Attention Deficit Hyperactivity Disorder (ADHD) and Autism

Autism and ADHD assessment services across North East and North Cumbria continue to experience exceptionally high levels of demand, resulting in longer waiting times. This reflects a national picture driven by increased awareness and changes in how people seek and access support.

To manage this pressure in a planned, fair and responsible way, the ICB has temporarily agreed revised activity plans with Right to Choose (RTC) providers for new autism and ADHD assessments. This approach is designed to protect existing services and ensure that people already in the system continue to receive safe and appropriate care. It is being applied consistently across all commissioned RTC providers.

It is important to be clear about what this means:

• New referrals are not being stopped or paused - referrals for autism and ADHD assessment can continue to be made.
• The revised activity plans apply only to Right to Choose providers and do not affect NHS Trust services.
• Children under the age of six are not impacted, as there are no RTC providers commissioned to assess this age group; these assessments continue through NHS Trusts.
• Providers will:
• Continue to see anyone with a booked appointment
• Prioritise and assess anyone considered clinically urgent
• Manage assessments for people already waiting within the agreed activity levels

As a result, people referred during 2025/26 may experience longer initial waiting times with RTC providers, but all existing referrals will retain their original referral dates. Anyone who already has an appointment, is part way through assessment, awaiting treatment, or receiving ADHD medication will continue to receive care without disruption.

Alongside this approach and immediate actions, the ICB is working closely with NHS providers and partners to redesign autism and ADHD services so they better meet the needs of our population. This includes:

• Reviewing how assessments are prioritised
• Improving the information, guidance and support available while people wait
• Making communication clearer for patients, families, professionals and the public
• Ensuring services are prepared to respond to questions and concerns

While waiting times remain too long and unmet need is significant with understandable anxiety for patients and families, it is also important to recognise that more people than ever before are receiving autism and ADHD assessments, and ADHD medication where clinically indicated. In 2025/26, more individuals have been supported than in any previous year.

Our aim is to be fair, consistent and transparent, while ensuring services are sustainable. This will allow a revised and improved approach to assessments to be implemented as soon as it is safe and responsible to do so. We will review this position in April 2026.

Questions or concerns

If you have any questions or concerns, please contact the NENC ICB Complaints Team.

Email: nencicb.complaints@nhs.net

Telephone: 0191 374 4218

Freepost: FREEPOST, NENC ICB COMPLAINTS Contact Address: Complaints Team, North East and North Cumbria Integrated Care Board, Pemberton House, Colima Avenue, Sunderland, Tyne and Wear, SR5 3XB

North East and North Cumbria Integrated Care Board (NENC ICB) plans and pays for NHS services in this area.

NENC ICB has become aware of the recent suspension of services from Holistic ADHD Solutions, also known as ADHD.net, which is commissioned by NHS Norfolk and Waveney ICB. However, some adults from the North East and North Cumbria populations have accessed this ADHD (attention deficit hyperactivity disorder) service under the NHS Right to Choose via a referral from their GP.  

The below information gives an update on the Holistic ADHD Solutions/ADHD.net suspension and describes what that means for people impacted in our population.

Who does this apply to?

This update applies only to patients on the Holistic ADHD Solutions waiting list, whose NHS care is funded by North East and North Cumbria ICB.

If your care is funded by a different ICB, please check messages from your provider. If your care is under a different provider, this does not impact you. 

What has happened?

In November 2025, Holistic ADHD Solutions Ltd (“Holistic ADHD”) was dissolved at Companies House, meaning that they were no longer able to trade or be registered with the Care Quality Commission (CQC). The CQC informed the host Commissioner, NHS Norfolk and Waveney ICB about this, who issued a Suspension Notice as a result.

While the provider is no longer showing as dissolved, concerns remain relating to how the organisation is being managed, including risks to continuous delivery of services. At present, the Suspension Notice remains in place until formally withdrawn by Norfolk and Waveney ICB. 

NHS Norfolk and Waveney ICB are currently transitioning patients to another provider and recommended that other ICBs obtain a list of any of their affected patients by contacting Holistic ADHD Solutions Ltd.

