Spiralling child waiting list forces CCG to take action

The move, by Devon Clinical Commissioning Group, comes less than a year after the organisation rejected a business case that sought to shrink waiting lists.

Around 1,800 people aged 18 or under in the county have not yet been assessed, as of August 2019.

One person has waited 122 weeks to be seen, while the average wait is 67 weeks – far above the recommended 12 weeks as stated by the National Institute for Health and Care Excellence.

The figures have prompted concern within the CCG, which last year awarded a seven-year contract worth £166m that includes autism services to a consortium of Devon’s NHS providers under the banner ”Children and Family Health Devon”.

The contract went live in April, but two weeks ago the CCG appealed to the market for potential new autism assessment providers to help reduce the number of under-18s waiting.

The initiative is part of a wider redesign and improvement of autism assessment and diagnostic services in Devon, according to a notice published by the CCG on a procurement website.

Autism assessment services in the county were provided by Virgin Care between 2013 and April 2019. The company said the waiting list was much larger than it had been told when it took on the contract. 

Since then, the waiting list in Devon has increased steadily over the last few years due to “demand outstripping capacity”, according to the CCG.

However, last October the CCG turned down a business case that sought to “manage the waiting list to an acceptable level”, according to its board papers.

The CCG, told HSJ this was “due to the ongoing procurement process for children’s services”.

Asked about the cost pressure caused by the long waiting times, CCG said it “could not quantify this exactly”.

“Any cost pressure will likely be for funding additional staff to provide capacity,” the organisation said in a statement. 

“We are working with the new provider to determine this and expect to complete this demand and capacity modelling in the next few months.”

Sharon Matson, the CCG’s head of commissioning for women and children, told HSJ: “We want families to receive these assessments as soon as possible and – in the short term – we are working on a targeted project to quickly reduce the number of people waiting.”

Asked if any of the people on the waiting list had come to harm before being assessed, the CCG said it could not provide this information due to the length of time it would take to source the answer.

In a statement the CCG said: “Children on the waiting list for assessment/diagnosis where there are previously identified risks have their cases reviewed regularly especially at points of transition, as well as working with child and adolescent mental health services if required.”

It added that the new provider would “bring about long-term improvement in waiting times and improve the experience of under-18s and their families”.

Anna Bailey-Bearfield, head of policy and public affairs at the National Autistic Society, told HSJ she was “not surprised” to hear about the length of time – and number of people – waiting for assessments in Devon.

“It does seem like there is a significant postcode lottery for waiting times both for children and adults,” she said.

Virgin Care said it had undertaken a waiting list reduction scheme which included designing a new assessment process together with parents. The company said demand increased by 20 per cent per year throughout the operation of the contract. 

A spokeswoman for Children and Family Health Devon said “improving ease and speed of access” was a ”key priority”.

She said work to improve the service included ”providing earlier support, self-help, support for parents and timely assessments when needed”.