old-style two-storey building near to the main road.
Reception can be accessed from Station Road.

Wheelchair access is available from a side entrance using an intercom
with HQ reception.

HQ can be contacted on 01845 573800.

Appendix 5

Document Outline