Debate contribution: Autism Services

Debate contribution by Mr Mike Nesbitt on 12 May 2026.

MLA

Mr Mike Nesbitt

Party at the time

Ulster Unionist Party

Date

12 May 2026

Type

Debate contribution (made as a minister)

Business

Private Members' Business

Heading

Autism Services

Assembly identifier

Official Report component 5528603

Read the official Assembly record

Text

Thank you, Mr Speaker, and thank you to all the Members who have contributed in the debate. I absolutely agree: we need to ensure that all those seeking autism services have access to the right type of service at the right time. I am fully committed to the full implementation of the Autism Act (Northern Ireland) 2011, as amended. Indeed, many of the issues that are being debated today are a focus for the Department of Health. Work is actively ongoing to try to address many of those challenges. However, I must also emphasise that all Departments need to work together to address the issues faced by people with autism. We have a growing prevalence of autism in our society. That places a responsibility on all Departments and public bodies to ensure that we are equipped and informed in our understanding of autism and in the delivery of the appropriate services. We need to strive to ensure that engagement enables autistic people, and their families and carers, to feel supported and to live fulfilling lives. That is the ethos of the autism strategy, which was published alongside the first delivery plan in December 2023. The strategy also focuses on the implementation and requirements of the Autism Act (Northern Ireland) 2011, as amended.

I recognise the very real challenges facing autistic people and those who support them. I completely agree with the findings of the Independent Autism Reviewer's first annual report: more must be done. We must recognise and address the fact that, while activity is evident, reliable delivery is not as evident. As on many issues, I want to push for standardised regional services that do away with postcode lotteries. As Members have mentioned, autism is part of daily life, and, indeed, it is part of daily life for members of my family. The motion seeks clarity across a number of areas and Departments, so I will respond to each in turn, starting with transitions. Transition from children's to adult services remains a recognised area of challenge, not least for young people with a diagnosis of autism. Practical improvements are under way. A regional transition protocol for children and young people with a learning disability, including children and young people with co-occurring autism, has been developed. Subject to the availability of funding, departmental officials will facilitate a pilot of that protocol to support full regional implementation. Children's and adult learning disability services across the health trusts remain committed to enhancing that transition process. In parallel, last month, the Department held a phase 1 workshop on transition pathways between child and adolescent mental health services (CAMHS) and adult mental health services. The focus was on exploring low-cost or no-cost improvements that can realistically be implemented within the current service constraints. The workshop aimed to develop a shared understanding of the current arrangements, including transitions from neurodevelopmental pathways, such as ASD and ADHD, and to lay the groundwork for co-developing a regional CAMHS to adult mental health services transitions pathway. I am on record as being committed to reviewing the Chronically Sick and Disabled Persons (Northern Ireland) Act 1978 and all appropriate legislation during the first year of implementation of the three-year service delivery plan for the learning disability service model. I want to determine whether there is a need for legislative change — I believe that there is — that better reflects today's needs and modern models of support for people with lifelong complex needs. The exact timeline for reviewing the legislation should be determined when both the learning disability service model and the service delivery programme are finalised. The review will require cross-departmental work involving not only Health but Education, Economy and Communities. A working group will be established to determine the terms of reference, scope and time frame for that review. I am aware of significant delays in accessing autism assessments. That is driving some to seek a private diagnosis. There remains a demand/capacity gap, and, consequently, we have long waiting lists. Work is under way to standardise the diagnostic pathway across all trusts while better meeting needs at an early pre-diagnosis stage. Trusts are working to manage demand and to use their existing resources as effectively and efficiently as possible. However, all Members will be aware of the significant funding challenges that I face, which mean making some very difficult decisions in respect of managing the resources that we have. The autism strategy acknowledges that the challenges faced by autistic people are cross-cutting and require coordinated action across services and Departments to address those needs. My Department will continue to work with HSC organisations and Executive colleagues to strengthen pathways and improve coordination of support for young people with complex needs for the remainder of the mandate and, hopefully, beyond. A key priority in the autism strategy is improving regional pathways of care. In support of that, my Department consulted on the children and young people's emotional health and well-being framework. The framework proposes an inclusive, needs-based approach to neurodiversity that does not require a formal diagnosis as a prerequisite for support. The model aims to reduce stigma, promote earlier intervention and improve outcomes across health, education and developmental domains. My Department continues to consider consultation responses and is working with colleagues in the Public Health Agency and child health to define the requirements that will underpin the pathway and inform future commissioning. To strengthen the focus on adult autism pathways, a dedicated project lead for adult autism was appointed in February 2025. Since taking up post, they have worked with trusts to map current diagnostic and support pathways, and they have convened a series of workshops to explore ways to optimise existing delivery and improve consistency within existing resources. Building on recommendations from the 2023 review of adult autism services, work is now ongoing to update the adult autism care pathway that was originally developed by the HSC regional autism spectrum disorder network. The review aims to deliver greater consistency in diagnostic and support services across trusts, aligned with NICE guidelines and reflective of differing levels of need. With regard to mental health, I make it clear that an autism assessment should not be required to access services to receive treatment. It is acknowledged that, often, interactions with general mental health services are more difficult than they should be for autistic people. The mental health strategy recognises that there are barriers currently preventing that client group and other marginalised groups from accessing mental health services and support. It is therefore actively seeking to reduce barriers and to implement a no-wrong-door approach, ensuring that staff are appropriately trained to identify and address the specific needs of marginalised or at-risk groups and that services can be flexible and meet individual needs at the point of contact. It is important that mental health services are fully equipped to identify the specific needs of individuals and address them appropriately, whether through engagement with support services such as social work teams, speech and language therapy or interpreting services; onward referral to specialist services or interventions, if required; or the employment of innovative solutions, such as digital mental health interventions. Training is key to ensuring that appropriate adjustments are made for each autistic person. Health and Social Care staff have access to a range of training modules, and work is being developed by my Department, in partnership with the Middletown Centre for Autism, which is an internationally recognised autism centre of excellence. The new modules cover autistic differences, providing supportive environments and promoting a neuro-affirming culture. The training has been co-produced with service users, and over 40% of the training includes neurodivergent people describing their lived experience. The training provides high-quality foundational knowledge to help staff to understand and implement reasonable adjustments. Additional specialist training for staff working in the area of mental health is being developed in partnership with Middletown. For autistic people with co-occurring learning disability, specialist services are provided and continue to reflect a strong evidential and professional basis. That is not to say that it is a perfect system. I am aware that specialist learning disability mental health inpatient services are significantly stretched, and there is an urgent need to develop a more robust community mental health system to prevent hospital admissions. The strategy aims to meet the requirements of our unique autism legislation, setting Northern Ireland apart from and, in some ways, ahead of many countries to ensure that public services understand the needs of autistic people and provide the right level and type of services. While considerable progress has already been made on the key actions in the mental health strategy, alongside the delivery of a range of other actions, they are being progressed with minimal budget, which I have repeatedly highlighted to Executive colleagues since taking up post. The funding plan, which was published alongside the mental health strategy in June 2021, identified a requirement of an additional £1·2 billion over the lifetime of the strategy to fully deliver all 35 actions. As many of you are aware, the autism strategy was developed and is being taken forward in a period of exceptionally constrained financial circumstances for all Departments. While there is a continued commitment to the implementation of the actions, that has necessitated a creative and innovative approach. The autism strategy sets out to deliver actions across health, education, housing and public services generally, including the Civil Service. Work is ongoing across Departments and public bodies, and progress is assessed through annual monitoring reports. The second progress report for 2024-25 is available on the Department's website. Work is also complete on the development of the delivery plan, which covers the remaining years of the strategy up to 2028. That is despite the challenge of long waiting lists, gaps in services and the constrained financial environment. The plan will remain a live document to enable the system to respond to emerging priorities. One of the key issues is the inclusion of measurable targets to assess effectiveness, which Pam Cameron highlighted in her remarks. I acknowledge that she has been at this a lot longer than I have. In the first two years of the implementation of the strategy, feedback from key stakeholders, including the Autism Reviewer, indicated that more focus is needed in that area. To address that, and in keeping with legislative requirements, departmental officials have developed the next delivery plan using specific, measurable, achievable, relevant and time-bound (SMART) targets and measures of success. Officials have also been working closely with Ema Cubitt on agreeing and finalising the delivery plan. Ema has provided some very helpful and constructive feedback on the plan, particularly in relation to SMART targets and measures of success. It was my honour to appoint Ema as our first Independent Autism Reviewer, just as it was my honour to be the first MLA to push for a mental health champion. Although I was unsuccessful at the time, I am delighted that Professor Siobhán O’Neill is now in place. It is important to highlight that many of the actions in the delivery plan are outwith my responsibility, and, therefore, focus may be better directed elsewhere. However, in relation to Health responsibilities, I will highlight some actions that are included in the plan, such as the implementation of the children and young people's emotional health and well-being framework and the publication of a learning disability strategic plan. It also includes support for:

