Demand for ADHD and autism assessments and treatment has increased significantly in recent years, creating considerable pressure on NHS services nationally and across Leicester, Leicestershire, Rutland and Northamptonshire.
Our ICBs are working with partners across health, social care and education, including primary and community care and ADHD and autism assessment providers, to develop a more effective and sustainable approach to supporting people who may need assessment, treatment or wider support.
Our longer-term aim is to develop a more joined-up, needs-led approach where people and families can access appropriate support as early as possible, while ensuring specialist assessment and care are available when required.
What are we trying to achieve longer term?
Over the next five years, we want to develop a more consistent, sustainable and joined-up approach across health, education, social care, primary care and community services.
This work aims to provide:
- a joined-up, needs-led system where ADHD and Autism support is available at the earliest opportunity, delivered in the right place and shaped around lived experience.
- strengthened prevention and improved pathways to assessment, helping people to access appropriate support earlier.
- support to families while they wait, including access to advice, guidance and practical support.
- timely access to specialist care when required, ensuring that people who need specialist assessment, treatment or support can access the right services.
As part of this work we will also be looking to identify opportunities to improve the pathway in the short-term.
Why is this work necessary?
Since the COVID-19 pandemic, referrals for ADHD and autism assessments have risen sharply, both locally and nationally. As demand has increased, waiting lists have grown considerably.
This has led to significant variation in waiting times and people’s experience of services, alongside increasing financial pressure on the NHS. Despite additional investment in assessment and diagnostic services, demand continues to outpace available capacity.
Put simply, people are waiting longer and may experience different levels of support depending on where they live or how they access services.
NHS organisations have a responsibility to operate within the resources available to them while ensuring services remain focused on those who need them most.
It is therefore important that we both manage current demand and develop new ways of providing support that are clinically effective, sustainable and fair for the longer term.
What is happening now?
While this longer-term work takes place, we also need to manage the significant current demand for ADHD and autism services and make the best use of the NHS resources available.
NHS England has asked Integrated Care Boards (ICBs) to work with providers to agree:
- The volume of assessments and appointments that can be delivered.
- The funding available to support those assessments and appointments.
This is known as an Indicative Activity Plan (IAP).
Providers can continue to accept referrals and add people to their waiting lists. However, where demand is greater that the level of activity planned and funded through IAP this may mean some patients wait longer before an assessment can be offered.
Assessment and diagnostics at direct NHS Providers such as Leicestershire Partnership Trust and Northamptonshire Healthcare Foundation Trust are continuing as usual.
What changes are being introduced?
While work continues to develop the longer-term approach, ADHD and autism assessment providers across Leicester, Leicestershire, Rutland and Northamptonshire are being asked to work within their agreed Indicative Activity Plans.
Within the capacity available, priority will be given to people who have already started their assessment or treatment process.
This may mean that people waiting for routine assessments experience longer waits than we would want while this longer-term work takes place.
Are referrals being stopped?
No. Referrals for ADHD and autism assessments can continue to be made. Indicative Activity Plans do not prevent providers from accepting referrals. Where demand exceeds the level of activity that can be delivered within the available NHS funding and capacity, this may affect how quickly an appointment can be offered.
Do patients need to do anything?
No action is required from patients at this stage.
These arrangements are being managed between NHS commissioners and service providers. Contacting a GP practice will not change the management of a referral once it has been made.
People will be contacted directly by the provider responsible for their care if there is information they need to know about their referral.
What support is available while people wait?
Advice, guidance and support are available for adults, children and families who may have autism, ADHD or other neurodevelopmental differences, regardless of whether they have received a formal diagnosis.
In Leicester, Leicestershire and Rutland people can visit: https://www.leicspart.nhs.uk/while-you-wait/adhd/ and also Autism Space | Leicestershire Partnership NHS Trust.
In Northamptonshire people can visit iDiscover tools and resources | NHFT
A key part of our longer-term work is to improve access to this kind of needs-led support, so that people and families can get appropriate help at the earliest opportunity and are supported while they wait for an assessment where one is needed.
What if someone is concerned about their mental health?
Anyone experiencing difficulties with their mental health should seek support and should not wait for an ADHD or autism assessment before doing so.
Information, self-help resources and local services are available, and people should contact their GP or an appropriate mental health service if they need further assistance.
