Private assessments
We aim to meet the identified needs of adults, children and young people, irrespective of their diagnosis.
Private assessments will be considered on a case-by-case basis and will be reviewed to ensure the assessment processes and diagnostics have followed National Institute of Clinical Excellence (NICE) guidelines. NICE provides guidance to professionals and patients around what is expected from an evidence-based assessment and/or intervention. The guidance is readily available online. For example, the guidance for ADHD is NG87 and for for autism in Under 19s is CG128. For adults, the guidance is CG142.
It is important to note that not all assessments carried out privately will meet the above criteria. Please check before proceeding with any private assessment that it will meet the necessary standards:
- Autism assessments must be conducted by a multidisciplinary team of appropriately trained and qualified clinicians. In practice, this means that at least two clinicians from different professional backgrounds must be directly involved in the assessment. This may be a practitioner psychologist (clinical or educational), paediatrician, psychiatrist, speech and language therapist, or occupational therapist.
- Whilst it is often beneficial for ADHD assessments to be conducted by a multidisciplinary team, this is not essential as one appropriately trained and qualified clinician is considered sufficient for the diagnosis of ADHD.
- The clinician(s) involved in an autism or ADHD assessment must be registered with an appropriate professional body [e.g. Health and Care Professions Council (HCPC) or General Medical Council (GMC)].
- All autism and ADHD assessments must gather a comprehensive history of general development. This must have included gathering information about biological, social, environmental, and psychological factors that might have impacted the adult or young person’s development.
- All autism and ADHD assessments must have gathered information from multiple sources about an adult or young person’s possible areas of difference across their lifespan. This should involve in-depth discussions with the person if they are able to engage in these conversations, in addition to their parent carer and others who know the adult or young person well (e.g. teachers, practitioners from other settings, other key people in the adult or young person’s life).
- All autism and ADHD assessments must have involved at least some interactional and/or observational assessment with the person directly. Whilst this can in some circumstances be via online video assessment, information from other sources must be sufficient to compensate for this.
- Any appropriate alternative or additional explanations for a person’s experiences or areas of difference have been adequately considered and assessed. This might include considering whether a person’s needs are better understood in terms of other diagnoses including a Learning Disability, Developmental Language Disorder, or Foetal Alcohol Spectrum Disorder.
- It might also include considering whether a person’s experiences may be better understood as a response to difficult or traumatic life events, a mental health concern, relational or attachment-based concerns, or developmental trauma. It is important to remember that both adults and young people with needs relating to these areas can appear similar to those who are autistic or have ADHD.
Our local process for accepting a private diagnosis is:
- For under 18s, private reports should be sent to navigo.ymmneuro@nhs.net
- For over 18s, private reports should be sent to either cpg.adhd@nhs.net for the Adult ADHD service or cpg.autismdiagnosticservice@nhs.net for the Adult Autism Service.
- The report will be reviewed by the appropriate clinicians to ascertain if it meets the criteria mentioned above.
- Adult ADHD and Autism services will complete a NICE approved checklist to determine validity of private diagnosis of ADHD or autism.
- If the report meets the necessary standards, the adult, or child or young person is moved on to our post-assessment pathway. This includes both Adult ADHD and Autism services, and only the ADHD pathway for children and young people.
- If it does not meet the necessary standards, the clinicians will make recommendations, which may include a recommendation that referral needs to be made to the Neurodevelopmental Service. Should the clinician decide not to refer to the service, then this will be fully explained.
Private diagnosis
If a child or adult is diagnosed by a private provider, and would like ongoing treatment from the NHS, this can be discussed with their GP and where appropriate the GP can make a referral to neurodevelopmental services.
The team will need to check that the assessment process has been completed in a NICE-compliant way as described above.
If the private report is not NICE-compliant, the services will usually advise on what information is missing and ask for this to be retrieved from the private provider's records, or will offer the option of reassessment (where appropriate) within the local NHS pathway. However, the child or young person will join the waiting list as a new referral.
Further intervention will not be able to be provided in the NHS until it is confirmed that an assessment and diagnosis has been reached following NICE standards of assessment and care.
If the adult or young person has been commenced on medication by a private provider, there are sometimes differences between what private providers prescribe and what NHS providers prescribe. This will be discussed at the time, however it may not always be possible to continue with the same medication or same dose commenced in a private setting.
There is no automatic follow-up for adults and children with a private Autism Spectrum Disorder (ASD) diagnosis. However, should there be a separate medical indication where there is a clinical need for follow-up (for example an associated difficulty). This should be discussed with your GP to make the appropriate onward referral.
It is the responsibility of the school that the child or young person is attending and the local authority or local council area the child and family reside in to use the outcome and recommendations of any private assessments by an organisation or provider to support the child or young person as required.
Support for children with neurodevelopmental differences can be found via the SEND Local Offer. The Local Offer is the place that provides and directs you to information that will support children and young people aged 0 to 25 years with Special Educational Needs and Disabilities (SEND).