Frequently Asked Questions (FAQs)

The individual should make an appointment to talk about their feelings with their GP or a referral specialist.

During the appointment, the professional should discuss all the options available, including support if applicable.

If an assessment isn't appropriate or the individual decides not to go ahead, the professional will explain what other help and support options are available.

This means that an individual referral meets the right medical, psychological, and developmental requirements for an assessment. This is based on set rules.

It usually includes:

• Clear signs of ADHD or autism, based on official medical guides (like DSM-5 or ICD-11).
• Problems in daily life, such as school, work, friendships, or taking care of themselves.
• Checking the person’s history to make sure there isn’t another reason for their symptoms.
• A referral from the right professional, like a GP.

For an ADHD or autism assessment, a GP, healthcare professional, or a local interface service*  will review the individual is clinically appropriate for an assessment.

*There may be some areas that have an interface service that work on behalf of Primary Care and can help with advice, support and pathways. Those interface services may also be a referral route into assessment.   

During the appointment, the GP or professional should talk about all the choices the individual or their carer has.

This may include their Right to Choose/Patient Choice, which assessment service provider can help them and what support is available.

To help the individual or carer choose, the specialist should:

• Explain that they can choose who provides their care and when this choice applies.
• Follow the National Institute for Health and Care Excellence (NICE) guidelines while talking about the individual’s specific situation.
• Discuss how any new care might affect ongoing treatments, especially if the individual has other health issues.
• Individuals can check if the potential assessment service provider offers care based on good evidence that meets their individual needs, including looking at recent reviews and ratings if available.
• Talk about any travel or access needs for face-to-face appointments or consider online options.
• Discuss how ongoing care after the referral might impact the individual, for example understanding the process for shared care and what would happen if shared care was not available. 
• If the individual needs more time to decide which provider to choose, they should be given time to talk about it with family or friends before making a final decision.

Right to Choose/Patient Choice applies when:

• If a GP agrees that an ADHD or autism assessment is clinically appropriate, the individual has the right to choose a provider that offers this service under NHS funding.
• The provider is NHS-approved – The chosen provider must have a contract with an NHS Integrated Care Board (ICB) or NHS England to deliver autism/ADHD assessments under Right to Choose/Patient Choice.
• The individual is registered with a GP in England – RTC applies to NHS individuals in England but does not cover Scotland, Wales, or Northern Ireland.
• There are long NHS waiting times (over 18 weeks) - this includes if Right to Choose/ Patient choice has not already been offered and the individual is on a waiting list.

Where Right to Choose applies (see above) Right to Choose/Patient Choice referrals can only be made by a GP, unless there is an ICB-commissioned interface service.

The individual may not get a list of assessment service providers from the referral source. They will need to look for assessment service provider in their own time and can use supporting information to help them make a choice.

Right to Choose/Patient Choice does not apply when:

• The individual is already receiving care and treatment for their condition. (However, it does apply for new episodes of care, even if they have been treated before.)
• They are using urgent, emergency, or crisis services.
• They need emergency or urgent treatment, like cancer services, where they must be seen within 2 weeks.
• They are a prisoner, temporarily released from prison, or held in a special facility (like a court, secure children's home, or young offender's institution).
• They are held in a hospital under the Mental Health Act 1983.
• They are an active member of the armed forces.

Yes, as long as the referral is:

• Clinically appropriate, and
• The service is led by a named consultant or healthcare professional.
• The provider has a current NHS Standard contract with the right organisation for the service needed.
• The service is for the correct age group of the individual.

In some cases, individuals can refer themselves to providers. However, if they do not meet the criteria under Right to Choose/Patient Choice the NHS will not cover the costs for these self-referrals, and these will be self-funded along with any treatment received.

There may be some areas that have an interface service that work on behalf of Primary Care and can help with advice, support and pathways. Those interface services may also be a referral route into assessment.

No prior approval from a commissioner or Integrated Care Board (ICB) is needed if the following criteria are met:

• The individual is getting a planned referral for their first outpatient appointment.
• The referral is clinically appropriate.
• The assessment service provider and team are led by a consultant or a mental healthcare professional.
• The assessment service provider has a contract with an ICB, or NHS England for the service needed.

GPs and referrers should let people know their options and support them in choosing their provider through shared decision-making.

However, if they are not offered these choices, the NHS Choice Framework gives information on what patients can do. 

People should first contact their local ICB.

They can also visit the WY ICB Comments, Concerns, and Complaints page for more help: WY ICB Comments, Concerns, and Complaints.