NENC ICB has since instructed Holistic ADHD Solutions to stop accepting referrals from GP practices in the North East and North Cumbria and is following the same process, by transferring patients to another provider for continuity of care, where required. 

What does this mean for people receiving care and/or treatment from Holistic ADHD Solutions Ltd

People currently in active treatment or receiving medication from Holistic ADHD solutions will be contacted and transferred to alternative provider Care ADHD to ensure clinical safety, unless the patient chooses to withdraw from the service upon notification.

People on the waiting list for an assessment that have not been seen/assessed by Holistic ADHD Solutions will be given the option to choose their own alternative provider via a referral from their GP. This could be an alternative provider under the NHS Right to Choose, or via your local commissioned service (Cumbria, Northumberland, Tyne and Wear NHS foundation Trust, or Tees, Esk and Wear Valleys NHS Foundation Trust). Patients waiting for an assessment will be contacted by the provider and redirected to their GP to discuss options for a new referral. 

Medication concerns

NENC ICB is arranging for the transfer of medication, treatment and care for those currently in receipt of this service from Holistic ADHD solutions to Care ADHD.  Patients can of course choose to decline or withdraw from this service however, should they so wish.

Medication breaks are safe for most ADHD medications (unless you are taking guanfacine/Intuniv). However, pausing or reducing ADHD medication may affect your ADHD symptoms, so you should always seek clinical advice. Where NENC ICB have been advised that patients have commenced medication and/or titration under Holistic ADHD Solutions, your care will be transitioned to Care ADHD unless you opt out. However, please consult your GP immediately for guidance if you are running out of medication.

Further information can be found here: Shortage of medicines for ADHD

Your Right to Choose

You still have the legal Right to Choose which NHS provider carries out your ADHD assessment if you have not commenced treatment and are on the waiting list.  Please contact your GP, who has access to a list of providers available under the NHS Right to Choose.

Support

If you are worried about your wellbeing, please contact your GP.

If someone is in crisis:

· For urgent health needs that are not life threatening, please use NHS 111 online at www.111.nhs.uk or by phone. Call 111 and press 2 for mental health. You will be put through to a trained mental health advisor.

· Call 999 if it is a life-threatening injury or illness

• Text SHOUT to 85258 (24/7)
• Call Samaritans on 116 123 (24/7)

Questions or concerns

These decisions were made by NENC ICB, who plan and fund NHS services.

If you have any questions or concerns, or would like to make a complaint, please contact the Complaints Team.

Email: nencicb.complaints@nhs.net

Telephone: 0191 374 4218

Freepost: FREEPOST, NENC ICB COMPLAINTS Contact Address: Complaints Team, North East and North Cumbria Integrated Care Board, Pemberton House, Colima Avenue, Sunderland, Tyne and Wear, SR5 3XB

Our goal is to help people with ADHD and/or autism get the support they need to live well and feel happy whether they have a formal diagnosis or not.

Everyone deserves the right help, and support should be based on what a person needs, not just on a diagnosis.

Our ambition across our region is to ensure that ‘needs led’ help and support is available whether there is a formal diagnosis of ADHD and or Autism, or not.  Having a person's needs met could include help to improve self-esteem and confidence, improve mental health, help with diet and nutritional advice, improve sleep or employment and or educational difficulties.

You should contact your local authority or local NHS team to find out more about what is available in your area.

Further resources:

ADHD & Autism

• ADHD in children and young people - NHS
• ADHD in adults - NHS
• Where to get autism support - NHS

Information on ADHD

• NHS Website

Information on ASD

• NHS Website

NHS Help and Support locally

• Support for neurodiverse children and young people

For some people, getting a better understanding of certain behaviours and personality traits can be powerful. Self – understanding tools can be a good way to learn more about yourself in relation to traits and behaviours without the need for a formal diagnosis of ADHD and or Autism.

We have used the word' tool 'to mean a few different things such as tests, questionaries and online resources.

There are lots of free online tools that might help you see if you have some traits of autism or ADHD. But be cautious– some of these can be unhelpful and or unclear.

The tools listed here are trusted, free and widely used. They have evidence behind them and may help you understand yourself and offer some insights.

