‘If providers cannot even provide a decent assessment while we are giving money to them, it is not acceptable’
The Council House in Old Market Square, Nottingham city centre(Image: Joseph Raynor/ Reach PLC)
Inconsistencies in the quality of autism and ADHD assessments undertaken by some providers outside local NHS systems are adding to the burden, health leaders and councillors have said.
Almost three quarters of children and young people in Nottingham schools are currently waiting longer than 18 months for an Autism Spectrum Disorder (ASD) and/or Attention Deficit Hyperactivity Disorder (ADHD) assessment, according to Nottingham City Council.
There are currently 7,000 adults on the local waiting list, with average wait times of around three-and-a-half years, for the service the council currently commissions.
However, in England those waiting for an assessment can use ‘Right to Choose’, a legal right under which people can seek faster alternatives. It was introduced in 2018 and allows people to choose a mental health care provider, including for autism and ADHD assessments, anywhere in the country.
The service is paid for by the NHS and is therefore free of charge.
Several clinics across the UK currently offer Right to Choose ADHD and autism assessments, but local NHS leaders and councillors say the quality of these assessments have been inadvertently causing more problems.
Councillor Maria Joannou (Lab), who has also worked in Nottingham City Council as an occupational therapist, told the Local Democracy Reporting Service (LDRS) the varying quality between Right to Choose providers was not acceptable.
“I’m a Governor at Bulwell Academy and the thing about getting people assessed is an ongoing issue,” she said.
“The taxpayer is paying for this. If [providers] cannot even provide a decent assessment while we are giving money to them, it is not acceptable.
“At the end of the day, while there is a lot of criticism for the NHS and the council, at the point of delivery they are providing a good service.
“These providers are stopping us from making the NHS and council services better. It is very underfunded. We could be training up more people to do these assessments for the NHS using this money paid to them.
“Otherwise we have got children and young people who go through school not achieving as they could. People in Nottingham are being offered an alternative service [through Right to Choose], but it is not going to solve the problem while they are being offered these services that aren’t getting them the support they need.”
The Nottingham and Nottinghamshire Integrated Care Board (ICB), which commissions the city and county’s health services, says local NHS professionals have sometimes been unable to prescribe the correct medication due to substandard assessments conducted by Right to Choose providers.
Maxine Bunn, director of transformation for mental health and children at the ICB, said: “As we do not hold contracts with providers who carry out assessments under Right to Choose, there may be inconsistencies in the specifications and quality standards for neurodevelopmental assessments commissioned by other ICBs compared to those which are contracted for in Nottingham and Nottinghamshire.
“If this occurs, it can result in challenges around the level of information provided to support the receiving local NHS clinicians and could inadvertently lead to delays for the patient in getting the medication they need.
“There are currently regional and national NHS conversations to develop standardised clinical and quality standards to address this.”
The problem was discussed at a city health scrutiny meeting on October 2, during which councillors and health leaders said the inconsistencies were adding to the burden.
Leaders said they would work to make the local NHS pathway the one people choose by reducing delays, and it is anticipated a new pathway for children will be introducing in July 2026.
If you or your child have been experiencing difficulties in getting an assessment, or the correct support, feel free to reach out at joe.locker@reachplc.com.