Autism diagnostic assessments for children (3 - 11 years) living in North and West Kent

Provision of a bespoke, community-based team of appropriately qualified and experienced medical professionals that are competent and have expertise in undertaking Autism Spectrum Conditions diagnostic services for children and young people agreed 3 - 11 years referred to them through the KCHFT Community paediatric service.

KCHFT community paediatric will refer on service users who are 3 - 11 years who have been identified as having a potential Autistic Spectrum Condition and who are currenting on the community paediatric waiting list for an autism diagnostic assessment. The service will cover the geographic area of Dartford, Gravesham and Swanley and west Kent all referrals will be registered with a GP within these geographical areas.

The provider of the specialist community based multidisciplinary team will provide a timely, integrated, person-centred diagnostic assessment. The provider will ensure that their clinical professional team has expertise in the assessment of ASC in children and young people.

Following assessment, the provider will make recommendations to include how the service user can access existing resources and support from local services, signposting to community and voluntary organisations. Any recommendations in regards to accessing health services, social care and/or mental health services for any identified needs will need to be in line with each service's existing referral criteria.

Predicted activity

A minimum of 30 diagnostic assessments per month for 6 - 7 months (September 2022- March 2023)

A maximum of 60 diagnostic assessments per month for 6 - 7 months (September 2022- March 2023)

Total activity: 210 - 420

Provision of Autism Spectrum Disorder clinics including assessment and diagnosis for children and young people 3 years to 11 years in Dartford, Gravesham and Swanley and west Kent delivered over a 7-month period (September 2022 - March 2023)

The provider will contribute to the bespoke face to face clinical MDTs for ASC assessment and diagnostics provided by KCHFT.

The provider will provide a suitably qualified and experienced team of clinical staff (the Team) comprising of the following as appropriate:

Either:

• A consultant community paediatrician; or
• A consultant child and adolescent psychiatrist

Plus

• A clinical psychologist; and/or
• A speech and language therapist; and/or
• An occupational therapist

The Team will be (as appropriate):

• registered with the relevant professional regulatory body, e.g. Health Care Professions Council (HCPC)
• clinically supervised by the provider, ensuring that all work falls within their Governance Framework.

The Team will undertake autism specific case history (using a standardised case history format) and a clinical observation assessment for autism reaching a conclusion regarding diagnosis and sharing this with the family at the time of assessment.

The autism diagnostic assessments will be undertaken utilising appropriate clinical assessment tools, e.g. Autism Diagnostic Observation Schedule (ADOS) and clinical judgement to support the differential diagnosis of autism spectrum disorder (ASD).

The provider's clinical staff will supply and use their own Autism Diagnostic Observation Schedule (ADOS) Kits for each clinical assessment undertaken as well as the relevant ADOS Module forms that are required as part of the assessment (the cost of these forms will be covered by the provider).

All autism assessments will be carried out by two or three clinicians one of whom will always be either a consultant community paediatrician or consultant child and adolescent psychiatrist. The others will be, either, a clinical psychologist, a speech and language therapist or an occupational therapist.

All assessments will follow the format detailed below:

• ADOS and developmental history carried out simultaneously
• Team confer and reach conclusion
• Conclusion offered to parents immediately with opportunity for feedback and questions

Full diagnostic reports with signposting to local services will be sent out six to eight weeks after the assessment.

Written reports completed by the provider following each assessment will be distributed directly to the child's family and relevant professionals. Copies will be sent electronically via secure email (nhs.net or similarly encrypted email) and within six to eight weeks of the assessment being undertaken, to the KCHFT Community Paediatric Service to be added to the clinical files.

The provider will ensure that the content of the reports are clinically appropriate to the assessment carried out and details the assessment findings and recommendations made by their staff during the assessment.

A full audit of the service will be provided at the end of the contract to include statistics on diagnosis rates, satisfaction scores and feedback from parents.

An identified provider staff member to be available five days per week as project manager for KCHFT staff to liaise with as required.

Where the individual exhibits behaviour which places them at risk of offending, then onward referral to the local forensic service for assessment may be required.

Service Coverage - Hours

The provider will deliver a minimum of 30 assessments per month, which is available throughout accepted business working times of 09.00hrs to 17.00hrs, Monday to Friday, some evenings e.g. 18.00hrs - 21.00hrs and most weekends (Saturday and Sunday) 09.00hrs - 17.00hrs

Scheduling of appointments (days and times) will be agreed by KCHFT with the provider based on staff availability and/or room availability at the sites being used.

Work will take place at KCHFT sites detailed below (although the venue may be changed in response to clinical requirements or room availability):

• Heathside Centre, Invicta House, Heath Road, Coxheath, Maidstone, Kent ME17 4AH
• Gravesham Community Hospital, Bath Street, Gravesend DA11 0DG

Reports / Information to service users

There will be a maximum of 8 weeks from completion of assessment to the provision of a written report with recommendations which incorporates:

• Patient details
• Report author, date and those present during assessment
• Documents seen before and during assessment
• Diagnostic tools used, purpose and respective contributors
• Referee history (e.g. developmental, family, educational)
• Referee presentation (e.g. appearance, communication, empathy)
• Diagnosis (e.g. meeting criteria, traits contributing to diagnosis, severity, further information required)
• Recommendations (e.g. further assessments, signposting).
• Sign off and assessor declaration

The Supplier will ensure that the content of the reports are clinically appropriate to the

assessment carried out and details the assessment findings and recommendations made by

their staff during the assessment

A full audit of the service will be provided at the end of the contract to include statistics on

diagnosis rates, satisfaction scores and feedback from service users and their families / carers.

An identified staff member from the Supplier to be available five days per week as project

manager for KCHFT staff to liaise with as required.

Location

The service will be carried out at the sites detailed below (although the venue may be changed in response to clinical requirements or room availability):

• Heathside Centre, Invicta House, Heath Road, Coxheath, Maidstone, Kent ME17 4AH
• Gravesham Community Hospital, Bath Street, Gravesend DA11 0DG

Where delivering face to face clinics the provider will ensure that staff are able to travel in order to deliver services across the designated KCHFT sites in Dartford, Gravesham and Swanley and west Kent, in order to ensure that service users are able to access services in their local areas.

The provider will ensure equitable access to their services and may include the use of technologies / digital provision, where agreed with KCHFT and appropriate to do so.

Delivery period

1 September 2022 - 31 March 2023