Referrals for ADHD and ASD Assessments

ADHD & Autism (ASD) Assessment Information

Guidance for Adults, Children & Young People

Overview

This page explains how referrals for ADHD and Autism Spectrum Disorder (ASD) work in our area. Pathways differ for adults and children, and you also have the option to use NHS Right to Choose (RTC) for specialist assessments.

ADULTS (18+)

If You Are Concerned About ADHD or ASD

If you believe you may have ADHD or ASD, please contact us using the online consultation system on our website.

In your request, please include:

  • The concerns or symptoms you are experiencing
  • How these symptoms affect daily life
  • Whether you already have a preferred Right to Choose provider

Your submission will be reviewed by our clinical triage and forwarded to our dedicated admin team, who will:

  1. Send you screening questionnaires
  2. Ask which provider you wish to be referred to
  3. Forward your completed forms to the clinical team
  4. Arrange for your referral to be processed

Local NHS Pathway – Adults

The local NHS adult ADHD/ASD pathway is currently closed to new referrals.

This is a changing situation, and services may reopen as time passes, but currently:

  • We cannot refer adults into a local NHS adult neurodevelopmental service
  • Waiting times and future availability are unknown

During this period, adults typically access assessment through:

  • NHS Right to Choose providers, or
  • Private assessments (self-funded)

Right to Choose assessments are free under the NHS.

Right to Choose (RTC) for Adults

Adults can request referral to an NHS-contracted provider for ADHD and/or ASD assessment, as long as the provider:

  • Is CQC-registered
  • Holds an NHS Standard Contract
  • Accepts adult patients

Please include your chosen provider in your online consultation request.

Medication & Shared Care (Adults)

Some RTC providers diagnose ADHD but do not offer medication titration.

Our practice can only take over prescribing if:

  • You are stable on a dose
  • The provider offers a shared-care agreement that meets local standards
  • Ongoing specialist monitoring is in place
  • Medication complies with NHS guidance

If the criteria are not met, prescribing must remain with the RTC provider.

CHILDREN & YOUNG PEOPLE (UNDER 18)

If You Are Concerned About Your Child

Please:

  1. Discuss your concerns with your child’s school or nursery, and
  2. Submit an online consultation through our website outlining your concerns

Our admin team will:

  • Send you the required questionnaires
  • Request school reports/SEN information
  • Ask whether you prefer the local NHS pathway or Right to Choose
  • Arrange for the referral to be processed

Local NHS Children’s Pathway – Community Paediatrics

In our area, Community Paediatrics provide ADHD and ASD assessment for children.

Referral rule:

Community Paediatrics usually only accept referrals from schools/educational settings, not from GPs.

Schools must provide:

  • Behavioural observations
  • SEN reports
  • Rating scales
  • Evidence of difficulties across settings

Community Paediatrics also provide ADHD medication titration and follow-up.

Right to Choose (RTC) for Children

Families may request RTC referral if the provider accepts under-18s.
Many providers assess adults only, so please check this carefully.

Schools still need to supply supporting information.

Medication & Shared Care for Under-18s

The practice does NOT enter shared-care agreements for ADHD medication started by Right to Choose providers for children under 18.

This means we cannot:

  • Prescribe medication initiated by RTC providers
  • Provide physical monitoring or titration
  • Adjust doses or manage side effects
  • Continue medication after discharge

If RTC is chosen:

  • All prescribing and monitoring must remain with the provider
  • Local services may not adopt the external diagnosis
  • A new school-led referral to Community Paediatrics may still be needed

When RTC Cannot Be Used (Children)

RTC is not available if:

  • Urgent support is needed
  • The child is already under Community Paediatrics
  • The provider does not assess children
  • The child is in a secure or inpatient setting

Useful Resources

ADHD

Autism (ASD)

Fear of Flying

Prescribers at Oaklands Medical Centre have reviewed benzodiazepine prescribing and have agreed a new policy not to prescribe benzodiazepines or sedatives (such as diazepam) to patients for fear of flying. 

Patients come to us, asking us to prescribe diazepam for fear of flying. There are several very good reasons why prescribing this drug is not recommended.

  • Diazepam is a sedative that makes you sleepy and more relaxed. If there is an emergency during the flight, it may impair your ability to concentrate, follow instructions and react to the situation. This could have serious safety consequences for you and those around you.
  • Sedative drugs can make you fall asleep; however, when you do sleep, it is an unnatural non-REM sleep. This means you won’t move around as much as during natural sleep. This can cause you to be at increased risk of developing a blood clot (DVT) in the leg or even the lung. Blood clots are very dangerous and can even prove fatal. This risk is even greater if your flight is greater than 4 hours.
  • Whilst most people find benzodiazepines like diazepam sedating, a small number have paradoxical agitation and increased aggression. They can also cause disinhibition and lead you to behave in a way that you would not normally. This could impact your safety and that of other passengers and get you into trouble with the local authorities.
  • According to doctors’ prescribing guidelines (BNF), Benzodiazepines are contraindicated (not allowed) in treating phobia. Your doctor would take a significant legal risk by prescribing against these guidelines. They are only licensed short term for a crisis in generalised anxiety. If this is the case, you should get proper care and support for your mental health and not go on a flight.
  • Diazepam and similar drugs are illegal in some countries. They may be confiscated, or you may be in trouble with the local authorities.
  • Diazepam stays in your system for quite a while. If your job requires you to submit to random drug testing, you may fail this, having taken diazepam.

