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'Is your health setting autism friendly?'

Stephen Simpson
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Whether you work in a clinic, GP practice or hospital setting, the environment will have an effect on both patients and the staff who support them. 

For people with autism and their families, if this is unfriendly, it can make the difference between timely and effective access to healthcare and poor health outcomes.

Compared to other conditions, autism is being diagnosed more than it has ever been. With prevalence rates of up to 1.5% recorded there will be many people with autism who look to their local GP practice as the first point to get help.

Many practice nurses are doing more consultations and procedures than ever before and they may be the first health professional they see – first impressions count.

So, are you prepared? Is your setting friendly and how do you know? One way would be to get some autism awareness training in addition to assessing the place you work.

The Checklist for Autism Friendly Environments is a document devised to raise awareness of the areas that you may want consider. It looks at the sensory environment, for example, it asks is your clinical area too bright? Is there a quiet waiting area? Are the walls too busy?

It also looks at whether signs are clear and staff are trained in autism. Filling out the tool does not take long and changes you make – no matter how small – could make a big difference.

Endorsed by National Institute for Health and Care Excellence and the National Autistic Society, this is a national resource that is free to download with accompanying guidance. 

Practice nurses have a key role in shaping friendly environments and can create, with other colleagues, an environmental plan for their setting. 

There are also a few key things that practice nurses can do when making an appointment with a patient with autism:

  • Write a letter or send a text with the date, time and clinician who is is going to be seeing the person. Many if not most people with autism seem to struggle on the phone, so do not, for example, send a letter asking them to ring to make the appointment if possible;
  • Ask for consent to speak to a relative if appropriate;
  • Longer double appointments are often best as sometimes communication difficulties make the experience very stressful;
  • Do not rush;
  • First appointments (in the morning or afternoon session) often work best as delays can severely evoke anxiety. Keep the person informed of any delays;
  • Is there a quiet waiting area? Tell the person it is there;
  • Is the check-in procedure clear at reception? You may want to have an autism champion here (someone trained in autism);
  • Establish any adjustments at the first appointment. Please do not be hesitant to ask the autistic patient or relatives what they need. Be clear how much time you have;
  • Ask the person “is it ok in here?”; “not too bright or noisy?” for example.

Stephen Simpson is a senior autism nurse practitioner (RNLD), South West Yorkshire NHS Foundation Trust

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