Regional Pathways
Diagnosis pathways, referral processes, and support systems vary significantly by location. Here's what to expect in your region.
Information here is general guidance. Specific services, waiting times, and processes vary within regions and change over time. Always check with your local services for current information.
Select your region
ADHD Pathway
Referral: GP referral to specialist ADHD or neurodevelopmental service
Who assesses: Paediatrician, psychiatrist, or specialist nurse prescriber
Typical waits: 1-4+ years in many areas (varies significantly)
- •Right to Choose allows NHS-funded assessment with private provider
- •NICE guidelines (NG87) govern assessment standards
- •Environmental interventions should be offered while waiting
- •Medication can be initiated by specialist, shared care with GP
Autism Pathway
Referral: GP or school referral to autism assessment team
Who assesses: Multidisciplinary team (paediatrician, psychologist, speech therapist)
Typical waits: 2-5+ years in many areas
- •Some areas have separate pathways for autism and ADHD
- •NICE guidelines (CG128) recommend MDT assessment
- •Post-diagnostic support varies significantly by area
- •Right to Choose may apply in some areas
Support systems:
EHCP (Education, Health and Care Plan) for educational support. CAMHS for mental health. Local authority SEND services.
ADHD Pathway
Referral: GP referral to CAMHS or paediatrics
Who assesses: CAMHS psychiatrist or paediatrician
Typical waits: Varies by health board (typically 6 months - 2+ years)
- •SIGN guidelines inform practice
- •No Right to Choose equivalent
- •Some areas have specialist ADHD pathways
- •Medication initiation and monitoring through NHS
Autism Pathway
Referral: GP, health visitor, or school referral
Who assesses: Autism assessment team (usually multidisciplinary)
Typical waits: 1-3+ years varies by health board
- •Scottish Autism Strategy guides service provision
- •Assessment pathways vary by health board
- •Some areas have One Stop Shop services
Support systems:
CSP (Co-ordinated Support Plan) or IEP. NHS and local authority services. Scottish Autism support.
ADHD Pathway
Referral: GP referral to CAMHS or paediatrics
Who assesses: CAMHS or paediatric service
Typical waits: Variable by health board
- •Follows NICE guidelines
- •Neurodevelopmental service availability varies
- •Some areas have integrated ND pathways
Autism Pathway
Referral: GP, school, or health visitor referral
Who assesses: IAS (Integrated Autism Service) or local pathway
Typical waits: 18 months - 3+ years
- •Integrated Autism Service provides post-diagnostic support
- •Code of Practice for autism in Wales
- •National autism team provides training and support
Support systems:
IDP (Individual Development Plan) replacing statements. IAS for autism support. Local authority SEND services.
ADHD Pathway
Referral: GP referral to CAMHS or paediatrics
Who assesses: CAMHS psychiatrist or paediatrician
Typical waits: Significant waits in most trust areas
- •Five Health and Social Care Trusts
- •Services vary by trust area
- •NICE guidelines referenced
Autism Pathway
Referral: GP or school referral to autism assessment service
Who assesses: Trust autism assessment teams
Typical waits: Often 3+ years
- •Autism Strategy (NI) 2013-2020 and beyond
- •Autism services vary by trust
- •Regional autism coordinator role
Support systems:
Statement of Special Educational Needs or non-statemented support. Autism NI provides support services.
ADHD Pathway
Referral: GP referral to HSE CAMHS or private
Who assesses: CAMHS psychiatrist (public) or private psychiatrist/paediatrician
Typical waits: HSE: often 2+ years. Private: weeks-months.
- •Significant public/private divide
- •Private assessment widely used but costly
- •Medication through specialist only
Autism Pathway
Referral: GP referral to HSE Assessment of Need
Who assesses: HSE Disability Network Teams or CHO teams
Typical waits: Often 2-4+ years for Assessment of Need
- •Assessment of Need under Disability Act 2005
- •Progressing Disability Services model
- •Private assessment may be faster but costly
Support systems:
Assessment of Need leads to service statement. NEPS (educational psychology). NCSE (special education). CDNT (Children's Disability Network Teams).
ADHD Pathway
Referral: GP referral to paediatrician or psychiatrist
Who assesses: Paediatrician, psychiatrist, or (in some states) psychologist
Typical waits: Varies by state and location (often 6-18 months public)
- •Medicare rebates available for some assessments
- •State-specific regulations on stimulant prescribing
- •PBS subsidises ADHD medications
- •Private assessment may be faster
Autism Pathway
Referral: GP referral or self-referral to assessment service
Who assesses: Multidisciplinary team (paediatrician, psychologist, speech pathologist)
Typical waits: 6-18+ months
- •Diagnosis needed for NDIS access
- •Medicare funding for some assessment components
- •Australian guidelines inform practice
Support systems:
NDIS (National Disability Insurance Scheme) for eligible children. State-based disability services. Education support varies by state.
How it works:
- 1Be on NHS pathway (referred by GP)
- 2Request Right to Choose from GP
- 3Choose an approved provider
- 4Provider invoices NHS directly
- 5You receive NHS-standard assessment
Important caveats:
- Not all services accept RTC
- GP must process the request (some resist)
- Ongoing care may need to transfer to NHS
- England only
Common challenges
Strategies:
- Start implementing strategies at home while waiting
- Explore Right to Choose if in England
- Request interim support from school
- Consider private assessment if affordable
- Keep documenting concerns
Strategies:
- Research your local services specifically
- Connect with local parent groups for insights
- Advocate for improved services
- Know your rights within the system
Strategies:
- Understand Right to Choose options
- Check if private diagnosis will be accepted
- Ensure private assessment meets standards
- NHS may need to re-assess for medication
Advocacy tips
Know your rights
Understand what you're entitled to in your region. Services can't deny statutory rights.
Document everything
Keep records of referrals, correspondence, and concerns. Paper trails matter.
Escalate when needed
PALS (England), ombudsman services, and formal complaints are valid options.
Connect with advocates
Parent carer forums, SEND advocacy services, and charities can help navigate systems.
Request in writing
Written requests create records and are harder to ignore.
Don't wait passively. While waiting for formal assessment, you can already be implementing strategies at home, working with school on support, and building your understanding.
Many accommodations and strategies don't require a formal diagnosis. Support your child based on their needs, not just their labels.