The 2016 Autism Self-Assessment in North west
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PowerPoint slides, one for each of the former Government Office Regions in England, display the responses of the local authorities within the region to the questions in the Self-Assessment. They are intended primarily to support local discussions.
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The 2016 Autism Self-Assessment in North west
- 1. The 2016 Autism Self-Assessment in North West Hiral Mehta
- 2. Background The Autism local self-assessment is a periodic exercise in which local autism strategy groups are asked to review their progress in implementing the government’s Autism Strategy in partnership with local residents with autism and their family carers. It is undertaken partly to assist local planning and partly to support the government in its duty to monitor progress in implementation of the Strategy. The full report of the most recent Self-Assessment exercise is at- https://www.gov.uk/government/publications/autism-self-assessment-framework- exercise The sets of PowerPoint slides in this package, one for each of the former Government Office Regions in England, display the responses of the local authorities within the region to the questions in the Self-Assessment. They are intended primarily to support local discussions. The slides should be used in conjunction with the main report which contains the full questions and instructions for responding. 2 The 2014 Autism Self-Assessment
- 3. Response rate 145/152 local authorities responded. 3 The 2016 Autism Self-Assessment Participation of partners Local Authority Adult Social Services- 95% Local Authority Department of Children's Services- 92% Employment Service- 59% Clinical Commissioning Group- 91% Local education authorities- 66% Health and Wellbeing Board- 30% Police- 55% Local Authority Public Health Department- 72% Probation- 36% Primary healthcare- 51% Court services- 27% Secondary health care providers- 62% Informal carers, family, friends of people on the autistic spectrum- 78% Local charitable / voluntary / self advocacy / interest groups- 83% People on the autism spectrum- 74% Where the partners were not involved, we did not ask if they were unwilling or not contacted
- 4. All questions comparison 4 The 2016 Autism Self-Assessment
- 5. Pattern of change • In both types of questions- identical and similar/ more precise, more number of questions have shown improvement 5 The 2016 Autism Self-Assessment Identical Similar / more precise Section Better Worse Better Worse Total Planning 6 1 2 1 10 Training 3 2 1 1 7 Diagnosis 0 2 0 0 2 Care and Support 2 0 1 1 4 Housing and accommodation 0 0 1 0 1 Employment 2 0 0 0 2 Criminal Justice System 1 0 1 0 2 Total 14 5 6 3 28
- 6. Key to tile charts 6 The 2014 Autism Self-Assessment Response 2016 2014 Specialist Integrated Green Amber Red Yes No Autism-specific Single General No response Not applicable
- 7. Planning 7 The 2016 Autism Self-Assessment BlackburnwithDarwen Blackpool Bolton Bury CheshireEast CheshireWestandChester Cumbria Halton Knowsley Lancashire Liverpool Manchester Oldham Rochdale Salford Sefton St.Helens Stockport Tameside Trafford Warrington Wigan Wirral Working with other local authorities-Identical-England Yes- 55%, No- 41% 2014 Designated strategy lead for adults with autism-New-England Yes- 93%, No- 2% 2014 Same as strategic joint commissioner-New-England Yes- 55%, No- 39% 2014 Separate operational lead-New-England Yes- 60%, No- 36% 2014 Needs of children and young people considered in the JSNA- Identical-England Yes- 67%, No- 28% 2014 Data collection-Identical-England G-13%, A- 76%, R- 7% 2014 Data collection for total number of people with autism meeting eligibility criteria for social care-Identical-England Yes- 82%, No- 13% 2014 Publish data other than that collected in JSNA-New-England Yes- 38%, No- 56% 2014
