When it is suspected that a child may have autism or ADHD, a specialist assessment is needed to confirm a diagnosis. In the case of autism this must be a multi-disciplinary assessment. Diagnosis is important for a child as it helps those around them to understand their needs and can open the door to the support they require being provided formally, for example under an Education and Health Care Plan. This is the document that sets out the support and adjustment a child needs in school and, often underpins the choice of the correct educational environment. These specialist assessments are carried out under the NHS but waiting times are substantial. The length of time a child will spend on the waiting list will depend on the particular NHS trust but typical waits run to years. In many cases, children spend a significant proportion of their time in school essentially treading water waiting for assessment which will guide how their education is best provided. Time and opportunities are lost for these children and their future outcomes are impacted. Private diagnostic assessment will reduce waiting time such that diagnosis can be achieved in matter of months but the cost, for a lot of families, is prohibitive. So, is there another route for a parent seeking timely diagnosis for their child?
In most cases where any referral is made under the NHS, the patient has the 'right to choose' the person or service who provides the assessment or care. This includes the legal right to ask for your care to be transferred to a different provider if you're likely to wait longer for it under usual NHS channels than maximum specified waiting times.
Crucially, this means that a patient can choose to be seen by a private service, as long as that organisation provides similar services to the NHS. Many private services who carry out diagnostic assessments for neurodivergent conditions do provide these services through the NHS. The National Autistic Society website sets out the rights of those seeking an autism assessment to choose the service that carries out the assessment and confirms that the 'right to choose' applies in these circumstances, provided that eligibility criteria are met. The eligibility criteria would cause no issue in most cases. They exclude those in prison, those detained under the Mental Health Act, those serving in the armed forces and those admitted to hospital or needing urgent medical testing. They require that the person exercising the right is registered with a GP in England and that the nominated service, as above, provides diagnostic assessments for the NHS, which very many private services do.
For many families, this route represents a quicker and easier journey to diagnosis and a better understanding of a child's presentation and needs. When families reach crisis point, they often can't wait months or even years for answers. There is a potential downside though. When a diagnosis is needed to underpin an application for an EHCP, councils will not always accept a diagnosis made by a private provider as evidence of a child's needs and may require an NHS diagnostic assessment. Anecdotally, it seems that this can be the case even if the assessment was referred through the NHS 'right to choose' pathway and was carried out by an approved NHS partner.
So while there is a route to swifter and less stressful diagnosis for children, it may not always offer the comprehensive solutions families are looking for. A diagnosis can, however, whether it opens the door to increased support or not, mean a great deal to a family who will at least be given some answers and a framework within which they can better understand their child.
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