Support for young people with autism and/or learning disability
Learning disabilities and autism - admission avoidance and discharge
Any child or young person with a formal diagnosis of learning disability and/or autism and deemed to have a significant mental health need that requires intervention from health professionals, that places them at high risk of admission to specialist mental health in-patient services, should be referred directly from any health, education or social service to the Learning Disability and/or Autism Admission Avoidance and Discharge team (LDA-AAD team). The team also accept self-referrals.
Access to the admission avoidance pathways requires consent. Depending on the child or young person's competence and understanding of what's fully involved they may be able to give consent themselves (Gillick competence). Otherwise, consent must be given on their behalf by someone with parental responsibility. Once eligibility to the service has been agreed, the individual will be added to the Dynamic Support Pathway and information about them will be shared with relevant system partners. The child or young person will receive a RAG (Red, Amber and Green) rating, which will be aligned to the level of risk linked to admission to specialist mental health in-patient services.
Find out more about the Learning Disabilities and/or Autism Admission Avoidance and Discharge team
Dynamic Support Pathway
The Dynamic Support Pathway is a pathway designed to monitor and track those individuals known to NHS Herefordshire and Worcestershire Integrated Care Board (ICB), who are at the highest risk of admission to specialist in patient – locked, secure and Tier 4 hospitals.
The Dynamic Support Pathway aims to ensure that:
- All appropriate health, education and social care services are working together
- People receive the right care and treatment, when they need it
- Crisis is prevented
- Risk factors are managed to prevent admissions to Tier 4 in-patient services, locked and secure services
Consent to be on the Dynamic Support Pathway is required from the child or young person. The referrer must ensure that the child or young person they are referring to the Dynamic Support Pathway has provided their consent, or they have completed and submitted the best interest decision documentation, following a Mental Capacity Assessment. All documents must be submitted to the LDA-Admission Avoidance and Discharge team (LDA-AAD team) and aligned with the referral process.
A child or young person can also self-refer themselves to the Dynamic Support Pathway by completing the Dynamic Support Pathway self-referral form.
Consent is reviewed annually according to the CETR/DSR policy.
Being on the Dynamic Support Pathway also means that the LDA-AAD team oversees the challenges, bringing our health, (education) and social care systems together to make sure the child or young person has the right support when they need it.
Find out more about the Dynamic Support Pathway
Care, Education and Treatment Reviews (CETRs)
The LDA Admission Avoidance and Discharge team (LDA-AAD team) facilitates and chairs Care, Education and Treatment Reviews (CETRs) for those known to Herefordshire and Worcestershire pathways.
A Care, Education and Treatment Review (CETR) is a person-centred review of care, education and treatment plans to make sure that the child or young person's and their family's needs are met and to challenge and overcome any barriers for progress and/or discharge.
It's important to know that the CETR does not decide whether a person should be admitted to or discharged from hospital. This remains the responsibility of clinicians (or the courts/Ministry of Justice (MoJ) under Part 3 of the Mental Health Act 1983).
Everyone has the right to request the Care, Education and Treatment Review. It is not a mandatory requirement for someone to be on the Dynamic Support Pathway to be able to have a CETR. However, it may take longer to process C(E)TR referrals for anyone not known to the Dynamic Support Pathway.
The LDA-AAD team will work with partners from health, education and care systems to address the concerns that led to the Care, Education and Treatment Review (CETR) request in order to reduce the risks of admission to a specialist locked mental health hospital.
Find out more about Care, Education and Treatment Reviews (CETRs)
System Navigator
The System Navigators (formally known as Key Workers) work with those children and young people known to the Dynamic Support Pathway. System Navigators are allocated to children and young people with a DSP RAG rating status of Red or Amber and who are at risk of admission to or are detained in CAMHS T4, locked and secure in-patient services.
- System Navigators work closely with the child, young person and their families to listen to them and gain an understanding of their health, education and social care needs
- System Navigators will help to navigate local health, education and social care systems to make sure that everyone is working together so that child or young person have the right support when they need it
- System Navigators will make sure that the child or young person's voice is heard across local health, education and social care systems to develop and plan their next steps
Once the child or young person comes off the Dynamic Support Pathway, they are offered on-going support and guidance from the Link System Navigator who can continue to follow up on any outstanding recommendations. The team will "move the person over" with their agreement.
Contact details
For all enquiries please email the LDA-AAD team at hwicb.lda-aad@nhs.net
The team will respond within two working days. The team is not an urgent service and operates Monday to Friday, 8am to 5pm excluding bank holidays.