- 8. Planning 8 The 2016 Autism Self-Assessment BlackburnwithDarwen Blackpool Bolton Bury CheshireEast CheshireWestandChester Cumbria Halton Knowsley Lancashire Liverpool Manchester Oldham Rochdale Salford Sefton St.Helens Stockport Tameside Trafford Warrington Wigan Wirral CCG involved in planning-Identical-England R- 59%, A- 34%, G- 3% 2014 Local autism programme board in place-New-England Yes- 86%, No- 9% 2014 Engaging self advocates and carers-Identical-England R- 48%, A- 39%, G- 8% 2014 Reasonable adjustments to general council services -Identical- England R- 9%, A- 51%, G- 35% 2014 Reasonable adjustments to NHS services-New-England R- 16%, A- 70%, G- 8% 2014 Reasonable adjustments to access health and social care information, support and advice-New-England R- 16%, A- 76%, G- 3% 2014 Reasonable adjustments to access other public services-New- England R- 13%, A- 72%, G- 7% 2014 Transition from children's to adult services -Identical-England R- 37%, A- 57%, G- 1% 2014 Planning for older people with autism -Similar-England R- 8%, A- 65%, G- 22% 2014
- 9. Planning section changes 9 The 2014 Autism Self-Assessment
- 10. Planning section changes 10 The 2014 Autism Self-Assessment
- 11. Training 11 The 2016 Autism Self-Assessment BlackburnwithDarwen Blackpool Bolton Bury CheshireEast CheshireWestandChester Cumbria Halton Knowsley Lancashire Liverpool Manchester Oldham Rochdale Salford Sefton St.Helens Stockport Tameside Trafford Warrington Wigan Wirral Multi agency training plan -Identical-England Yes- 48%, No- 47% 2014 Autism awareness training for health and social care staff -Similar- England R- 17%, A- 68%, G- 10% 2014 Recording of uptake levels of autism awareness training-New- England Yes- 63%, No- 31% 2014 Self advocates with autism and/or family carers included in the design of training-New-England Yes- 74%, No -21% 2014 Autism training for staff doing statutory assessments -Identical- England R- 27%, A- 41%, G- 26% 2014 Autism training focussed on adults aged 65 and over-New-England Yes- 11%, No- 84% 2014
- 12. 12 The 2016 Autism Self-Assessment Training BlackburnwithDarwen Blackpool Bolton Bury CheshireEast CheshireWestandChester Cumbria Halton Knowsley Lancashire Liverpool Manchester Oldham Rochdale Salford Sefton St.Helens Stockport Tameside Trafford Warrington Wigan Wirral CJS-police autism training-Identical-England Yes- 77%, No- 16% 2014 CJS- local court services autism services training-Identical- England Yes- 32%, No- 45% 2014 CJS-probation services autism training -Identical-England Yes- 46%, No- 44% 2014
- 13. Training section changes 13 The 2016 Autism Self-Assessment
- 14. Diagnostic pathways 14 The 2016 Autism Self-Assessment BlackburnwithDarwen Blackpool Bolton Bury CheshireEast CheshireWestandChester Cumbria Halton Knowsley Lancashire Liverpool Manchester Oldham Rochdale Salford Sefton St.Helens Stockport Tameside Trafford Warrington Wigan Wirral Established local autism diagnostic pathway-Identical-England R- 52%, A- 41%,G- 2% 2014 Ability to meet the NICE recommended [QS51] waiting time-New- England R- 22%, A- 23%, G- 43% 2014 Description of local diagnostic pathway-Identical-England Yes- 67%, No -24% 2014 Diagnosis automatically leads to offer of a community care assessment -Identical-England Yes- 45%, No -47% 2014
- 15. Diagnosis section changes 15 The 2016 Autism Self-Assessment
- 16. Diagnosis section changes 16 The 2014 Autism Self-Assessment
- 17. Waits and changes in this region 17 The 2016 Autism Self-Assessment
