York: adult autism and ADHD assessment pilot criticised

York Disability Rights Forum (YDRF) say a pilot brought in this week by the North Yorkshire and York Health and Care Partnerships will mean that adults who approach their GP seeking an autism and or ADHD diagnosis will be refused access to assessment unless they meet urgent criteria.

These include the patient being at risk of immediate self-harm or that they may harm others; they are at risk of being unable to have planned life-saving hospital treatment, operations, or care placement or there's an imminent risk of family court decisions being determined on diagnosis.

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A YDRF spokesman said: "We are speaking out against this plan of action which will deprive people of their access to assessment and diagnosis. We are very concerned that there has been no risk assessment, no engagement with the people who will be affected, and no consideration of the potential deadly impact of this decision.

"This decision appears to have been made purely for financial and systemic reasons, without due regard for patient wellbeing."

North Yorkshire and York Health and Care Partnerships say it is not a way of saving money and say urgent action has to be taken as the demand for the service has skyrocketed.

In September 2021 there were 60 referrals for adult autism/ADHD, by April 2022 this had gone up three-fold to 180 and there are currently 1,500 people on the waiting list and a further 2,000 to be triaged.

They say it's part of a three-month trial which started on Monday (March 27) and referrals will be directly through a web-based screening and assessment system called Do-it Profiler. People seeking an assessment can be given access from their GP and the pilot is intended to test the new referral process.

York GP Dr Brian McGregor, who is chair of the Yorkshire Regional Council of the British Medical Association, said doctors have raised concerns which have already led to some changes.

But he said: "We are also concerned that this will raise demand and expectation in primary care and general practice, at a time when practices are already struggling under unprecedented patient demand and workforce challenges." 

Dr Brian McGregor

A spokesperson for the North Yorkshire and York Health and Care Partnerships said: “The pilot is to test an approach we feel we have to try in the face of unprecedented demand which has resulted in unacceptable wait times and the need to prioritise resources towards those most at-risk adults. If we did nothing and based on current demand, it is estimated the number of referrals currently on the waiting list, along with those yet to be triaged, will use 90 per cent of the contract value and take the remaining four and a half years of the contract to complete. This means that any referrals made now would face approximately a five year wait for assessment.

“We are triaging the most at risk to get them through the system.

"The feedback and responses to the Do-it Profiler will help us in our evaluation and inform future commissioning decisions.

"Feedback will be actively encouraged from those using it and professionals. This will be monitored and independently evaluated by Healthwatch over the next three months.”

They said the profiler scores responses to the eligibility criteria and will refer those who meet one or more of these directly to The Retreat for assessment.

All those who complete the profiler will receive immediate functional guidance and a unique profile describing strengths, challenges, and the skills to develop at home, socially and in the workplace.

The new approach is designed to connect people with support more quickly and help prioritise resources towards most at-risk adults.