"more timely access to assessment, support and intervention before, during and after diagnosis"

and the:

"Implementation of a regional protocol to standardise the approach to transitions for children with learning disability and co-occurring autism".

Each of those actions has a range of measurable quality assurance and impact indicators and timelines for completion, which will enable scrutiny against delivery.

Moving forward, that will also support stronger alignment between monitoring and delivery planning, thus improving the visibility of outcomes. It will also lay the foundation for the next autism strategy in 2028. If we genuinely want to realise vital improvements in our autism services in order to meet the needs of those with an autism diagnosis and, indeed, for the whole population, autism services need real and sustained funding additionality to ensure the full delivery of the strategy.

Several Members referred to the 'Spotlight' programme, 'I Am Not Okay' and to some of the mums. A few days ago, I had the pleasure of visiting the Redwood home, just down the hill on the Belmont Road, which has finally reopened, with its famous — or infamous — staircase having been reinstalled. Two of the children who featured in Tara Mills's excellent 'Spotlight' programme are now in place in Redwood, and it is anticipated that a third will have a space in Redwood before our summer recess. I am glad to note that at least some progress is being made in providing the right services and accommodation for those children. I finish by encouraging all Members to support the efforts to achieve the outcome that, we all agree, we seek.

2,165 words. Text as published by the Northern Ireland Assembly.

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Assessed 21 October 2026 at 15:37 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

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