Introduction
In Somerset, we aim to meet the identified needs of children and young people, irrespective of their diagnosis.
Private assessments will be considered on a case-by-case basis.
There is no reason why a diagnosis should be ignored simply because it was obtained privately. However, private assessment processes and diagnoses should meet the same standards as those expected of the NHS.
National Institute of Clinical Excellence guidelines
If an assessment completed by a privately funded provider or practitioner complies with National Institute of Clinical Excellence (NICE) guidelines, then it should be considered equivalent to an NHS assessment and should be treated as such. NICE guidelines can be found here:
- Autism spectrum disorder in under 19s: recognition, referral and diagnosis
- Attention deficit hyperactivity disorder: diagnosis and management
It is important to note that not all assessments carried out privately meet the above criteria. Please check before proceeding with any private assessment that it will meet the necessary standards:
- Autism assessments must be conducted by a multidisciplinary team of appropriately trained and qualified clinicians. In practice, this means that at least two clinicians from different professional backgrounds must be directly involved in the assessment. This may be a Practitioner Psychologist (Clinical or Educational), Paediatrician, Psychiatrist, Speech and Language Therapist, or Occupational Therapist.
- Whilst it is often beneficial for ADHD assessments to be conducted by a multidisciplinary team, this is not essential as one appropriately trained and qualified clinician is considered sufficient for the diagnosis of ADHD.
- The clinician(s) involved in an Autism or ADHD assessment must be registered with an appropriate professional body [e.g. Health and Care Professions Council (HCPC) or General Medical Council (GMC)].
- All Autism and ADHD assessments must gather a comprehensive history of general development. This must have included gathering information about biological, social, environmental and psychological factors that might have impacted the young person’s development.
- All Autism and ADHD assessments must have gathered information from multiple sources about a young person’s possible areas of difference across their lifespan. This should involve in-depth discussions with the young person if they are able to engage in these conversations, in addition to their parent carer and others who know the young person well (e.g. teachers, practitioners from other settings, other key people in the young person’s life).
- All Autism and ADHD assessments must have involved at least some interactional and/or observational assessment with the young person directly. Whilst this can in some circumstances be via online video assessment, information from other sources must be sufficient to compensate for this.
- Any appropriate alternative or additional explanations for a young person’s experiences or areas of difference have been adequately considered and assessed. This might include considering whether a young person’s needs are better understood in terms of other diagnoses including a Learning Disability Developmental Language Disorder, or Fetal Alcohol Spectrum Disorder.
- It might also include considering whether a young person’s experiences may be better understood as a response to difficult or traumatic life events, a mental health concern, relational or attachment-based concerns, or developmental trauma. It is important to remember that young people with needs relating to these areas can appear similar to those who are Autistic or have ADHD.
Accepting a private diagnosis
Our local process following a private diagnosis is:
- We can review and ratify reports if this is something the family would like. In most cases this is not necessary. Private reports should be sent to ChildNDSReferrals@Somersetft.nhs.uk
- The report will be reviewed by the appropriate clinicians to ascertain if it meets the criteria mentioned above. There may be a wait for this to happen.
- If the report meets the necessary standards, CYPNP will issue a letter to confirm this. The diagnosis is then fully accepted by the Somerset system.
- If the report does not meet the standard, the young person can access the assessment through the CYPNP Somerset assessment pathway.
- Where an ADHD assessment was through a private provider, medication may be started and maintained by the private provider. Whilst this is happening the CYPNP will not take on responsibility for ADHD care including taking over medication.
Transferring to NHS care
If a child or family wants to transfer back to the local CYPNP NHS team for ADHD care following a private assessment the following must all be completed:
- The young person must be fully discharged from private care
- Families will 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 privately.
The CYPNP is not able to prioritise any post-assessment care, including ADHD medication, for young people seen via RTC or privately
