Important changes to how we receive Autism and ADHD referrals

What are we commissioned to provide?

The Autism and ADHD services at the Retreat clinics are currently resourced and commissioned to receive an estimated 720 referrals per year (60 per month) however due to an unprecedented increase in demand throughout 2022 and 2023 our referral rate increased considerably and on average we received 1840 referrals per year (153 per month) which unfortunately has impacted on our ability to respond as quickly as we would like to, if you have not heard from us regarding your referral and whether you have been accepted onto our waiting list this will be because you are still in triage – at present we estimate that this delay will be around 12-15 months.

We are commissioned to provide the below assessments per year –  

• 214 Autism diagnostic assessments per year
• up to 242 ADHD diagnostic assessments per year – we are also commissioned to provide medication reviews and support, dependant on demand there may be priority given to medication clients within the ADHD pathway due to urgent need, this may impact on the number of ADHD assessments we are able to provide. 

Due to the increased demand on our services, we are continually exploring ways to make changes to our assessment pathways so that our clients receive efficient and robust assessments whilst ensuring that we see as many people as we can, however, please be aware that we are unable to beyond our commissioning capacity due to limitations within our current NHS contract.

 

Update

This is an update regarding changes in the referral pathway for Adult Autism and Attention Deficit Hyperactivity Disorder (ADHD) assessment Service at The Retreat Clinics in North Yorkshire and York. This is a commissioner led change, resulting from actions from the local NHS Integrated Care Board (formally known as the NHS Clinical Commissioning Groups), to pilot the introduction of the criteria for referral to assessment and a new approach to screening for neurodiversity. This applies to new referrals. The changes come into effect from Monday 27 March 2023.

Why have these changes been made?

Autism and ADHD services across the nation have seen a steady increase in demand over recent decades. At The Retreat Clinics, this demand now far exceeds our capacity as a service with an increase of 400% in referral rates. This issue is something that is currently receiving significant focus from both our local Trust and regional commissioners. The changes have been made to pilot a new pathway and way of working.

What do the changes mean?

Please meet with your General Practitioner (GP) if you are seeking a diagnostic assessment for Autism/ADHD and you live within North Yorkshire and York. Your GP will be able to guide you through and explain the new pathway. Referrals will be directly through a web-based screening and assessment system called Do-it Profiler.

What is Do-it Profiler?

Please watch the video in the following link which explains it all: https://doitprofiler.com/

Whilst the Do-it Profiler does not give a diagnosis, the Neurodiversity Screener will identify characteristics and provide a unique profile describing strengths, challenges, and the skills to develop at home, socially and in the workplace. The profile will also identify where reasonable adjustments should be made which should start as a basis for discussion with occupational health, employers, and educational environments. All clients who complete the profile will receive immediate functional guidance and signposting to support networks.

Once logged in, the profiler will ask you an initial set of questions to determine whether you will be referred on to The Retreat for an assessment for diagnosis or be directed through the profiler for access to support and useful resources. Everyone who completes the profiler will receive immediate functional guidance and signposting to support networks. These changes are part of a pilot, and the commissioners welcome your input. There will be an opportunity to provide feedback within the profiler tool which we would encourage you to do. This will help the commissioners to collate information as part of our evaluation and inform future commissioning decisions.

For some people, a referral is still appropriate and will be made to us through the profiler. Please allow time for our clinical team to consider your referral (called ‘clinical triage’ please note there is a delay in receiving your referral and accepting/rejecting your referral this wait is estimated between 12-15 months). Once we have considered your referral, we will be in touch with you directly to let you know if a diagnostic assessment will be offered – we will backdate any referral accepted onto our waiting list to the date the referral was made.

Please note that due to limitations on information provided to our clinical team resulting from the use of the profiler we may request further information from you and your GP to support your referral prior to triage.

For further information on the Do-It Profiler, including technical support, any questions on how friendly it is for Autism, ADHD and learning difficulties, or what to do if you don’t have access to a device or technology, please contact:

If you are within North Yorkshire: hnyicb-ny.engagement@nhs.net

If you are within York: hnyicb-voy.contactus.yorkhcp@nhs.net

The Retreat Clinics are not providing the Do It Profiler, as this is a commissioner change to the pathway. Therefore, please do not contact us to seek guidance or advice on the Do It Profiler, as we will only be able to provide you with the same information as explained here.

Can I access assessment and treatment from an alternative provider?

This is a piloted change to the commissioned pathway and the eligibility criteria will therefore also apply to other providers, including online private providers. Referrals which fall outside of the eligibility criteria will not be reimbursed by the NHS.

If you are eligible for assessment, you have a legal right to choose your specialist provider. We suggest you discuss this option with your General Practitioner. You may also prefer to obtain private care, but please ensure you clarify the details with your General Practitioner, as for ADHD services, there are no shared care arrangements in place between primary care and private providers and you will be expected to continue to pay for your medication rather than this being prescribed by your local practice. Using an alternative provider may offer you more timely access to assessment and treatment. That said, it is worth clarifying with the provider what they provide before getting a referral to avoid disappointment. Eligibility criteria applies to all providers and general practice will be encouraged to direct patients to the Profiler and not make NHS referrals to other providers. Referrals which fall outside of the eligibility criteria will not be reimbursed by the NHS.

What if I disagree with this change of pathway for the diagnostic assessment? Where do I go to for any complaints or queries? 

Please contact:

If you are in North Yorkshire: hnyicb-ny.engagement@nhs.net

If you are in York: hnyicb-voy.contactus.yorkhcp@nhs.net

Please do not call The Retreat Clinic’s administration team to enquire about the change to the pathway and process: our team will not be able to advise or comment on the Do It Profiler, or the commissioner led changes. They will only be able to advise you with the same information provided here: you need to make contact using the details above.

I am not a ‘new’ referral, what does this mean for me?

The commissioner-led change is for referrals received from 27 March 2023.

If you or your referrer have received notification you are on our ‘awaiting triage’ list, we will be honouring this and triaging your referral. Please do not contact us to enquire about waiting times, as we cannot comment specifically or individually on how long it will take us to triage your referral.  For current waiting times (CLICK HERE)

If you or your referrer have received notification that your referral has been accepted, then you will remain on our waiting list and we will be in touch when it is time for your assessment.

What are your current waiting times?

Waiting times for assessment:

We recognise and appreciate that people requiring our Autism & ADHD services have lengthy waiting times. This is something we are trying to address. Whilst we acknowledge how difficult it is to wait, we ask people to please not contact the service regarding their wait time as this is often changeable but unfortunately lengthy.  For current waiting times (CLICK HERE)