Unlike in adults where Autism and ADHD assessments are all made by Psychiatric services, in children the NHS assessments are undertaken by different services.
There are self-referral processes for both types of NHS assessment, these are then triaged by the relevant service.
There are lengthy waits for these appointments. 40 months is quoted at the time of writing this (Sept 24) on the HDFT website for an Autism assessment.
Autism NHS assessments are carried out through a dedicated Children’s Autism Assessment Service at Harrogate District Hospital, part of the Paediatric department.
ADHD NHS assessments are carried out by a different team, part of the Child and Adolescent Mental Health Services (CAMHS). In this area CAMHS is provided by TEWV NHS Trust.
Some parents may choose to approach private providers for assessment, diagnosis and management of Autism and ADHD. The Practice operates the same policy with regards to “Right to choose” for children and adults, as outlined above in the Adult section.
Before using the “Right to Choose” please be aware of the following:
- 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, only the initial assessment and diagnosis is funded by the NHS.
- The GP practice 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 NHS “Right to Choose”), as this is the specialist provider’s contractual responsibility, even if they operate a remote access tele-health service.
Prescribing for Children
As with adults, medication for children with ADHD can only be initiated by a specialist and must continue to be supervised long term by a specialist. Most of the medications used are legally classified as Controlled Drugs, which means that a maximum of 28 days prescription can be issued at a time.
Once a child is stable on medication (i.e. they have been prescribed the same dose for at least 3 months), we will usually enter a “Shared Care Agreement” with the NHS team at CAMHS (or HDFT), so that we take over the prescribing. The child will remain under the care of the specialist for monitoring and will be required to attend regular review appointments.
We will not enter into a shared care agreement for prescribing for a child with any private providers. Please be aware that if you choose to fund the initiation of medication in the private sector, you will be required to do so long term.
In deciding whether we are able to undertake shared care with a provider we are informed by BMA guidance on GP responsibilities working with private providers, as well as the detailed NHS England guidance on prescribing between providers.
Due to these considerations we are therefore unable to enter into a “Shared Care Agreement” with any private provider without careful consideration.