- 18. Changes in diagnosis waiting time 18 The 2016 Autism Self-Assessment
- 19. Changes in diagnosis wait by region 19 The 2016 Autism Self-Assessment
- 20. Diagnosis pathway numbers 20 The 2016 Autism Self-Assessment North West Referred out of area Referred for an assesment but waiting for a diagnosis- rate per 100k population (number) Diagnosed- year to end of March 2016- rate per 100k population (number) Eligible for adult social care services having a diagnosis of autism and in receipt of personal budget- rate per 100k population (number) With autism but no learning disability- proportion of those with autism and having a personal budget (number) With autism AND learning disability- proportion of those with autism and having a personal budget (number) Blackburn with Darwen 0 8.9 (13) 23.8 (35) Blackpool Suppressed 0 (0) 0 (0) 38.8 (43) 20.9 (9) 79.1 (34) Bolton 0 1.1 (3) 15.6 (44) 38.1 (82) 100 (82) 19.5 (16) Bury 0 6.4 (12) 19.2 (36) 46.1 (67) 35.8 (24) 64.2 (43) Cheshire East 0 5.3 (20) 39.2 (147) 2.3 (7) 0 (0) 100 (7) Cheshire West and Chester Cumbria 11.4 (57) 29.9 (149) 12.9 (53) 17 (9) 83 (44) Halton 0 3.2 (4) 13.4 (17) 113 (111) 79.3 (88) 41.4 (46) Knowsley 0.7 (1) 10.9 (16) 22.7 (26) 65.4 (17) 34.6 (9) Lancashire 0 5.7 (68) 24.5 (292) 32.9 (316) 10.4 (33) 89.6 (283) Liverpool 0 10.2 (49) 25.3 (121) 9.8 (38) 0 (0) 100 (38) Manchester 0 7.7 (41) 40.9 (169) 0.6 (1) 99.4 (168) England 457 7.8 (5182) 9.7 (6048) 35.4 (13746) 15.1 (3797) 83.2 (9235)
- 21. Diagnosis pathway numbers continued North West Referred out of area Referred for an assesment but waiting for a diagnosis- rate per 100k population (number) Diagnosed- year to end of March 2016- rate per 100k population (number) Eligible for adult social care services having a diagnosis of autism and in receipt of personal budget- rate per 100k population (number) With autism but no learning disability- proportion of those with autism and having a personal budget (number) With autism AND learning disability- proportion of those with autism and having a personal budget (number) Oldham 0 7.8 (18) 29.5 (68) 44.6 (77) 0 (0) Rochdale 0 11.2 (24) 37.3 (80) 88.2 (144) 28.5 (41) 71.5 (103) Salford 35 4.1 (10) 6.9 (17) 0 (0) Sefton 0 0.4 (1) 13.2 (36) 26.3 (58) 19 (11) 81 (47) St. Helens 0 0 (0) 13.5 (24) 14.9 (21) 19 (4) 81 (17) Stockport 54 0 (0) 0 (0) 0 (0) Tameside 0 45.1 (100) 14 (31) 15.6 (27) 11.1 (3) 88.9 (24) Trafford 0 5.1 (12) 11.6 (27) 7.8 (14) 71.4 (10) Warrington 0 0.5 (1) 8.2 (17) 41.1 (67) 9 (6) 91 (61) Wigan 0 7.1 (23) 17.1 (55) 60.5 (154) 18.8 (29) 81.2 (125) Wirral 0 43.3 (139) 21.8 (70) 15.4 (39) 12.8 (5) 87.2 (34) England 457 7.8 (5182) 9.7 (6048) 35.4 (13746) 15.1 (3797) 83.2 (9235) 21 The 2014 Autism Self-Assessment
- 22. Access to post-diagnostic services 22 The 2016 Autism Self-Assessment With a learning disability Without a learning disability Access to post-diagnostic psychology services
- 23. Access to post-diagnostic services 23 The 2016 Autism Self-Assessment With a learning disability Without a learning disability Access to speech and language therapy assessments
- 24. Access to post-diagnostic services 24 The 2016 Autism Self-Assessment With a learning disability Without a learning disability Access to occupational therapy assessments
