The Learning Disabilities and Autism Programme (formally Transforming Care), aims to make things better for children, young people and adults who have:
- autism
- learning disabilities
- challenging behaviours
- mental health problems
This programme focuses on providing better help within your local community.
The goal is to prevent you from having to go to a mental health hospital or a residential facility that is far away from your home. Instead, we want to ensure you get the support you need closer to where you live.
The principles of the Learning Disabilities and Autism Programme
These are the 9 principles of the Learning Disabilities and Autism Programme:
- I have an interesting life that I enjoy
- My care and support is well planned
- I have choice and control about my care and support
- I live in the community with the support I need
- I have choice about where I live and who I live with
- I get good care from health services
- I get help from specialists in the community when I need it
- I get help to stay out of trouble with the police if I need it
- If I have to go into hospital because my health needs cannot be met in the community, it is high quality, and I don’t stay there longer than I need to
How the programme can help
We want to create excellent services in collaboration with various partners, including community organizations. This way, you won't have to go to the hospital or a distant residential facility if you don't need to.
If you need to go to the hospital, we'll ensure you get excellent care and leave as soon as you're better. We'll try to place you in a nearby hospital. After your hospital stay, we'll help you reintegrate into your local community.
Dynamic support register (DSR)
Hammersmith & Fulham has a register for children and young people with a learning disability or autism who need support because they may be at risk of going into a mental health hospital.
A group of professionals from health, social care and education (if appropriate) meet regularly to ensure that there are plans in place to reduce the risk of admission and that the right support is in place.
The register also includes children and young people who are under 18 if they might need to live away from home if they don't get the right care and help in their community.
If your care, treatment, or education is not meeting your needs, the DSR process can look at what changes can be made to help and to prevent crisis.
Being on the register is optional. The person or their parent, depending on their age, must give consent. The health and care professionals or teachers working with the child or young person can request for that person to be on the register. Or the person themselves can request to be on the register.
There are 3 dynamic support registers in Hammersmith & Fulham:
- children and young people (up to 18 years old)
- autistic adults
- adults with a learning disability including those who are also autistic
To contact all 3 registers:
- Email: nhsnwl.cypldateam@nhs.net
The new Dynamic Support Register and Care (Education) and Treatment Review policy and guidance – NHS England was published in January 2023 and was coproduced by people with learning disabilities and autistic people.
Watch this video from the National Autistic Society about how to avoid unnecessary admission to hospital: VIDEO: Top tips on avoiding crisis and admission to an inpatient mental health hospital-(NAS)
Care Education and Treatment Reviews (CETR)
When a child or young person who has autism or a learning disability is at risk of being admitted to a mental health facility, a special meeting called a Care Education and Treatment Review (CETR) can be arranged. This meeting can be requested by the individual themselves, their family, or a professional.
During a CETR, family members and professionals come together to discuss the young person's needs and figure out the best steps to take. They work as a team. There are two key people at the meeting: a clinical expert who understands mental health, and a family member who has experience dealing with similar situations from a different place. These individuals provide fresh perspectives.
If the young person is no longer in school, the meeting is called a Care and Treatment Review (CTR).
You can find out more about CETRs and CTRs on the NHS England website.
The ASD & LD keyworker team
The North West London ASD & LD keyworker team helps young people under 25 with a learning disability or autism and have complex behaviour or mental health issues. These issues might lead to them being hospitalised or placed in residential facilities.
The goal is to prevent hospitalization, assist families when their child is in the hospital, shorten hospital stays, prevent re-hospitalization, and help these young people return to their communities. Essentially, it's a support service to keep these individuals out of hospitals or care facilities and help them reintegrate into their communities faster.
What a keyworker can do
Keyworkers team up with various agencies to help children and young people. They ensure these young people, and their families receive the right support when they need it.
Keyworkers work closely with families and caregivers to involve them in plans and make sure they feel heard and informed. They coordinate support to reduce stress and bring stability to families' lives.
A keyworker can:
- help the young person figure out what skills they want to learn
- find support for them to go out and be part of the community
- teach them how to stand up for themselves
- assist them in getting ready for adulthood
- help them solve problems and understand risks
- support them in meetings and make sure their opinions are respected
Who can have a keyworker
A keyworker helps children and young adults up to 25 years old who have learning disabilities, autism, or both. They step in when there's a chance the child might have to stay in the hospital, is already in the hospital, or if they're on the DSR. Information about how to include your case on the register is above.
Mental health admission
When a young person is in a mental health crisis and might harm themselves or others, they might need to go to a special hospital for safety. This is usually because they are experiencing an episode of crisis.
Sometimes this is needed to reduce the risk and understand the causes, but research shows people with a learning disability or autism, can find these environments difficult and challenging to be in.
Keyworkers can help planning for discharge from hospital as soon as possible. They figure out what support the person needs to stay safe and reconnect with their community. Keyworkers also help other professionals with assessments and plans, making sure the young person understands what's happening.
How to access the keyworker service
If you think that your child or young person might be at risk of admission, or is already in a mental health setting, your social worker, mental health care co-ordinator or any professional working with you can refer to the keyworker service via the dynamic support register.
Contact the ASD & LD keyworker team
If you would like any further information about the keyworker service:
Annual health checks
All people with a learning disability aged 14 and above can access an annual health check. This is usually with the GP or practice nurse.
See Annual health checks for people with a learning disability