ADHD and Autism

The way ADHD and autism assessments are commissioned has been updated to improve fairness, quality, and consistency across all ages.

The previous temporary age-based restriction for new adult ADHD referrals has been removed. Referrals for ADHD and autism are now considered across all ages, based on clinical need and functional impact rather than age. 

Under the revised policy:

• Children, young people, and adults (18+) can be referred for an NHS ADHD / autism assessment if referral criteria are met.
• Referrals are now based on clinical need and functional impact rather than age.
• All providers (including Right to Choose providers) must meet clear quality, safety, and follow‑up standards.
• Self-referrals are not permitted.

These changes aim to ensure people receive high‑quality assessments and appropriate support after diagnosis.

Right to Choose is a legal NHS funded option that allows your GP to refer you to certain approved providers. There are providers across all ages, however providers may have different criteria for accepting referrals.

Under the current policy:

• Right to Choose can be used where the provider meets NHS quality and governance requirements
• Providers must be able to complete assessments safely and provide follow‑up care

Your GP can advise whether Right to Choose is appropriate for you.

You may be referred for an NHS neurodevelopmental assessment if:

• You are registered with a GP in Coventry and Warwickshire,
• There is evidence that autism and or/ADHD‑related concerns are having a moderate or greater impact on your daily life (for example at work, education, home, or in relationships).

This applies to both adults and children.

For children, the minimum age you need to be referred is:

• 2 years and above for an autism assessment.
• 6 years and above for an ADHD assessment.

If you are aged 18 or over and think you may have ADHD or be autistic:

• Speak to your GP about how your concerns affect your day‑to‑day life.
• Your GP can refer you for an NHS funded Autism and/or ADHD assessment if the referral criteria are met.
• Your referral will be directed to the most appropriate provider based on the clinical judgement of your GP.

If you are aged under 18 and think you may have ADHD or be autistic:

• Referrals to the local provider (CWPT Neurodevelopmental Service) are typically made by your child/young person’s educational setting and/or health professionals.
• You or your parents / carers may also speak to your GP about right to choose and if there are appropriate providers available to meet the needs of the child/young person.
• Children under the age of 6 years are not routinely referred for ADHD assessments.
• For school-age children and young people, education settings will be asked to provide information to support the referral and the assessment where possible.
• Prior to requesting a referral for an autism and/or ADHD assessment it is recommended that you seek information and support from local and national resources and services.

Referrals focus on functional impact and need for an assessment.

Your GP may include:

• A brief description of your concerns
• Examples of how these affect everyday life
• Screening questionnaires

Yes.

Other conditions do not exclude you from assessment.
Where appropriate, services may offer a combined ADHD and autism assessment.

ADHD and autism can co-occur, and some features can overlap.

A dual assessment means the service considers both ADHD and autism within one integrated assessment pathway where this is clinically appropriate.

• This can reduce duplication, avoid unnecessary delays, and help clinicians understand the person’s full neurodevelopmental profile.
• A dual assessment will not be needed for everyone.
• The decision should be based on the person’s presentation and clinical judgement.

Not all providers will be able to offer both autism and ADHD assessments immediately following implementation of the policy. Some providers may currently offer assessment for one neurodevelopmental condition only while they develop their pathways and workforce capacity.

Where separate assessments are required, there may also be a period of time between an autism assessment and an ADHD assessment. Patients and/or their families or carers will be provided with information about the assessment pathway relevant to their referral and local provider arrangements.

Not quite. Not all providers are eligible. Some providers do not offer a full range of services that meets the criteria.

Approved providers must:

• Meet NHS assessment standards
• Have appropriately trained clinicians
• Be able to provide medication, titration, and follow‑up if needed
• Meet safety and governance requirements

Your GP will help select an appropriate provider. 

After assessment:

• You will receive a clear outcome and written report
• A diagnostic decision, which may be that a diagnostic criterion is not met
• You will receive advice, recommendations, and support whether or not a diagnosis is made

Where ADHD is diagnosed, a plan for ongoing care will be discussed. 