- 25. After diagnosis 25 The 2016 Autism Self-Assessment BlackburnwithDarwen Blackpool Bolton Bury CheshireEast CheshireWestandChester Cumbria Halton Knowsley Lancashire Liverpool Manchester Oldham Rochdale Salford Sefton St.Helens Stockport Tameside Trafford Warrington Wigan Wirral Post-diagnosis reasonably adjusted psychology assessments for people with autism and a learning disability- New-England R- 49%, A- 35%, G- 10% 2014 Post-diagnosis reasonably adjusted psychology assessments for people with autism and without a learning disability- New-England R- 16%, A- 34%, G- 42% 2014 Post-diagnosis reasonably adjusted SALT assessments for people with autism and a learning disability-New-England R- 49%, A- 34%, G- 11% 2014 Post-diagnosis reasonably adjusted SALT assessments for people with autism and without a learning disability -New- England R- 12%, A- 26%, G- 54% 2014 Response Green Amber Red No response 2016 2014
- 26. After diagnosis 26 The 2014 Autism Self-Assessment BlackburnwithDarwen Blackpool Bolton Bury CheshireEast CheshireWestandChester Cumbria Halton Knowsley Lancashire Liverpool Manchester Oldham Rochdale Salford Sefton St.Helens Stockport Tameside Trafford Warrington Wigan Wirral Post-diagnosis reasonably adjusted OT assessments for people with autism and a learning disability-New-England R- 49%, A- 31%, G- 14% 2014 Post-diagnosis reasonably adjusted OT assessments for people with autism and without a learning disability-New- England R- 11%, A- 33%, G- 48% 2014 Post diagnostic support with clinical psychology for people with autism and a learning disability-New-England Yes- 88%, No- 5% 2014 Post diagnostic support with clinical psychology for people with autism and without a learning disability-New-England Yes- 64%, No- 28% 2014 Crisis services identify the needs of people with autism- New-England R- 7%, A- 66%, G- 16% 2014 Response Green Amber Red Yes No No response 2016 2014
- 27. Autism pathways 27 The 2016 Autism Self-Assessment BlackburnwithDarwen Blackpool Bolton Bury CheshireEast CheshireWestandChester Cumbria Halton Knowsley Lancashire Liverpool Manchester Oldham Rochdale Salford Sefton St.Helens Stockport Tameside Trafford Warrington Wigan Wirral Single identifiable point of contact- 21%, Single- 22%, General- 52% 2014 Care assessment and other support for people with autism but not learning disabilities-New-England Yes- 80%, No- 15% 2014 Response Autism- specific Single General Yes No No response 2016 2014
- 28. Care and Support 28 The 2016 Autism Self-Assessment BlackburnwithDarwen Blackpool Bolton Bury CheshireEast CheshireWestandChester Cumbria Halton Knowsley Lancashire Liverpool Manchester Oldham Rochdale Salford Sefton St.Helens Stockport Tameside Trafford Warrington Wigan Wirral Advocates have autism training-Identical-England R- 43%, A- 41%, G- 11% 2014 Advocates available for adults with autism, not participating in needs assessment, care and support planning, appeals, reviews or safeguarding processes-Similar-England R- 58%, A- 35%, G- 3% 2014 Information about local support-Similar-England R- 25%, A- 66%, G- 3% 2014 Assessments offered to carers-Identical-England R- 78%, A- 15%, G- 3% 2014 Response Green Amber Red No response 2016 2014
- 29. Care and Support section changes 29 The 2016 Autism Self-Assessment
- 30. Accommodation 30 The 2016 Autism Self-Assessment BlackburnwithDarwen Blackpool Bolton Bury CheshireEast CheshireWestandChester Cumbria Halton Knowsley Lancashire Liverpool Manchester Oldham Rochdale Salford Sefton St.Helens Stockport Tameside Trafford Warrington Wigan Wirral Housing strategy considers autism-Similar-England R- 9%, A- 51%, G- 34% 2014 Key local housing staff have autism training-New-England Yes- 20%, No- 73% 2014 Response Green Amber Red Yes No No response 2016 2014
- 31. Employment 31 The 2016 Autism Self-Assessment BlackburnwithDarwen Blackpool Bolton Bury CheshireEast CheshireWestandChester Cumbria Halton Knowsley Lancashire Liverpool Manchester Oldham Rochdale Salford Sefton St.Helens Stockport Tameside Trafford Warrington Wigan Wirral Promoting employment for people with autism-Identical- England R- 31%, A- 55%, G- 9% 2014 Employment focus in transition to adult services-England R- 40%, A- 55%, G- 1% 2014 Response Green Amber Red No response 2016 2014