Although we appreciate that the fear of flying is very real and very frightening, we will no longer be providing benzodiazepines or sedatives for flight anxiety and instead suggest the below aviation industry-recommended flight anxiety courses, which are easily accessible for those who wish to conquer their fear of flying:

  1. Easy Jet – www.fearlessflyer.easyjet.com
  2. British Airways – www.flyingwithconfidence.com
  3. Virgin – Advice For Nervous Flyers | Virgin Atlantic

Covid Vaccines

COVID-19 vaccination is an important part of protecting yourself if you’re at increased risk from severe COVID-19. To find out if you are eligible for a Covid-19 vaccine, please go to nhs.uk.

Non-NHS Services

Some services provided are not covered under our contract with the NHS and therefore attract charges.

Examples include the following:

  • Medicals for pre-employment, sports and driving requirements (HGV, PSV etc.)
  • Insurance claim forms
  • Prescriptions for taking medication abroad
  • Private sick notes
  • Vaccination certificates

The fees charged are based on the British Medical Association (BMA) suggested scales and our reception staff will be happy to advise you about them along with appointment availability.

Please note: Passports and shotgun licences are no longer signed by the doctor.

First Contact Musculoskeletal (MSK) Practitioner

Our Musculoskeletal (MSK) First Contact Practitioner works full time at the Oaklands. First Contact Practitioners are physiotherapists with expertise in the assessment and management of musculoskeletal (MSK) conditions.

Our Musculoskeletal (MSK) First Contact Practitioner is here to assess patients with soft tissue, muscle and joint pain and to decide on the most appropriate management pathway. They can perform MSK assessments and support patients who are suffering from any bone, joint or muscle pain.

This includes the following:

  • Low back pain
  • Sciatica
  • Neck Pain
  • Arthritis symptoms
  • Shoulder, hip, knee and foot/ankle pain
  • Elbow, wrist and hand pain
  • Acute injuries and falls
  • Sprains, strains and sports injuries
  • Problems with mobility and activity
  • Work related posture problems
  • Persistent/chronic pain episodes (including Fibromyalgia flare ups)

To book an appointment contact the practice and we can arrange a first contact appointment.

Our Musculoskeletal (MSK) First Contact Practitioner can not provide help for the following problems:

  • Patients that are acutely unwell
  • Children under 16
  • Medical management of rheumatoid conditions
  • Women’s health, antenatal and postnatal problems
  • Neurological and respiratory conditions

Move More

The One You Cheshire East team want to help you stay fit at home. There has never been a more important time to stay active, keep moving and look after our physical health.

  • The NHS suggest that adults should aim to do at least 150 minutes of moderate physical activity a week.
  • Physical activity helps reduce the risk of developing conditions such as coronary heart disease, Type 2 diabetes, obesity, stroke, certain cancers, musculoskeletal conditions and mental health issues.
  • Physical activity can improve your mental wellbeing, your sleep pattern and relieve stress.

One You Cheshire East team have a range of services and motion available to keep you moving, find out more here. 

Veterans in Mind Service

Veterans in Mind service is a specialist IAPT psychological therapy service run by Greater Manchester Mental Health Trust (GMMH) providing assessment and treatment across Cheshire to military veterans.

They also provide substance misuse recovery interventions and work alongside our Warrington Armed Forces Community Support Hub, Veterans in Sefton and Veterans of the Foundation who provide a wraparound service addressing social, financial, occupational and employment issues.

Please note that individuals referred to the service must be registered with a GP in Cheshire.

A veteran is someone who has served at least one day in any of the British Armed Forces, regular or reserves.

Their aim is to contribute to improving the mental health and wellbeing of ex-forces personnel and their families.

Smoking Cessation

One You provides support and gives advice about the treatments available to help you stop smoking.

One You provides help for the residents of Cheshire East who would like support to stop smoking.

You are three times more likely to succeed by working one-to-one or in a group with a Health Coach than going it alone.

You will get lots of support and motivation from your Health Coach. They will be able to tell you about nicotine replacement products and other stop smoking medicines. They can also recommend which product or combination of products could work for you.

We can also measure the levels of carbon monoxide in your body – the monitor shows how your level drops to the same as a non-smoker’s just 24 hours after your last cigarette.

If you would like help to stop smoking please call One You free on 0808 1643 202.