If medication is recommended:

• It must be started by a qualified specialist
• The provider will manage medication titration and monitoring
• Physical health checks are required where clinically needed
• If medication is prescribed by a qualified practitioner and after a period of stabilisation (sometimes known as ‘titration’), it is possible for GPs to prescribe medication through a Shared Care Agreement with your GP.

Medication is part of a wider care plan and may not be suitable for everyone. 

A Shared Care Agreement is an arrangement where:

• A specialist starts ADHD medication
• Your GP may agree to continue prescribing once treatment is stable
• You will be asked to sign an agreement between you, your GP and a provider that sets out everyone’s roles and responsibilities.

GPs are not required to accept shared care. If shared care is not agreed:

• The specialist provider remains responsible for prescribing and follow‑up.

You should not be left without support.

Private assessment is a personal choice; it is funded by you and not the NHS. The ICB will not retrospectively fund private assessments, even if you get a confirmed diagnosis.

Before proceeding:

• Speak to your GP
• Be aware that a private diagnosis does not entitle you to NHS prescribing for medication

If you have an existing ADHD / autism diagnosis:

• Register with a local GP
• Provide your diagnostic paperwork
• Your GP can refer you for ongoing care if needed

If records are missing or care has lapsed, further review may be required.

The new policy does not require your referral to services to be reviewed, and any referral already made for an autism and/or ADHD assessment will not be affected.

There may be a review of current waiting lists across all providers, as we are aware that some people may be on more than one waiting list. In future, we would ideally ensure that people who have already received an assessment are removed from another provider waiting list.

If you have received an assessment and you are on another waiting list, please inform the provider so you can be removed from their list.

We understand that waiting for an ADHD and/or Autism assessment can be frustrating and worrying. You do not need to wait for a diagnosis to get help — support is available now.

Talk to your GP. Your GP can:

• Talk through how neurodevelopmental‑related difficulties may be affecting your daily life
• Help with sleep, stress, anxiety, or low mood
• Discuss reasonable adjustments at work or in education
• Review your overall health and wellbeing

If you are struggling or feel at risk

• Call NHS 111 for urgent advice
• Contact your GP or local crisis service
• In an emergency, call 999

If your situation involves:

• Significant risk
• Safeguarding concerns
• Severe functional impairment

Your GP may consider an Individual Funding Request (IFR).
This is used only in exceptional circumstances.

If you are unhappy:

1. Speak to your GP or service first
2. If you are unhappy about a referral decision, the way your provider choice has been explained, or how your case has been handled, speak to your GP practice or the service involved first and ask for a clear explanation.
3. Remember that a diagnosis is not guaranteed
4. If the issue is not resolved, you can contact Coventry and Warwickshire ICB’s complaints team.

• Email: cwicb.complaints@nhs.net
• Telephone: 024 7652 6815
• Post: Complaints Team, NHS Coventry and Warwickshire Integrated Care Board, Shire Hall, Market Place, Warwick, CV34 4RL

Please note that second opinions are not routinely funded.

We recognise that waiting and uncertainty can be stressful and take concerns seriously.

• Not all providers offer the same range of assessments and services.
• ADHD & autism assessments are available for adults and children
• Referrals focus on impact on daily life
• Providers must meet clear NHS standards
• Medication and follow‑up care must be planned safely
• Support is available while you wait

Clear information and signposting for adults, children, and families can be found here

NHS information about ADHD

• Trusted NHS guidance and coping strategies

Talking Therapies (free NHS support)

• You can self refer if you are feeling anxious, stressed, low, or overwhelmed here

Recovery and Wellbeing support

• Free courses and workshops to support wellbeing and daily coping skills:

Local Wellbeing Resources

• Information about local services and support

Community Autism support Service

• Supporting autistic children, adults, families and professionals across Coventry and Warwickshire, through social sessions, small groups and workshops that build skills, confidence and understanding.

Due to ongoing changes in demand and provider capacity, waiting times for neurodevelopmental assessments are continually reviewed and may vary across services and providers.

Patients should contact their relevant provider for the most accurate and up-to-date waiting time information.

No, the implementation of this policy will not impact on your current care or your place on the waiting list. It only applies to new referrals for ADHD and autism assessments.