Introduction
In Somerset, children and young people can get support based on their individual needs. They do not need to have a diagnosis to have support.
An assessment for Autism or ADHD is about helping everyone understand a child or young person’s strengths, needs, and experiences better.
Having a diagnosis does not usually unlock extra services in health or education. The main exception is that an ADHD diagnosis can allow access to medication if needed.
There are three main routes for assessment for a school aged young person:
- Local NHS service (CYPNP)
- Right to Choose (RTC)
- Private Assessments- please see Somerset’s Position Statement on Private Assessments
All are valid options. This guide explains the differences so you can make an informed choice.
Local NHS Service: Children and Young People’s Neurodevelopmental Partnership (CYPNP)
Most referrals to the CYPNP come through schools via the next steps form. This uses evidence of strengths and need and shows that support has already been tried over time. Young people aged 11 and over need to be involved in the process and agree that they want to have an assessment.
- Current waiting times are long- details are provided on Neurodevelopmental assessment waiting times
- While waiting, families can access various forms of ongoing support via a local neuro affirmative support hub.
- This support starts soon after the referral is reviewed and continues until an assessment begins. There is no limit on how often this support can be used.
How local assessments work
- Assessments look at the whole child or young person. The team will focus on hearing about your young person’s story including their strengths and things in their life that may be more difficult or challenging. Your young person will be seen face to face for a half day appointment with members of a multi-disciplinary team. This means the most appropriate health professionals can work directly with your young person to understand their unique strengths and challenges. The team will also spend time speaking directly to parents/carers to understand their child’s experiences.
- You will explore together different explanations, including Autism, ADHD, both differences occurring together, or another reason or way of understanding your child’s difficulties. If needed the team can ask for further assessments. The team are used to speaking with staff from different teams in health, education and social care who might work with your young person.
- Families will receive a detailed report written to their young person with personalised recommendations linked to local services and support available within Somerset.
Right to Choose (RTC)
Right to Choose is part of the NHS patient choice framework. It means that once it has been agreed that a young person needs an Autism or ADHD assessment, you can ask to be referred to an NHS provider of your choice.
Right to Choose allows families to ask their GP to refer them to any NHS assessment provider with an NHS contract.
This can include face to face and virtual providers offering online assessments.
- There is more choice of providers via Right to Choose
- Waiting times may be shorter, but they can be unpredictable.
- Assessment quality and how it is carried out can vary between providers.
How Right to Choose assessments often work
- Assessments usually look at only one condition at a time (Autism or ADHD).
- Schools and other local services working with a young person may not always be fully involved in the assessment.
- Reports may not reflect local services or support options.
- Some families are surprised to find that support after the assessment is limited.
- A RTC assessment may not fully explain a child’s needs and if this is the case it can feel like the process has to begin again.
Important things to think about
- An assessment should support understanding and planning — it should not delay or replace needs led support at school or elsewhere.
- You can only be on one waiting list at a time. If you choose to have a RTC assessment, your child will need to come off the local CYPNP waiting list.
- You would not be able to access CYPNP pre-assessment support whilst you wait for RTC or a private assessment.
- Many children need assessment to think about both Autism and ADHD. In these cases, it is often more helpful to access one assessment that considers your young person’s needs even if this means a longer wait. If this was done under RTC it would usually means two separate RTC referrals. These assessments will not happen in a joined-up way.
Important Notes about ADHD medication
There are some important differences to be aware of between RTC, private and local services:
- RTC and private providers sometimes start ADHD medication very soon after diagnosis.
- Locally, the NHS usually focuses first on psychoeducation (helping families understand ADHD and use support strategies). This is because evidence shows that this is the best approach for children and young people.
- Medication should always be started and maintained by the RTC or private provider. There is no obligation for CYPNP to prioritise or take on post-assessment care including ADHD medication for young people seen via RTC or privately.
- RTC and private providers may ask GP practices to continue prescriptions through shared care. Not all GP practices will do this.
- If a child or family wants to transfer back to local NHS care for ADHD follow up following RTC or Private assessment:
- Families will usually need to complete the local psychoeducation course
- Normal NHS waiting times will continue to apply
- Medication reviews cannot be fast tracked by local teams because the assessment was done through RTC or privately.
Summary
Both CYPNP, Right to Choose and private companies are valid routes for assessment. The best choice depends on your child, your family, and what you are hoping the assessment will achieve.
- Local services offer joined up, strengths and needs based assessments with strong links to local support, but with longer waits.
- Right to Choose can sometimes mean shorter waits, but with much more variation in approach and follow up support.
- Private assessments are often quickest but can be expensive and variable in quality.
If you are unsure, talking with your school, Somerset Parent Carer Forum, or healthcare professionals working with your child can help you think through what feels right for your family.
Tips for parents and carers
- Ask questions: Make sure you understand what each provider offers: assessment, diagnosis, medication, or post-diagnostic support. This is likely to be very different for every provider and is changing all the time.
- Check NHS contracts: Only providers with NHS contracts qualify under Right to Choose.
- Waiting times for assessment and medication vary between providers and change all the time. Please check waiting times specifically for Somerset patients if considering RTC.
- Use the Private Position Statement page to ensure that any private assessment meets your needs and expectations, including what is possible locally after an assessment.
- Make sure that you are clear what you want or expect to change after any diagnosis.
- Remember- support does not need to wait for a diagnosis and can and should be happening for young people at the point when needs are identified.