ADHD/Autism Referrals and Treatment
Adults
GPs are no longer able to directly refer adults for NHS ADHD/Autism assessments and diagnosis. The current referral pathway, put in place by our local ICB (Humber and North Yorkshire Health and Care Partnership), requires patients to complete a self-assessment tool online (The ‘Do IT Profiler’), to assess eligibility.
If the details provided meet their acceptance criteria, your referral will be sent on to The Retreat (who run The Tuke Centre in York) for triage (this is the designated provider, in the region, for NHS assessments for ADHD and Autism). If the criteria are not met, you will be given the option of remaining on a waiting list, which is managed by the ICB.
If you wish to complete this self-assessment pathway, please send an eConsult to the surgery, and request that we send you the link for the ‘Do IT Profiler’. If you meet the threshold for referral, you will then be guided through the self-referral pathway.
Disabled Student Grant Applications
GP practices are not able to provide evidence for Disabled Student DSA applications. If you are waiting for assessment through this route, the Do-It Profiler will provide a standard letter, signed by an ICB GP, which patients can then pass to the University.
Right To Choose
We are aware that NHS services for ADHD/Autism assessment, diagnosis and treatment are limited, with extensive waiting times. An increasing number of patients are therefore choosing to access private providers, sometimes under the NHS ‘Right to Choose’ rules.
Adults will only be eligible to use the NHS ‘Right to Choose’ pathway IF the ‘Do IT Profiler’ tool identifies you as eligible for assessment on the NHS. You must provide a copy of the ‘Do IT Profiler’ report, identifying you as being eligible for referral, and the provider you are choosing must have a contract with NHS England for the required service.
The ‘Right to Choose’ pathway will not fund subsequent non-NHS prescribing costs or review appointments.
For the avoidance of doubt, we would not be able to perform any investigations, physical health checks or ongoing monitoring on behalf of a private provider (whether or not you were referred under the ‘Right to Choose’), as this is their responsibility, even if they operate a remote access tele-health service.
Shared Care Prescribing.
If you are assessed under the NHS pathway at the Tuke Centre, they may initiate you on medication, if considered appropriate. Once a patient is stable on a dose of medication, we will usually take over ongoing prescribing from the Tuke Centre, under a ‘Shared Care Agreement’. Patients remain under the care of the specialist and will be required to have ongoing reviews (at least annually and interim reviews if deemed necessary due to change of symptoms, severity or medication queries).
We will NOT enter into a ‘Shared Care Agreement’ with a private provider. This means that if you choose to initiate medication in the private sector (even if this was through a ‘Right to Choose’ referral), you will be required to continue to fund this long term, with periodic reviews by that provider. If in the future you wish to transfer your care to the NHS, we can refer you to the local NHS commissioned service (The Retreat/Tuke Centre in York).
There is an extensive waiting list for these NHS appointments, and we would not be able to prescribe for you during the time you are waiting for an appointment. Depending on the source of your diagnosis, it is possible that the Tuke Centre would not recognise this, and would not agree to take over prescribing on the NHS.
Please ensure that the private provider has a copy of this information, if you go ahead with your assessment, so that they are fully informed.
Children
Autism assessments are carried out through a dedicated team at Harrogate District Hospital. ADHD assessments are carried out by a different team, based at CAMHS (part of TEWV NHS Trust). There are self-referral processes for both assessments, which would then be triaged by the relevant service.
There are lengthy waits for these appointments. 32 months is quoted at the time of writing this (Sept 23) on the HDFT website for an autism assessment.
Children’s Autism self-referrals can be made here:
Children’s ADHD self-referrals can be made here:
Some parents may choose to approach private providers for assessment, diagnosis and management of Autism and ADHD. The Practice operates the same policy for children and adults, as outlined above. We are unable to provide investigations, physical health checks or ongoing monitoring on behalf of the provider, this is their responsibility, even if they operate a remote access tele-health service.
Prescribing
Please refer to the information above about prescribing arrangements for adults, as this is mirrored for children.
Once a child is stable on medication, we will usually enter a ‘Shared Care’ arrangement with the NHS teams at HDFT or CAMHs, so that we take over the prescribing. The child will remain under the care of the specialist and will be required to attend regular review appointments.
We will not enter into a shared care agreement with a private provider, so if you choose to fund the initiation of medication in the private sector, you will be required to do so long term.