Ensuring the continuation of our Adult Autism Services during Covid-19

The outbreak of Coronavirus brought with it changes to care for many children and adults across the country. Many of our teams in worked creatively to ensure we were able to ensure continued access to services throughout the pandemic through new and innovative solutions.

We spoke to Michelle Field, Operational Lead for Adult Autism Diagnostic Services, to learn about how their service adapted and changed over the course of the last year, and why they’re proud to have completed more assessments than they thought possible.

The Adult Autism Service diagnoses autism in adults. Referrals usually come from GPs or mental health teams, and during the pandemic we have seen a slight increase in the amount of these referrals.

Once referred, the individual would attend one or two face-to-face diagnostic assessment sessions, followed by a feedback session.

As the country went into the first lockdown, we worked proactively in engaging with other teams across Yorkshire to discuss what we could do and how best we could manage referrals in new ways. Working together in this way was really helpful as we had a good level of governance and understanding about the quality of diagnostics across the local area.

We had a lot going on at the time – some team members were on secondment for improving accessibility to Autism services for example – and I think we easily could’ve panicked and pulled people away from important projects to support this change, but we didn’t. If anything, we made ourselves more available to other services for additional support as required.

We worked with a charity called Matthew’s Hub, who helped us develop a process through which we could continue to connect with patients on our waiting list, ensuring they recieved support before diagnosis. This joint working  has helped service user’s mental health and wellbeing during this difficult time.

The pandemic has been challenging for everyone, however, some autistic people really struggled during the pandemic because of increased social isolation and added anxiety about the future or their safety. We work really hard to ensure any individuals who came for assessment had reputable information about the virus and how to keep themselves safe and well, both physically and mentally, during the pandemic. We also wrote letters of support to enable people to exceed the guidance on exercise allowance to support their mental health and maintain home placements.

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The next step we took was to work proactively to determine how best we could continue the provision of services online using Upstream. Our IT department were very helpful in the onboarding process and also in taking on our feedback when we felt certain features could be improved for our use specifically.

Once we felt we had a good understanding of how best we could use the software with our service users, we developed a Standard Operating Procedure for video assessments which helped support staff further and even inspire other teams to do the same.

Over time, we used this knowledge to further adapt our ways of working. One thing we noticed was that technical options posed a challenge for complex diagnosis, so we began to figure out ways to provide face-to-face sessions safely. This sometimes meant that one clinician would meet the service user in person, and dial in any other professionals who were required to support, helping us to limit the amount of people attending appointments.

Patients adapted to this change of service really well. We always asked them if they were happy to proceed with their assessment digitally, and we found that some people needed reassurances that the quality of care would be the same and that a diagnosis would still be possible where relevant, so we made sure that we gave them all of the information we had and explained the process in full. This tended to put most people’s concerns at ease and meant we were able to continue our assessments virtually.

The technology element is something we will definitely continue into the future. On the whole, we have learned that our patients prefer it. Dealing with anxiety around new environments and the pressure of attending appointments or adapting their routine are some common struggles for Autistic people. Having our appointments virtually has been a relief for many, as they have been able to dial in from the comfort of their own home.

 

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As the second wave began, the team found that working from home became a challenge; the limited opportunity for informal supervision was particularly missed. Also, innovative projects such as service development work usually would benefit from us working together in person, and it was something we missed.

However, there were also times that we were grateful for the ongoing opportunity to work from home. A large portion of our job includes writing lengthy reports after assessment, which requires a great deal of focus. We all found that working from home allowed us to do this more productively, and I think that the biggest thing I have learned during this time is the importance of hybrid working.

We have acknowledged that both working from the office and working from home have their advantages and that we can work flexibly in a way which benefits the team as a whole. We know how important it is to understand a member of staff’s individual needs and how they work best at certain points in time.

“Flexible working has been brilliant for us. I think it’s a learning curve we all had to get used to in the beginning, but one which has been essential in delivering our services so well at this time.”

It’s also so important to personalise your service in similar ways. If one service user has more complex needs than another, it’s about navigating their needs and ensuring that you are delivering the service in a way that best suits that individual. Having a one rule fits all approach doesn’t benefit staff or our service users, and that’s a lesson I’m grateful to be taking with us into the future.

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The thing I’m most proud of is the team’s positive attitude and their determination in continuing to provide our service.

We took proactive steps to ensure our prioritisation criteria would continue to meet the needs of our service users, in line with an expected increase in referrals, and we adopted a strategy which would ensure we could carry on supporting our service users during uncertain times. I think this was pivotal in what I believe is a great and ongoing positive achievement for our team, and I can’t thank everyone enough because without their hard work and dedication, it wouldn’t have been possible.

The whole team have been incredible but I would like to give a special mention to Sushie Dobbinson, whose work has been paramount in ensuring the support has been there for both our service users and staff.

Overall, it was a pleasure to see how the team adapted so quickly and how they have maintained a good pace throughout. Since the first lockdown, we have delivered around 200 digital assessments. This is extremely impressive given that we’re a fairly small team and that we had to take the time to adapt our service in a way that not only meant we could stay open, but that we could continue to deliver our service to the highest standard. I think we can all be really proud of ourselves.