Rapid Conversion Evidence Summary (RaCES) Internship with the Person-Centred Complex Care (PCCC) theme

Background: Individuals with Autism Spectrum Disorder (ASD) have a higher prevalence of long-term health conditions, unmet health needs, and face significant barriers when accessing and utilising healthcare services. A lack of specialist training for healthcare professionals has been suggested to contribute to these inequalities in healthcare provision. Previous research has highlighted that healthcare professionals feel they have inadequate training to provide the best standard of care for individuals with ASD. This project aimed to understand the barriers and facilitators experienced by those with ASD and their carers, and to develop an intervention to address some of the potential training gaps for healthcare professionals, which may be contributing to the inequalities in accessing healthcare for individuals with ASD and their carers.

Research aims and objectives: This RaCES project aimed to;
i) to explore the barriers and facilitators experienced by those with ASD and/or their carers, when accessing and utilising healthcare services,
ii) to explore methods to reduce health inequalities faced by individuals with ASD when accessing healthcare services,
iii) to develop a potential intervention to improve and reduce inequalities in healthcare provision for those with ASD,
iv) to suggest ways to evaluate the effectiveness and fidelity of such an intervention.

Methods: A systematic review which explored the barriers and facilitators that individuals with intellectual disabilities, autism spectrum disorder, or both, as well as their carers, experience when accessing primary healthcare (Doherty et al., 2020) was critically appraised using the Joanna Briggs Critical Appraisal Tool for Systematic Reviews and the findings summarised. The findings from the review were then considered in the development of a potential intervention that may improve and reduce inequalities in accessing healthcare for individuals with ASD and their carers. Key elements were considered at this stage including what already exists (e.g., a review of existing training materials), the delivery method (e.g., face to face, virtual), factors that may influence its implementation (e.g., commissioning), and decisions around measuring effectiveness and the fidelity of the intervention.

Patient and public involvement: Input provided by public advisers was essential in the development of this project, such as considering the format of ASD training for healthcare professionals.

Findings: Six main themes relating to the barriers and facilitators were identified in the systematic review; training, knowledge and awareness, communication, fear and embarrassment, lack of involvement in healthcare decision making, and time. The findings of the review suggested that the provision of ASD-specific training for healthcare professionals had the potential to overcome barriers and facilitate equitable healthcare provision for individuals with ASD.

Potential impact: The development of a training package to deliver to healthcare professionals could improve the experience of individuals with ASD and their carers when accessing and utilising healthcare services.

Links:
• Publication – Barriers and facilitators faced by individuals with intellectual disabilities and/or autism when accessing primary healthcare: a commentary of a systematic review
• Poster – Improving Access to Healthcare for Individuals with Autism Spectrum Disorder

For more information, contact chloe.poole8@nhs.net