70 years of the NHS - 1948-2008 

Dr Silvana UnigweWe’re marking the NHS’ 70th birthday this week with a series of blogs, including this one from Dr Silvana Unigwe, clinical adviser to the Royal College of General Practitioners (RCGP) on autism.

5 July 1948 marked the start of the National Health Service (NHS) in the UK, with the aim of providing care for all on the basis of need and free at the point of delivery. We are marking its 70th birthday this year. From its beginnings at what is now Trafford General Hospital, the NHS has grown to become one of the biggest and best health care systems in the world. Since 1948 there have been numerous advances in medicine, such as the discovery of DNA, organ transplants, prosthetic joint replacements, national screening and vaccination campaigns, a plethora of pharmaceutical medication and high tech diagnostic equipment. As a result of better healthcare overall life expectancy has risen. A baby born today could expect to live up to the age of 79 years (male) or 83years (female).

The field of autism has itself gone through many changes and developments over the last 70 years. From the original observations in the 1940s, through to the work of people like Lorna Wing in the 1970s and 80s, and now present-day researchers, our understanding of autism has grown.  More people (children and adults) are being diagnosed and some areas of the country have great facilities for assessment and support. There is less stigma and more public understanding of autism than before.  Ground-breaking work continues with the hope that one day we will more fully understand autism and be able to help autistic people, whatever their challenges, to live fulfilling lives.

The NHS needs to keep pace so that it can adequately provide care for all of its autistic patients. The Royal College of General Practitioners recently completed a clinical priority programme in which it provided autism awareness training to GPs. As part of this, we created an important toolkit for GPs to use to support autistic people. I have come across a number of colleagues, from receptionists through to doctors, who have had moments of revelation during the training sessions. They better understood the challenges faced by their autistic patients and how easy it was to make reasonable adjustments for them. For example, offering appointments at the beginning of a clinic to avoid long waits in often busy reception areas can be greatly appreciated by autistic patients and their carers. Understanding that an autistic individual may have normal intelligence/IQ but still struggle with adaptive functioning and basic activities of daily living has been another realisation for some. In training sessions, we have stressed points such as the importance of using appropriate literal language, attending to the needs of carers and being aware of diagnostic overshadowing (i.e. not attributing every symptom to autism). There will now be greater prominence of autism in the new GP training curriculum.

Of course a lot remains to be done in general practice, primary care and the NHS as a whole.  Many areas of the country have low provision of autism diagnostic and support services. This should not be the case. We know that there are high levels of mental health problems including anxiety and depression in autistic children and adults, and they are not always managed well. We also need a better system of monitoring the physical health needs of autistic patients.

It will take efforts from all of us, including autistic people and their carers, to keep up the pressure for better awareness and health care provision.  Let us be encouraged by the progress of the NHS and autism awareness over the last 70 years and hope that the time comes soon when all autistic people and their families feel well cared for by our healthcare system.

Read Mark Lever’s NHS70 blog


Read Emily Swiatek’s NHS70 blog


Read Isabelle Garnett’s NHS70 blog

Read National Autistic Society information and advice about accessing health and care services.