Single service for the delivery of SEND assessments

This service will be hosted by Gloucestershire Health and Care NHS Foundation Trust, bringing together the Social Communication and Autism Assessment Service (SCAAS), CAMHS Neurodiversity Team and the Paediatric (under 11s) ADHD Clinic within the hospital. This will be a multi-agency team including Clinical Psychology, Psychiatry, Paediatricians, Occupational Therapy, Speech and Language Therapists, and Nurses. The service is commissioned to offer assessment when a child or young person’s presentation is having significant impact on day-to-day life.

Referrals into the service can be made by any health, education or social care professional working with the child or young person. Before any child or young person is referred support must be put in place via the Gloucestershire Graduated Pathway (My Plan Plus (or equivalent) or EHCP), based on the child’s needs, prior to an assessment being undertaken. Two review cycles of the plan alongside the completion of a My Assessment, must have taken place before an assessment is requested, to ensure presenting needs have been addressed and appropriate holistic support is in place.

Due to very high levels of demand, there is a long wait for both Autism and ADHD assessments, locally and nationally. A diagnosis of any neurodivergent condition is not required in order to access support via the Gloucestershire Graduated Pathway.

Children and Young People’s Autism and ADHD Assessment Service Q&A

Why is it difficult to get hold of us?

Unfortunately, as the demand for the service is much higher than was initially anticipated the service has needed to recruit additional administrators to manage the volume of emails and referrals. The service is currently receiving over 250 referrals per month. This has taken time and had a significant impact on the ability to communicate both with those on the waiting list and those who have just been referred.  The service is exploring a range of digital approaches to help improve communication with families.

What does the assessment look like?

If following the screening process Autism and/or ADHD is indicated, the service will carefully consider the best assessment approach for each child and young person. Clinical Psychologists, Speech and Language Therapists, Occupational Therapists, Paediatricians, Psychiatrists and Clinical Nurse Specialists can be part of the assessment clinic teams. The assessments always comprise a developmental history, observational assessment (known as the ADOS. This is play-based for younger children, team discussion and feedback. The service will also build in conversations with education settings and schedule medical appointments if these are indicated.

How long is the waiting time?

Currently the wait time is around 2 ½ years for the majority of those referred. If a young person is well known to a Consultant within Gloucestershire Health and Care NHS Foundation Trust, the service may not need to complete a full assessment, and for these young people the waiting time is 9 months.

How do I access the courses that you offer?

Following an Autism diagnosis the service offer two parent and carer workshop opportunities, which will be discussed with you directly following feedback.

A half day Introduction to Autism course, which should be completed within 6 months of diagnosis.

The service also offers a 6 week All About Autism course, which is completed with a range of professionals including Speech and Language Therapy, Occupational Therapy and Clinical Psychology. Any family with a child who has undergone an Autism assessment via the NHS pathway, Right to Choose or Privately since January 2023 and has received a diagnosis is entitled to access the post-diagnostic All About Autism course delivered by Gloucestershire Health and Care. To access this you will need to contact the service via email: SCAAS.team@ghc.nhs.uk

I am worried about my child - how do I get them more support?

The Graduated Pathway is the best way to do this. This can be done through your SENCO at school, or through other professionals such as a Health Visitor or Family Support Worker. It is vital that support is put in place before a referral is made to make sure that your child has an agreed plan in place to get the help they need. This should continue to be reviewed regularly whilst they are waiting for further assessment. If you are having difficulties getting a plan in place for your child, the Special Educational Needs and Disabilities Information, Advice and Support Service (SENDIASS) may be able to help with this. You can also use the local neurodiversity guidance and resources website to help you find ways of supporting your child.

How do I find out more?

Please visit the website: SCAAS > Gloucestershire Health & Care NHS Foundation Trust. There are lots of frequently asked questions on the webpage in addition to information about the service.

Private and Right to Choose Assessments

Everyone has a right to request a Right to Choose assessment for Autism and/or ADHD, as part of the NHS Patient Choice commitment. Right to Choose enables people to access their assessments using providers who have a contract in place with any NHS Trust across the country. Everyone is also entitled to fund private Autism and ADHD assessments should they wish to.

It is important to understand the implication of making this decision particularly in relation to accessing ADHD medication following an assessment. If it is advised that your child or young person may benefit from medication to manage their ADHD and you would like to access this via the NHS, before any medication is begun our local clinicians must be confident in the quality of the assessments that has been completed. This is because they will be responsible for the oversight and management of medication going forward. This means that your child will need to be referred to the assessment service and await their assessment to be reviewed by the clinical team. The team may be satisfied with the assessment and begin medication or may feel a reassessment is required and complete this. It is recognised that there is a long waiting list for these assessments to be reviewed and the service alongside commissioners will be considering this as part of our wider pathway work, alongside our local approach to the Right to Choose assessment pathway.

If you wish to look at beginning medication with the private or Right to Choose Consultant (if they are able to offer this) and request a shared care arrangement with the GP it is important to know they are not obliged to accept this and can decline shared care if, for instance, they do not feel they have the expertise to do so. At a national level there is already guidance on the sharing of care between a provider and GP - the Shared Care for Medicines Guidance. Some GPs who have the relevant experience and expertise in this field will feel confident to take on Shared Care Arrangements and others not. If your GP does not feel able to agree shared care, then the above process will need to be followed.

ADHD Medication Shortage

It is acknowledged that nationally there is a shortage in ADHD medication which is causing issues for people accessing their prescriptions. Locally our medical teams are working closely with pharmacies in the county to agree new ways of managing this issue and causing the least amount of impact to the public.

It is recommended that wherever possible you collect prescriptions on the day they are issued to provide the best chance that it will be in stock by the time you reach the pharmacy. Derbyshire Health Care NHS Foundation Trust have developed a useful Frequently Asked Questions (FAQs) page relating to this situation which you can find here: National supply shortage of ADHD medication :: Derbyshire Healthcare NHS Foundation Trust

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