- 32. Housing/accommodation changes 32 The 2016 Autism Self-Assessment
- 33. Employment changes 33 The 2016 Autism Self-Assessment
- 34. Criminal justice service 34 The 2016 Autism Self-Assessment BlackburnwithDarwen Blackpool Bolton Bury CheshireEast CheshireWestandChester Cumbria Halton Knowsley Lancashire Liverpool Manchester Oldham Rochdale Salford Sefton St.Helens Stockport Tameside Trafford Warrington Wigan Wirral Police, Probation and Court Services working in partnership- Similar-England R- 11%, A- 63%, G- 21% 2014 Appropriate Adult services available for people with autism- Identical-England R- 22%, A- 67%, G- 5% 2014 Response Green Amber Red No response 2016 2014
- 35. Criminal Justice System section changes 35 The 2016 Autism Self-Assessment
- 36. Local good practice 1 • Prevention/ enablement initiatives: 37% • Support groups or networks-13% • Employment support- 8% • IT based support- 8% • Enhancements to assessments and advice processes: 31% • Staff training- 14% • Assessment improvements- 10% • Advocacy- 7% 36 The 2016 Autism Self-Assessment
- 37. Local good practice 2 • Enhancement in information services: 22% • Information services- 16% • Surveying local assets/ mapping local services- 6% • Initiative to enhance local provider markets: 10% • Approaches for transition of children and young people’s to adult services: 10% 37 The 2016 Autism Self-Assessment
- 38. Publications 1. A full report providing details of responses to each question, with maps and charts to show the patterns of progress 2. Separate volume of personal experiences submitted Available at: https://www.gov.uk/government/publications/autism-self-assessment- framework-exercise To follow: 1. Online interactive display of the results 2. Spreadsheet version of all the data to facilitate comparisons 38 The 2016 Autism Self-Assessment
- 39. Further information 39 The 2016 Autism Self-Assessment Archived website: https://tinyurl.com/ihalarchive Community of interest Knowledge Hub group – email LDT@phe.gov.uk for an invitation to join LDT@phe.gov.uk @ihal_talk The pictures in these slides are from Photosymbols: www.photosymbols.co.uk
- 40. Presentation notes Additional overview notes for all the slides are given in the notes page for this slide. We suggest speakers/presenters print these out for reference. 40 The 2016 Autism Self-Assessment
Editor's Notes
- This slide shows an overview of the profile of responses from all local authorities to all of the questions. The central, ladder-like figure shows the proportions of green, amber and red responses for each question. For yes/no questions dark blue (yes) and light blue (no) is used. The ladder-like figure to the left at this shows the response profiles for comparable questions in the 2014 SAF. A chart to the right shows the net change in responses. To produce this we scored each local authority’s answers to the question in both years assigning a score of +1 for an improvement, -1 for a worsening and 0 for no change. The largest red bar in the change chart is for question 18 – autism awareness training. This question was similar to last year and so were the red, amber and green ratings. Local investigation is required to find out the reasons behind the deteriorated performance. For example- The responses from all local authorities for Q 18 were as follows- 37 authorities showed worsening (-1*37= -37) 16 authorities showed improvement (+1*16=16) 89 authorities showed no change (0*89=0) Thus, the net change in responses for this question was -21.