A shared care agreement is an arrangement between the assessment service provider the individual has chosen for their autism and/or ADHD assessment and their GP. This is needed when the individual is on medication prescribed by a specialist and they are to receive on-going prescriptions from their GP.

The individual should be under the care of the assessment service provider and could have appointments once a year or more often.

If the GP and the service provider agree to share care, the GP will write prescriptions and check on the individual as described in the shared care agreement.

The GP does not have to agree to a shared care arrangement. In these circumstances, the individual should remain under the care of the assessment service provider.

Choosing the right service for an Autism and/or ADHD assessment is an important decision. 

There are some things to think about or to find out when you are choosing a service, click here to public information relating to choosing your NHS funded Autism and/or ADHD assessment service.  

Once you have decided on the provider you can inform the GP/referral professional who you want to be referred to.

The GP/referral professional will need to check that the service you have chosen meets the NHS criteria before they can refer you. If they don’t meet the criteria you will have to choose a different provider. You can discuss this with your GP/referral professional.

No: The NHS Individual Funding Request (IFR) is for treatments not usually paid for by the integrated Care Board (ICB), and where the individual has clinically exceptional reasons why they should be able to access that treatment, (if it isn’t available to other people with a similar condition). A GP can apply if they believe an individual has special medical needs. This is different from the Right to Choose/Patient Choice, which lets patients pick an NHS provider for treatment. IFRs are only for funding special treatments, not choosing providers.

No – it’s the Right to Choose provider’s job to arrange any tests they think are needed.

The Right to Choose provider who started the ADHD medication is responsible for prescribing it. They are also responsible for keeping track of the patient’s progress until the dose is stable and the GP decides about shared care. This should follow local or national shared care guidelines. The Right to Choose provider must handle all health checks, like heart history, heart rate, blood pressure, weight, and ECG (if needed).

Yes, shared care means that both your Right to Choose/Patient Choice assessment service provider and your regular doctor (GP) work together to look after your health. The Right to Choose/Patient Choice assessment service provider should check on you at least once a year. If the Right to Choose/Patient Choice assessment service provider stops helping you, your regular doctor won't be able to give you medicine anymore.

If you get a new GP or change GP practice, the Right to Choose/Patient Choice assessment service provider must write to them and ask if they can enter shared care. Your old GP might help by telling the new GP too. If the new GP doesn’t agree, the Right to Choose/Patient Choice assessment service provider will need to keep looking after you and giving you your medicine and prescriptions.

This question was raised with Dr Janine Robinson, National Speciality Adviser for Autism and here is her response:

In April 2023 the National Autism Team produced guidance for services and clinicians around optimising processes and patient experiences. This includes information shared with both referrers and the public around local pathways, processes and what to expect. Whilst we understand that seeking an autism assessment can be a daunting experience for some, it remains important that a balance is reached with respect to the detail of information that is provided about exact tools used since several factors may affect clinical decisions about the type of assessment that is conducted and any standardised tools that might be employed.

In fact, it is not essential for a diagnostic assessment tool to be part of the process since it is often only used to support the information gained from the developmental assessment. Hence, the diagnosis of autism is a clinical diagnosis. For people who meet the classification criteria a diagnosis can be made.

This does not preclude services from providing general information about what to expect from the assessment process or encouraging individuals from preparing their own questions and notes in advance of the assessment.  Whilst there are no specific or validated assessment tools for women or girls, national guidance advises assessment services on various factors that may need to be considered when assessing individuals from previously or typically under-represented populations and emphasises the importance of clinical decision-making regarding contextual factors rather than reliance on any tools per se. 

Sometimes, your GP can give you your ADHD medicine. This is called “shared care”. Shared care means your GP works with your ADHD specialist (the doctor or nurse who first prescribed your medicine). Your specialist is still responsible for your overall care.

Your GP does not have to agree to shared care. They can say no if they do not feel confident, or if they think it is not safe.

If your ADHD specialist is from a private clinic (not the NHS), GPs are advised not to do shared care. This is because NHS and private care must be kept separate.

Each GP decides for themselves if they want to do shared care with you and your specialist.

Before you choose your NHS assessment provider, we recommend you check:

• Does the provider offer ADHD medicine if you need it? (Some only provide assessments and not treatment, such as ADHD medication.)
• Will your GP agree to enter into shared care for ADHD medication with that provider if you need it?

If your current specialist has a contract with an NHS Integrated Care Board (ICB) in England, they must follow the NHS Right to Choose and Patient Choice rules. These rules say your specialist cannot just stop your ADHD medicine when you move. They must make sure you keep getting the help you need, including your medicine.

