Agenda item

Marie Hackshall, System Programme Lead Kent and Medway – Learning Disability, Autism and ADHD was in attendance for this item. 

1.     The Chair welcomed Marie Hackshall, System Programme Lead Kent and Medway – Learning Disability, Autism and ADHD, to the meeting and invited questions from the Committee.

2.     Marie Hackshall shared a report on the progress made on the health commissioned care pathway for adult Autism and ADHD services in Kent, the revised commissioning processes that had being undertaken, the governance arrangements for this, engagement with people with lived experience and future actions planned to address challenges within this clinical area. This report followed a previous briefing to the Committee in October 2024.

3.     The Chairman commented that he was impressed with the work carried out so far in engaging with the community and that he attended one event in Ashford which was very well run. He asked for feedback from this event.

a       Marie Hackshall said that, between November 2024 and the end of February 2025, her service ran a number of engagement sessions, as well as an online survey. for people who were waiting for an ADHD assessment or who had a diagnosis of ADHD. The online survey received over 1,500 responses. The responses were used to inform the engagement sessions - two were online and two in person - which were attended by 42 people.

b       The responses highlighted significant challenges in accessing assessments and treatment, as well as support before and after diagnosis. Respondents said that they needed tailored support such as coaching, therapy, crisis services, financial and employment guidance. Other suggestions to help improve services included awareness and training for healthcare staff and GPs, better communication during the process, self-referral options, crisis escalation pathways, and a central directory for ADHD-friendly services.

4.           In reply to a question about the reasons for the increase in demand for autism and ADHD services, Marie Hackshall explained that the reasons were multifaceted and complex. There was a comprehensive workstream at national level aimed at understanding why the demand had risen, and about how best to address it. 

5.           In Kent that demand had followed the national trend and was strongly influenced by increasing public awareness of ADHD along with social and environmental changes that had impacted on people’s lives following the pandemic. Demand for ADHD assessments had risen at such pace that current service models, and the ability to keep pace with demand, had been recognised by NHS England as a significant challenge for all ICBs.

6.           The Committee requested a report providing more detail about national-level work aimed at understanding the reasons for the increase in demand for autism and ADHD services, and about the commissioning and contractual arrangements of the ICB for the assessment and treatment of these conditions.

7.           In answer to a question about how to improve the provision of medication for ADHD in a timely way, Marie Hackshall said that the main aim was to offer ‘hub and spoke models’ involving more localised services to improve access to treatment. The plan was, over the course of the next 12 months, to offer those services through more localised infrastructure primary care and community care rather than through more expensive specialist settings.

8.           Dr Jack Jacobs (Kent Local Medical Committee)commented that the medications that were used for some patients with ADHD were not part of the normal, core prescribing of GPs. A voluntary ‘Shared Care Agreement’ was necessary for GPs to do so. The visit involved a comprehensive assessment and not all practices had the resources to do so. This was one of the main reasons why this service was not offered by all GP practises.

RESOLVED that the Committee note the report.