- The numbers in this chart are the number of questions and not the number of local authorities For example: The first line shows that of the 10 questions in the planning section, 7 were identical and 3 were similar/ more precise compared to 2014. Of the 7 that were identical, 6 showed improvement and 1 got worse. 19 questions were identified as being identical to last year 9 questions were identified as being similar/ more precise 24 questions were identified as being new Since this table shows the pattern of change, we are just comparing the ones that were identical and similar/ more precise
- This is a key to charts on slide numbers 6, 7, 10, 11, 13, 24, 25, 26, 27, 29, 30, 33
- This slides relates to question numbers 3, 4, 4.04, 5, 6.01, 7, 7.01 and 8.01 in the SAF Questionnaire The questions which were new in 2016 have been marked white in 2014 since the question did not exist The lines which have the questions in them, indicate 2016 responses. 2014 responses have a ‘2014’ before them. Each question has a question line (2016 response) followed by the 2014 response
- This slides relates to question numbers 9, 9.01, 10, 11, 12, 12.01, 12.02, 13 and 14 in the SAF Questionnaire The questions which were new in 2016 have been marked white in 2014 since the question did not exist The lines which have the questions in them, indicate 2016 responses. 2014 responses have a ‘2014’ before them. Each question has a question line (2016 response) followed by the 2014 response
- This slides relates to question numbers 17, 18, 18.01, 19, 20 and 21 in the SAF Questionnaire The questions which were new in 2016 have been marked white in 2014 since the question did not exist The lines which have the questions in them, indicate 2016 responses. 2014 responses have a ‘2014’ before them. Each question has a question line (2016 response) followed by the 2014 response
- This slide relates to question numbers 23, 24 and 25 in the SAF Questionnaire The lines which have the questions in them, indicate 2016 responses. 2014 responses have a ‘2014’ before them. Each question has a question line (2016 response) followed by the 2014 response
- This slide relates to question numbers 26, 29.01, 33 and 34 in the SAF Questionnaire The questions which were new in 2016 have been marked white in 2014 since the question did not exist The lines which have the questions in them, indicate 2016 responses. 2014 responses have a ‘2014’ before them. Each question has a question line (2016 response) followed by the 2014 response
- This slide shows the diagnostic waiting times for each of the local authorities within this region. The X axis shows the waiting times in weeks and Y axis shows the local authorities within this region Blue line indicates the waiting time in weeks for the year 2016. Where the wait has increased compared to 2014, it is shown by a red bar- since it’s a negative move. The starting point of the red bar is the wait in weeks in 2014. Likewise, Where the wait has decreased compared to 2014, it is shown by a green bar- since it’s a positive move- green since it is a positive move. The end point of the green bar is the wait in weeks in 2014.
- This chart shows the wait in weeks for each local authority and how has this changed compared to the previous self assessment. The Y-axis shows the wait in weeks and the X-axis shows the local authorities The blue dots depict the waiting time in weeks for the local authorities in 2016. Each dot corresponds to one local authority. The red lines depict the local authorities where the wait has gone up compared to 2014- red since it is a negative move Likewise, the green lines depict the local authorities where the wait has gone down compared to 2014- green since it is a positive move
- This slide is similar to the previous one except that the local authorities are grouped by regions. It helps to clearly see what is going on in each region- for example, the waiting times for all the local authorities in London have gone up since 2014. On the other hand, the waiting times for most of the local authorities in the South West have gone down
- England- median
- England- median
- This slide relates to question numbers 35, 35.01, 36 and 36.01 in the SAF Questionnaire The questions which were new in 2016 have been marked white in 2014 since the question did not exist The lines which have the questions in them, indicate 2016 responses. 2014 responses have a ‘2014’ before them. Each question has a question line (2016 response) followed by the 2014 response
- This slide relates to question numbers 37, 37.01, 38, 38.01 and 39 in the SAF Questionnaire The questions which were new in 2016 have been marked white in 2014 since the question did not exist
- This slide relates to question numbers 41 and 42 in the SAF Questionnaire The questions which were new in 2016 have been marked white in 2014 since the question did not exist The lines which have the questions in them, indicate 2016 responses. 2014 responses have a ‘2014’ before them. Each question has a question line (2016 response) followed by the 2014 response
- This slide relates to question numbers 43, 44, 46 and 47 in the SAF Questionnaire The lines which have the questions in them, indicate 2016 responses. 2014 responses have a ‘2014’ before them. Each question has a question line (2016 response) followed by the 2014 response
- This slide relates to question numbers 48 and 49 in the SAF Questionnaire The lines which have the questions in them, indicate 2016 responses. 2014 responses have a ‘2014’ before them. Each question has a question line (2016 response) followed by the 2014 response
- This slide relates to question numbers 50 and 51 in the SAF Questionnaire The lines which have the questions in them, indicate 2016 responses. 2014 responses have a ‘2014’ before them. Each question has a question line (2016 response) followed by the 2014 response
- This slide relates to question numbers 50 and 51 in the SAF Questionnaire The lines which have the questions in them, indicate 2016 responses. 2014 responses have a ‘2014’ before them. Each question has a question line (2016 response) followed by the 2014 response
- This slide and the next pull out the key findings from Q54 and Q55 of the report. Local authorities are advised to read through the examples of local innovations from the main report and identify areas of practice which they feel best aligns with their local population
- The Improving Health and Lives website has now been archived and a community of interest Knowledge Hub group created. To join the group, email LDT@phe.gov.uk for an invitation. Group members will receive notifications when anything new is posted or uploaded.