Your current provider must help you move your care to a new ADHD specialist and, if needed, to your new GP (if your new GP agrees to shared care).

Your care will not transfer automatically. All the doctors, specialists and you, must agree and make a plan together. Your current specialist can only stop supporting and giving you ADHD medicine after they have made sure you have another specialist to help you, and everyone has agreed to the plan.

If you had ADHD care or medications from a private provider, you can ask your GP to move your care to the NHS. Your GP will talk to you about which NHS services you can use. These might be in West Yorkshire or somewhere else. If your GP agrees, you will join the NHS waiting list just like everyone else.

There are national rules that say private care and NHS care must be kept separate for the same condition. You cannot have both at the same time. The NHS is free when you need it, and everyone gets help based on their health needs, not what they can afford to pay.

Sometimes, the NHS specialist team may want to check the diagnosis you received from the private provider. This can take time, but it is to make sure your diagnosis is safe and matches NHS standards in West Yorkshire.

More children and adults are being checked for ADHD, so more people need the medication. Sometimes, there isn’t enough ADHD medication produced or delivered to the UK. This is a problem in many countries.

In addition, there aren’t enough professionals who can prescribe ADHD medications, especially in West Yorkshire.  Because of these reasons, people may have to wait a longer time to get their medicine.

West Yorkshire NHS is working hard to put contracts in place with new safe and high-quality providers who can offer ADHD medication as part of their service.

Sometimes, a GP can ask for a new NHS assessment if there is clinical information showing your needs have changed a lot, or if there might be a new or different condition that needs checking.

This is not the same as getting a second opinion or repeating the same assessment. It isa new referral because something important has changed or wasn’t checked before.

If your GP makes a new referral, you will join the NHS waiting list just like everyone else. Your place in the queue won’t be moved up because you previously had an assessment.

If there is no new clinical information, your GP should explain that you cannot have another NHS assessment for the same thing. This is because you’ve already had your assessment with your chosen provider, and under NHS Patient Choice/Right To Choose, you can’t have another unless something has changed.

If you are not sure about the result of the autism and/or ADHD assessment, or if you think something is not right, here’s what you can do:

1. Ask the assessment provider questions: If you do not understand the assessment, or if you think there is a mistake, ask the professionals who did the assessment to explain it to you.
2. Talk about your worries: If you are unhappy with the diagnosis or the recommended follow up plan, talk to your assessment provider. Sometimes, just having a conversation can help you understand things more.
3. Making a complaint: If you still feel something is wrong, you or a parent carer can make a complaint. Complain first to the organisation who did the assessment. They must look into the complaint and reply to you.
4. If you are not happy with the response. Follow the NHS complaints procedure. The WY ICB Complaints Policy and FAQs can be found at: www.westyorkshire.icb.nhs.uk/contact/comments-concerns-complaints.
5. Get help with complaints: If you are not sure who to complain to, you can ask the West Yorkshire ICB Patient Advice and Liaison Service (PALS) Team for help. They will give you advice on what to do and how to do it.
6. What to say in your complaint: Say exactly what you think was wrong or missing in the assessment. Ask for answers to your questions and for them to explain how they followed the WY ICB service specification for autism and/or ADHD diagnosis, and ADHD treatment.
7. If you need a second opinion: If you want another doctor to look at your case, talk to your GP. Your GP may request a new NHS assessment if there is clinical evidence that your needs have changed a lot or if there may be a new or different condition. Your GP will need to tell the new provider why this is a new referral and include the clinical reasons for asking for it.
8. Your place in the waiting list: If you get a new referral, you will need to join the waiting list like everyone else who is referred to that provider. Your previous assessment won't affect your position in the queue. 
9. No new evidence: If nothing important has changed, your GP will tell you that you cannot have another assessment through the NHS, as you’ve already had one.

Remember, you can always ask questions and ask for help if you don’t understand something about your assessment or care.

Autism Assessment Providers

ADHD Assessment and Treatment Providers

Combined ASD and ADHD Assessment Providers

* Please note that contracts with WYICB can start and end at any time, therefore WY ICB will keep you informed of any changes to this provider list.

• NHS: National Health Service
• ADHD: Attention Deficit Hyperactivity Disorder
• ASD: Autism Spectrum Disorder
• GP: General Practitioner (your family doctor)
• ICB: Integrated Care Board (the NHS organisation that plans health services in your area)
• NHS Right to Choose: A rule that lets you choose which NHS provider you want for your care
• Shared care: When your GP and your specialist doctor work together to give you your medicine