Mr Patsy McGlone (Mid Ulster): To ask the Minister of Health to detail any steps he will take to improve support for young adults with recognised learning difficulties and complex needs, in rural areas.
Minister of Health: My Department recognises the particular challenges faced by young adults with learning difficulties and complex needs in rural areas. Currently across all Health and Social Care Trusts there is no specific Programme of Care to support people with learning difficulties, presenting as distinct to individuals with a diagnosed learning disability. Across each Trust, adults with a diagnosed learning disability receive support and service provision from Learning Disability Services.
Health and Social Care support for people with learning difficulties, is currently determined by their specific presenting needs. Where individuals have complex needs that relate to healthcare, physical disability or sensory needs, the Physical and Sensory Disability Services situated within the region’s Health and Social Care Trusts are positioned to assess and provide the individual with the relevant supports e.g. equipment, social care, signposting. In a similar vein, individuals presenting with Mental Health Needs may access support from Community Mental Health Teams.
Health and Social Care Trusts plan and deliver services in line with local population needs and Section 75 equality requirements, including consideration of rural impact, to ensure the most effective use of available resources.
It is acknowledged that young adults with learning difficulties and complex needs can experience challenges in terms of continuity of care provision when entering Adult Services. While Trusts will often consider how individual needs may be best met under ‘Best Fit’ principles, it can be challenging to meet the ongoing social care needs of these individuals when they do not meet access thresholds for existing statutory support services such as Learning Disability, Mental Health or Physical & Sensory Disability Services.
Consideration is required across the Health and Social Care system to clarify existing care pathways and determine how these individual’s needs should be best met on a regionally consistent basis. Ensuring that young people in rural areas receive consistent and equitable health and social care support remains a priority for my Department.
A key priority within the Autism Strategy is improving regional pathways of care. In support of this, my Department recently consulted on the Children and Young People’s Emotional Health and Wellbeing Framework. The Framework proposes an inclusive, needs‑based approach to neurodiversity which does not require a formal diagnosis as a prerequisite for support. This model aims to reduce stigma, promote earlier intervention, and improve outcomes across health, education, and developmental domains. My Department is currently considering consultation responses and is working with colleagues in the Public Health Agency and Child Health to define the requirements that will underpin this 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, during summer 2025, convened a regional workshop to explore ways to better manage waiting lists and improve consistency within existing resources. Building on recommendations from the 2023 review of Adult Autism Services, work is now underway to update the Adult Autism Care Pathway originally developed by the HSC Regional Autism Strategy Development Network. This review aims to deliver greater consistency in diagnostic and support services across Trusts, aligned with NICE guidance and reflective of differing levels of need.
When undertaking strategic planning and in turn commissioning of services, my Department explores potential barriers that may impact on providing equitable access to care. This approach is inclusive of considering rural needs. My Department works collaboratively across Executive Departments with colleagues in order to minimise barriers that may be experienced by individuals with complex needs. An example of this is taking cognisance of the advice, guidance and valuable insights from organisations such as the Inclusive Mobility and Transport Advisory Committee (IMTAC) who have undertaken a number of surveys and produced publications, highlighting the impact of transport and travel in regards to accessing health and social care, often which can particularly impact on rural areas.
The draft Learning Disability Service Model sets out a new approach to supporting adults with a diagnosed learning disability across Health and Social Care services. It outlines the outcomes we want to achieve, the principles that will guide delivery, and the actions required to drive improvement across the system. It has several key ambitions for adults with a learning disability with complex needs, which once delivered will support delivery of lifelong, co-ordinated support tailored to their needs and enabling choice and control.
Finally, in relation to ADHD, my Department has commissioned a regional needs assessment covering both adults and children across all Trusts. This work will inform the development of a future commissioning model for ADHD services. The primary objectives in conducting this assessment are to understand overall demand across the lifespan and to identify detailed recommendations to support future planning.
My Department continues to operate within a constrained financial context and must prioritise work that can be delivered within current resources. Any future commissioning decisions will be informed by evidence of demand and a clear understanding of service need.
ENDS
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