1. Is a formal diagnosis necessary to access support for Autism or ADHD?
While having a diagnosis can be helpful to identify and validate the difficulties people may face, it’s not always required for accessing support for autism or ADHD. Support should be tailored to an individual and made available based on a person’s difficulties and challenges, even without a formal diagnosis.
Here’s why a diagnosis isn’t always necessary for support:
- Focus on Needs: Support is based on the individual’s specific needs, not just a diagnosis.
- Varied Support Options: Support can come from various sources, including professionals, charities, local authorities, and family/friends.
- Education: Education settings can offer many different types of support and can help to access more specialist support without a diagnosis. A diagnosis is not needed for an Education, Health and Care Plan.
- Social Care: Social care assessments can be requested to identify support needs, and don’t require a diagnosis.
- Benefits: Some benefits are awarded based on individuals' needs and how they impact daily living, including Disability Living Allowance, and Personal Independent Payment.
- Impact of assessment: A diagnostic assessment can offer understanding of neurodiverse presentation and validation for individuals, but it’s not essential for accessing support.
In summary: While an assessment can be beneficial for understanding neurodiverse presentations, it’s not a requirement for receiving assistance tailored to individual needs. Individuals can access support through various avenues, even before or without a formal assessment.
2. Why are the waiting times so long for Autism and ADHD assessments?
As a population we are getting better at understanding what neurodiversity looks like and are better able to identify where a referral for assessment might be helpful. This is one reason why there has been a rapid increase in need for assessment in the UK and in many parts of the world.
In Northamptonshire, as elsewhere nationally and internationally, this surge in demand has outpaced the capacity of NHS services, leading to long waiting lists.
We are working hard to increase the number of assessments being offered and delivering the most efficient pathways possible to reduce waiting times, as well as provide help for families while they wait.
We are aiming to reduce the waiting time over the next few years. The waiting time nationally for completing ASD/ADHD assessments can range from 1 year to as long as 13 years.
3. Prescribing following an ADHD diagnosis
- If a patient has been seen by an NHS ADHD service and medication is recommended, this is normally started by the NHS service. Once the dose is stabilised, GPs can prescribe as part of a Shared Care Agreement
- This enables the care and treatment you receive for ADHD to be shared between the NHS service and your GP. This will only occur with your agreement and when your ADHD medication is stable. For more information, please see the General Medical Council (GMC) practice advice Shared care - professional standards - GMC
- GPs are not expected to initiate or manage treatment without support from a specialist.
- They retain the clinical right to decline shared care if they feel it is unsafe or inappropriate.
We have Shared Care Agreements in place with NHFT and NGH based on national Regional Medicines Optimisation Committee (RMOC) templates. These allow for safe NHS prescribing when the patient is under ongoing specialist care.
If the provider only offers diagnosis without follow-up, any request for your GP to prescribe would be considered a transfer of care, not shared care — and GPs would be advised to decline.
Right to Choose providers may have a contract that allows prescribing. It is best to check this before being referred. There are no agreed shared care arrangements with any RtC providers for ADHD medications in Northamptonshire and GPs are not expected to prescribe.
If someone is seen privately and medication is recommended, then prescribing would also be expected to be private.