Safety fears over threat to Highland autism service

Funding cutbacks by NHS Highland are threatening to shut down a vital service for the autistic community, prompting fears for the safety of service users.

The One Stop Shop (OSS) in Inverness supports autistic adults and has been funded by the Scottish Government and NHS Highland. But both have refused to fund the service for the next financial year, which begins in April.

Unless extra funding is obtained, the service is likely to close at the end of March. People would then find it difficult to stay in touch with their social support networks and access the benefits they need which could lead to poverty and even suicide, a staff member warned.

The OSS is based in a building in Inverness where autistic adults can go to socialise and get practical support on claiming benefits, the education system and parenting.

Staff also go to Skye, Lochaber and Caithness to host drop-in centres for autistic people. The service helps around 570 people across the Highlands.

But NHS Highland defended its decision to cut funding, saying that the support OSS offers is “not within the current priorities of NHS Highland in these challenging financial times”.

NHS Highland costs

Cost (£m)
NHS Highland budget 2017-18817
NHS Highland savings 2017-1835
One Stop Shop Highland total running costs0.14

In 2012 the Scottish Government provided funding to set up six OSSs across the country. Three major autism charities ran two of them with Autism Initiatives running OSS Highlands which is in Inverness.

The government funding was supposed to be for three years before these services were to be sustained by local funding.

The Scottish Government ceased its funding in 2016 but NHS Highland gave the Inverness OSS £50,000 a year for two years, to help towards its running costs of around £140,000.

NHS Highland refused to fund the service for the current financial year, 2018-19. But it was kept going because the Scottish Government and an anonymous private donor intervened to save it for twelve months.

A Scottish Government spokesperson told The Ferret: “When we made funding available last year to help keep the Inverness OSS open, we made it clear this was a temporary measure which couldn’t be repeated and it was essential that Autism Initiatives secure sustainable funding from NHS Highland to support the shop in future.

“Despite the best efforts of both Autism Initiatives and the Scottish Government, NHS Highland have said they cannot renew the funding they previously gave the project. Given NHS Highland’s position it would, very sadly, be inappropriate for the Scottish Government to intervene again.”

Twenty-one year old Ruth Strong has been going to the OSS in Inverness since 2014. She goes there to socialise and staff there supported here when she was very unhappy at college.

Before Strong found the service, she did not know many other autistic people and felt she had to hide her autism so that people would treat her normally.

“Since discovering the OSS, I no longer feel that way,” she said. “They helped me learn more about autism, because the staff actually knew all about it – in fact, a few of them were autistic themselves – and I also got to meet the autistic service users, whereupon I realised lots of them were very similar to me. There I felt valued and understood.”

Strong added: “At the OSS, people are generally very accepting of each other, despite the fact that we have different interests. Difference seems to connect us, unlike in many other parts of society, where people try to follow the crowd and are under pressure to be exactly the same as everyone else.

“If we lost the OSS, I would no longer have a place to go to specifically get help from people who know all about autism. I’d also be a lot more isolated because I’d end up losing regular – if not total – contact with many wonderful friends.

“Having this amazing service available to me helped me grow in confidence and become more independent, so without it, I could end up going back to square one, since I often struggle to find friends in other parts of society, where there can be less sympathy and understanding.”

Jennifer Pacitti used to be a OSS service user and is now a staff member there, running a drop-in centre and organising activities like going to the cinema or playing pool. She said that, like Ruth, lots of people are worried about losing contact with their friends if the service shuts down.

“We have a core group of service users that regularly attend our activities and for those people, it will be devastating because we are basically the only socialisation they have and the only support network they have. They’re all frightened that they’ll lose touch with each other.”

“I know from speaking with some of the people that it’s quite terrifying because they don’t know what they’re going to do when we do close. There are very poor mental health services for those on the autistic spectrum and a lot of our people will struggle to get any support at all because mental health services don’t really want people with autism.”

Many of the service users would struggle to deal with the employment, housing, education and benefits systems without advice from the OSS, she said.

“Benefits is a major worry because we have Universal Credit and that scheme is designed to…well it’s not a very good scheme. People are not getting their benefits paid, they’re not getting their rent paid.”

If the service shut down, Pacitti said: “A lot of autistic people would go without benefits. A lot of autistic people would then hit the poverty line. A lot of people would then be at the point where suicide was an option.

“A lot of people would stop looking after themselves because they would have no reason to look after themselves. They’re not going anywhere, they’re not seeing anybody. They’re just stuck indoors all the time on their own.”

Pacitti accepted that NHS Highland has many demands on its funds but said the OSS saves the NHS money in the long-run. Improved mental health saves the NHS money on drugs and support, she said.

She was supported by local Conservative MSP, Edward Mountain, who told The Ferret: “What I would say to NHS Highland is be careful about allowing projects like this to fail because there could be an increased cost to NHS Highland as a result of it, or even the government. It could be a false economy.”

An NHS Highland spokesperson said: “The Scottish Government originally funded One Stop Shops across Scotland with the intention that they would identify ways to become self-sustaining. NHS Highland is supportive of the work that the Highland One Stop Shop achieves and has met with Autism Initiatives to discuss alternative models of partnership working.

“However the kinds of support that the OSS currently offer to autistic people is not within the current priorities of NHS Highland in these challenging financial times and therefore we are not in a position to meet their funding shortfall.”

NHS Highland is currently making spending cuts on what it calls “an unprecedented scale”. These cuts follow years of overspending in which the Scottish Government has had to plug budget deficits.

In the 2018-2019 financial year alone, NHS Highland aimed to save £50 million. Their total annual budget is just over £800 million.

NHS Highland attributed overspending to difficulties recruiting, the rising costs of drugs and rising adult social care costs – but the Auditor General also blamed “weaknesses in financial management”.

In January 2019, NHS Highland appointed a new chief executive and its chair and medical director have just resigned ahead of a report into alleged bullying.

A spokesperson for Autism Initiatives said: “We are committed to the OSS model and keeping their One Stop Shops open. We recognise the value they offer to autistic people in these areas and are in discussions about continuation.”

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