Autism and ADHD assessment waiting times - a plan for action
BCHC is committed to working with partners to address pressures facing children’s neurodevelopmental services due to significant increases in referrals for autism and attention deficit hyperactivity disorder (ADHD) assessments.
The challenge remains the most significant quality and safety concern facing BCHC.
Between 2020 and 2023, with the support of Birmingham and Solihull ICB, we committed significant resources to reducing historically high waiting times in these pathways. The service has since seen a major increase in referrals for both autism and ADHD. This reflects the national picture, as a surge in referrals outstrips available capacity.
Due to the increasing demand, the increased capacity improvements have been outstripped, such that more than 10,000 children now sit within the overall pathway, 8,300 of whom are at the initial triage stage. As a result, the average wait for initial assessment for for ASD for Birmingham children and families is now 70 weeks and the pathway from referral to diagnosis can take up to two years.
Our preferred response remains delivering maximum activity from current available clinical capacity, prioritising children with the highest needs. Alongside, we will develop a support offer for children, parents, schools and early years settings to support children who are unlikely to be assessed within a reasonable timescale.
This challenge demands a multi-agency approach across healthcare providers, early years setting and schools and children’s social care. We appreciate the support of our partners in considering how best to address the issue but we also accept our responsibility for the assessment and diagnosis pathway and a need to identify action we can take.
BCHC has therefore approved the following actions, for discussion among partners and stakeholders:
Autism Pathways
- maximise current capacity and ensure we can deliver at least 160 assessments per month by March 2025;
- prioritise children and young people with the highest needs for the available assessment capacity;
- work with partners to develop an alternative support offer for children and young people, their families, early years settings and schools for children with lower support needs;
- work with partners to develop a more sustainable longer-term pathway, including a realistic assessment of resource in commissioning discussions for 2025/6.
Preferred option: ADHD Pathways
- see through plans to use existing investment from commissioners to increase recurrent capacity;
- maintain strengthened 'front-door' triage arrangements already put in place;
- take stock for 2025/6 of the extent to which these measures successfully meet demand.