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.    A Member asked how the re-procurement of the care pathway would access non-NHS providers, bearing in mind there were a number of partners involved in that pathway. Ms Hackshall explained that the interface with the third sector would be in pillar one (the self-support, self-management offer) which was being developed by the ICB as a digital offer. This would also link to the social prescribing “Joy Platform” that was jointly commissioned with KCC and linked to the primary care and voluntary sectors.

3.    A Member questioned why the number of adult ASD and ADHD diagnoses had increased so significantly in recent years, and whether there were adequate self-support tools available to prevent the number of patients requiring clinical support from increasing. Ms Hackshall said the increasing demand reflected a national trend, which was present prior to the Covid-19 pandemic but had risen dramatically since (an increase of 600% in Kent and Medway since 2022). It was believed that this increase was due to increased awareness and social normalisation of neuro divergence and diagnoses, especially amongst females.  

4.    Ms Hackshall went on to say that the pathway was often the first point of contact for many individuals, and the NHS needed to improve how cases were prioritised. The importance of early support was recognised, and this was being frontloaded in the pathway. 

5.    A Member asked if the financial envelope for the service remained unchanged, and Ms Hackshall confirmed that was the case. However, she added that the diagnostic element of the service fell under the “right to choose” regime which allowed patients to select a provider from an accredited list – this created a financial risk to the ICB. She also confirmed an additional £1.3 million of funding was being directed to community support for those with autism. 

6.    A task force was being established by NHSE to understand the increased demand and how to manage it. Neuro-divergence could be addressed with a clinical or social model, and NHS Kent and Medway were taking the latter approach. The ambition was to implement an all-age pathway, but this was not yet possible. 

7.    A Member questioned whether integration was taking place with family hubs. Ms Hackshall reported that resources were being put into community resources and Family Hubs were part of that. 

8.    Ms Hackshall confirmed that the NHS did not see the proposal as a substantial variation of service because it was amalgamating current services into one pathway – although one Member noted the high demand and limited funds available. The Committee discussed the advantages and disadvantages of declaring the item a substantial variation of service. It was confirmed that there would be no delay in moving the proposals forward should the Committee decide the changes were substantial. 

9.    Following a question from Mr Goatham (Healthwatch) about listening to the voices of those with lived experience, Ms Hackshall confirmed this feedback was being fed into the service specification. There was a reference group of 20 people as well as wider engagement with those on waiting lists and the general population.  

10. Mr Streatfield (MBE) proposed, and Cllr Jeffrey seconded, the motion that: 

a.    The Committee deems that the procurement of the adult autism and ADHD pathway in Kent and Medway is a substantial variation of service. 

b.    NHS representatives be invited to attend this Committee and present an update at an appropriate time.? 

When put to the vote, the motion fell. 

11.The Chair proposed, and Mr Chard seconded, the motion that:? 

a.    The Committee deems that the procurement of the adult autism and ADHD pathway in Kent and Medway is not a substantial variation of service. 

b.    NHS representatives be invited to attend this Committee and present an update at an appropriate time. 

The vote passed and the motion was carried.?

12. Members requested a further update within a year. 

13. Resolved that: 

a.    The Committee deems that the procurement of the adult autism and ADHD pathway in Kent and Medway is not a substantial variation of service. 

b.    NHS representatives be invited to attend this Committee and present an update at an appropriate time.