Early Health Care Needs Assessment Request - BRISTOL

As of the 1^st of March 2023, the criteria that lead to acceptance for an assessment of autism are changing. A young person can now only be accepted for an assessment if they meet the following criteria:

1. Children and young people whose education placement is breaking down despite appropriate support (including those who are NEET – not in education, employment, or training – and those at risk of permanent exclusion, transfer, or long period of school refusal). This may include children and young people who need an Autism diagnosis to access the required specialist provision. 
2. Children and young people whose family unit is at risk of breakdown despite support from appropriate agencies (parents/carer and social care are unable to meet the children and young person’s needs, leading to risk of child protection proceedings and/or child needing alternative placement). This can also include children whose adoption is at risk of breaking down.
3. Children and young people in care or on a child protection plan for whom an assessment is needed (e.g., to inform placement planning).
4. Children and young people who are open to Children and Adolescent Mental Health Services (CAMHS) with severe and enduring mental health difficulties (i.e., high risk to self or others) where an autism diagnostic assessment is required to support their formulation and care. Or children who are not open to CAMHS but are presenting with a serious risk to self or others (e.g., risk of exploitation, significant self-harm, dangerous levels of aggression towards others).
5. Children and young people who are involved with youth offending services and/or are engaged in repeated offending behaviours.
6. Children with very low levels of communication where the difficulties are likely to be associated with autism (usually Early Years)

(Referral Criteria – Sirona care & health NHS services (sirona-cic.org.uk))

The reason given for this change is the huge number of children being referred for a diagnosis and the long waiting lists for these – the idea behind it is to reduce waiting times for those most in need. This means that, if your child does not meet these new criteria, you will not be accepted on to the waiting list for assessment, and your child will not get a formal diagnosis. If you do not agree with this decision and feel that important information has been missed out which should have led to a diagnosis, you will need to resubmit the request in full with the new information included. This must include new information that supports your case. This will not normally be considered with 24 months of the first submission, but may, in exceptional cases, be considered within 12 months if sufficient new evidence can be provided.

A second opinion will generally not be offered, however if you do not agree with the outcome of your request, you can request a review, after 6 weeks have passed from the original feedback meeting. To do this:

Families should send a request outlining their concerns in writing to the ASD coordinator who will direct the request to the professionals, involved in the assessment. The following may be possible:

1. Discussion between the family and the professionals leads to a joint understanding  and no further assessment required.
2. If the situation cannot be resolved, a professional, specialising in ASD, who was not on the original team will conduct a review of the process to make sure the National Institute for Health and Care Excellence (NICE) guidelines were followed and that the assessments were appropriate.

(Referral Criteria – Sirona care & health NHS services (sirona-cic.org.uk))

The new process accepts that a child’s need change over time, and if their difficulties increase they may become eligible for assessment under the new criteria, where they have previously not done so. If this is the case, you can complete a prioritisation request form to ask that your child is reconsidered.

(NEW-PRIORITISATION-FORM.doc (live.com))

Schools and educational settings are being told to treat undiagnosed children in exactly the same way as if they were diagnosed; by providing interventions and educational plans to meet their needs and to provide specialised support.

Your child does not need a formal diagnosis to apply for an EHCP or for Disability Living Allowance.

You can seek a private diagnosis, which will, provided it follows NICE guidelines, be accepted by medical professionals and schools. This is an expensive option, but one that can give the reassurance of a formal diagnosis. A private diagnosis can highlight the areas of impairment that your child is experiencing, and support and guidance to help them manage these.

There are also services offering a report which shows the likelihood for autism in a child but does not provide a formal diagnosis. These reports can also offer valuable guidance and support options and can help you and your child to understand their needs. BIBIC is an example of a provider of this type of report.

All of the forms that you will need to complete can be found in the links below.