In York and North Yorkshire our ambition is for more timely adult ADHD and autism diagnoses and quicker support for everyone seeking health and care advice for their needs before and after assessment.

To help us do this we have been piloting an approach to assessment referrals since March 2023 which connects people with the most severe needs to assessment first, while ensuring that everyone referred has access to support tailored for their individual needs prior to an assessment. This will give people access to information more quickly to empower them to make choices and influence changes in their life, for example to open up conversations with employers.

With use of the online neurodiversity screening tool the North Yorkshire & York Platform for Adult Autism and ADHD Referrals (previously referred to as the Do IT Profiler), accessed through GP referral we are now able to follow a triage approach to identify people with the most acute healthcare needs and prioritise these individuals for assessment. Previously, all referrals were assessed in chronological date order and there was no system for identifying those people who needed help more urgently.

Clinicians and professionals were supported by commissioners to design additional modules within the screening tool and referrals platform to help determine eligibility for referral based on three assessment criteria, with patients who meet one or more of these referred directly for assessment.

The experiences of people who've used the platform first-hand will be important in helping to determine what a future referral pathway might look like. Following invaluable feedback during the initial three month pilot programme we have identified a number of adjustments since the platform was introduced.

Everyone registered with the platform will be offered the opportunity to remain on a triage waiting list and based on their needs will be referred for an assessment or offered/signposted to appropriate relevant support.

Data from the platform shows the number of people experiencing mental health issues and data from the sensory profile can be used to map support activity such as executive functioning, independent living skills, time management/organisation, dealing with anxiety and low mood and understanding local pathways to services. The aim is to develop programmes/workshops for people needing such support.

Healthwatch York, an independent voice and patient champion, is conducted an assessment on the first three months of the pilot (March – June 2023) and their findings will also help us adjust the platform to better meet the needs of people seeking support.

This pilot program ended in June 2024. Here are the key changes:

Why We Had to Make Changes

• Because of the significant increase in demand for assessments, the service was at risk of closing to new referrals, or the Provider stopping their contract.
• The ICB (Integrated Care Board) had to act quickly to keep the service open and running safely.
• The pilot allowed the ICB to test, evaluate, and improve the assessment process so that it prioritised access for those people with the greatest need, whilst also providing access to a waiting list and support for everybody who wants to access an assessment.
• Feedback from people who use the service and from clinical professionals made it clear that the service needed to change in order to manage increasing demand.