Children feared ‘lost to the system’ by failing service

The autism assessment and intervention service in the Midlands was taken over by Midlands Partnership Foundation Trust in October in an interim capacity, when commissioners decided to change the provider.

Yet HSJ has established the service, which covers South Staffordshire, is still being dogged by serious concerns.

These include delays in children accessing autism assessments, growing backlogs and files not being transferred from the previous provider — a social enterprise called Midlands Psychology — to MPFT.

According to a statement on the trust’s website, the main concern raised by parents was that their children had been “lost to the system”.

The service can initially give children a “working diagnosis” of autism, and later a confirmed diagnosis. Once they have either form of diagnosis, the service provides various interventions, and the individual is also able to access other support.

‘Deliberate confusion’

The trust has confirmed to HSJ it received 187 case files for children awaiting an autism diagnosis assessment from the previous provider in October. As of last week, only 15 of them had their assessment completed.

The trust has also confirmed it did not receive files for 306 children with a working diagnosis, but who still needed to be assessed, until early this month — five months after it took over the service.

Midlands Psychology chief executive Angela Southall told HSJ her organisation had been instructed not to hand over certain files — classed as “closed” — and said: “There seemed to be some deliberate confusion.”

Hundreds of children had their files deemed “closed” under the previous service, as they were not actively receiving interventions when the service was taken over, and have not been transferred over. MPFT has said that when these children access the new service, it will not be able to access their old notes, and indicated that capacity issues will mean some of them join a waiting list.

The trust told HSJ “staffing issues” had led to delays in parents receiving appointments for their children. It has been unable to confirm how long children on lists will be left waiting.

Reprocurement

On 7 February, MPFT said it intended to seek external providers to deliver some services.

It comes as the commissioners of the service (Stafford and Surrounds, South East Staffordshire and Seisdon Peninsular, and East Staffordshire clinical commissioning groups) are in the process of procuring a new service, which is due to be in place by June.

Last May, the area’s CCGs, MPFT and Midlands Psychology were all criticised in an independent report claiming suicidal children with autism were being left at risk.

Midlands Psychology’s contract ended in September, at which point the CCGs awarded an interim contract to MPFT. The CCGs were planning to reprocure it with a new service model in 2020.

Health and social care secretary Matt Hancock asked NHS England chief executive Sir Simon Stevens in November to review the CCGs’ handling of the service.

HSJ has asked NHSE for an update on its review. It did not respond to the question but said it was “working closely” with the CCGs.

‘Minimal’ oversight

In October, HSJ revealed the previous leaders of South East Staffordshire and Seisdon Peninsula CCG provided only “minimal” oversight of the children’s autism services, despite concerns being raised. Multiple reports, dating back as far as 2011, were found to have flagged concerns over the contracting of the services, which had left some children without support in times of crisis.

A spokesman for the Staffordshire CCGs told HSJ “assessments take 26 weeks to complete” so the fact a small number have been completed since it took over in October was “alone is not an accurate measure of the performance of the interim service”.

However, he said: “We acknowledge that there have been staffing challenges within the interim service. MPFT are working hard to resolve these issues.

“MPFT have been actively recruiting and a speech and language therapist has now commenced in the team, two new assistant psychologists have recently taken up appointment and two staff members are returning from maternity leave.”

An MPFT spokesman said: “We apologise to families who are feeling let down with the level of support the service is able to offer at this time.

“Interventions are being held on both a one-to-one and group basis and we are prioritising those children and young people who are experiencing the longest wait and the greatest clinical need.”

Updated on 24 February after feedback received by HSJ.