Dr. Louise Higgins:

Yes, regarding the timing of PDS and the establishment of the majority of the new CDNTs, it happened just after PTAs. PTAs were certainly very challenging and many clinicians made a decision at that time to step out of disability services. It also happened after Covid-19 where many therapists were redirected into testing, swabbing and different areas. This, on top of years of underfunding of AON and disability services, meant that, while we completely support the principles of PDS in respect of equitable access, collaborative ways of working and person-centred services, parts of which we all adhere to, the challenge was that those waiting lists did not move but got longer and increased.

The other challenge in thinking about PDS and the CDNTs is that some of the supports which were in place for clinicians prior to the PDS programme were dismantled. At a time when clinicians most likely needed extra supports, some of those support structures were pulled away. There was then a real loss of experienced clinicians because, historically, disability services were run with many areas of expertise around autism, intellectual disability and physical disability. The merging of that certainly presented challenges for many newer or inexperienced staff because there was a real need for continuing professional development, CPD, training, and all of those things. There are multiple factors why working in a CDNT is challenging and I hope I have explained that.