- It is helpful to look at these slides with a copy of the report to hand. This is because the slides inevitably cannot give all of the detailed wording for all of the questions. Where questions arise about how local areas responded to specific questions, this detail is usually needed. Slides 1, 2 and 3 are self explanatory. Slide 4. This slide shows an overview of the profile of responses from all local authorities to all of the questions. The central, ladder-like figure shows the proportions of green, amber and red responses for each question. For yes/no questions dark blue (yes) and light blue (no) is used. The ladder-like figure to the left at this shows the response profiles for comparable questions in the 2014 SAF. A chart to the right shows the percentage change in responses. To produce this we scored each local authority’s answers to the question in both years assigning a score of +1 for an improvement, -1 for a worsening and 0 for no change. The largest red bar in the change chart is for question 18 – autism awareness training. This question was similar to last year and so were the red, amber and green ratings. Local investigation is required to find out the reasons behind the deteriorated performance. Slide 5. Between the 2014 and 2016 exercises, a few of the questions were changed. In most cases this was done to clarify ambiguities or to make the questions more precise. Out of the 28 questions appearing in both years, twenty were completely unchanged and eight either similar or more precise. Unlike 2014, no particular pattern of differences between similar/ more precise and identical questions were reported between 2014 and 2016. Slide 6 Gives a key for the tile charts on slides 7, 8, 11, 12, 14, 25, 26, 27, 28 and 30 Slide 7 to 16 and 25 to 35. These slides show the responses for each local authority to each of the coded questions. BY ‘coded’ we mean questions answered with red/amber/green, yes/no or some other short set of options. Where responses are other than red/amber/green, a key is provided. Charts have a column for each local authority. The first row for each question in the charts give the response for 2016, the row beneath that in paler colours give the responses for 2014 for comparison. Where the question was not asked, or the local authority did not respond, the box is marked white. A separate set of slides (9, 10, 13, 15, 16, 29, 32, 33, 35) show changes more clearly. These slides also indicate whether or not the questions asked in both years had been modified. Slide 17-21 The next four slides describe the waiting times in the diagnostic pathway. Slide 17 shows the detailed position for local authorities in this region Slide 18 shows how these have changed from 2014. The shift in waiting time for each local authority is shown as a vertical line between the wait in 2014 and the wait in 2016. Where waiting times have got shorter these are coloured green, where longer, red. Slide 19 shows the same data but with local authorities ordered in groups by region. Slide 20, 21 show the other numerical measures of the diagnosis pathway that were reported. Slide 22-24 The next three slides shows the differences in access to post-diagnostic services for those with autism and a learning disability and those with autism and without. Generally, those with a learning disability have better access to post-diagnostic services compared to those without. Slides 36 and 37 pull out the key findings from the local innovation questions. Slide 38 sets out the various publications Slide 39 gives details of where further information can be found