Tools that are available for children and young people are best used for ages 6-17, and for Adults we mean ages 18 or over.

Remember:

• No online test can give you a diagnosis.
• These tools are just to support you to understand you better.
• They can help you decide whether to get more support or advice.

Autism Self-understanding: For Children and Young People

Trusted tool: Children’s Empathy Quotient (Ages 4-11) and Empathy Quotient for Adolescents (Ages 12-15)

Details:
These are a group of short surveys for parent or carers. They can help parents or carers learn how their child thinks about and reacts to other people’s feelings. They include real-life examples where understanding others’ emotions (empathy) is important.

Good things about it:
- Helps parents or carers understand a child’s strengths and challenges in social situations. 
- Shows how children and young people think about emotions and relationships.
- Uses age-appropriate questions for clearer results.

Things to keep in mind:
- Some children learn what is expected in public. This might make them seem more empathetic than they really are which can affect the results.
- Results are based on parent or carer answers. Responses may be influenced by memory or opinion.
- This tool is for self-understanding only. The tool does not diagnose autism.

Links to the tools:
Children’s Empathy Quotient (EQ-C) – Ages 4–11

Empathy Quotient for Adolescents – Ages 12–15

ADHD Self-understanding: For Children and Young People

Trusted tool: Cambridge Neuropsychological Test Automated Battery (CANTAB)

Details:
The CANTAB test is a set of short, computer games. They check how well someone can remember things, focus, and control their actions. It is sometimes used to learn more about thinking skills linked to ADHD.

Good things about it
- Easy to do – you do not need any medical machines or special tools.
- Gives clear results about how you pay attention and think.
- Shows patterns in how your brain works and how you understand information.

Things to keep in mind:
- Being tired, worried, or not being used to computers can change the results.
- This tool is for self-understanding only. The tool does not diagnose ADHD.

Top tips
- It works best in a quiet, tidy place with no distractions.
- A touchscreen device, like an iPad, gives the best results.
- The test is better for teenagers than for younger children.

Link to the tool:
Cambridge Neuropsychological Test Automated Battery (CANTAB)

Autism Self-understanding: For Adults

Trusted tool: Autism Spectrum Quotient (AQ-50)

Details:
This is a test to see if people have traits that might be linked to autism. It looks at:
- Personality traits
- Ways of communicating
- Attention patterns

Good things about it:
- It looks at lots of things. This includes social skills, communication, and attention to detail. 
- Gives a clear picture of traits linked to autism, not just a single score.

Things to keep in mind:
- There is more than one way to score the AQ-50, so a high or low score does not always point to the same result which can be confusing.
- People who mask or hide their traits well may score lower.
- Some questions may be less relatable for women.
- This tool is for self-understanding only. It does not diagnose autism.

Top tips:
AQ-50 works better for women when used with other tools such as the CAT-Q to understand masking behaviours or the EQ-40 to understand empathy responses.

Link to the tool:
Autism Spectrum Quotient (AQ-50)

Trusted tool: Camouflaging Autistic Traits Questionnaire (CAT-Q)

Details:
The CAT-Q test can help people understand their traits and or behaviours in social situations, known as 'masking'. It looks at:

- How people copy others
- How people try to fit in
- How people use certain habits

These are things people might do to feel more comfortable around others.

Good things about it:
- Helps people understand their own habits for coping mechanisms.
- Shows the different ways people mask, like copying others or hiding their feelings.

Things to keep in mind:
- People without autism can also mask in everyday situations. Masking can be a positive and helpful trait.
- The results depend on how well someone knows their own behaviour.
- This tool is for self-understanding only. It does not diagnose autism.

Top tips:
It works best when used with AQ-50 Autism Spectrum Quotient (AQ-50) as they look at different things and can be more helpful when used together to give better understanding.

Link to the tool:
Camouflaging Autistic Traits Questionnaire (CAT-Q)

Trusted tool: Empathy Quotient (EQ-40)

Details:
The EQ test helps people understand how easily they notice and respond to other people’s feelings. It is like other empathy checks, such as the EQ-C and EQ for Adolescents.

Good things about it:
- Helps people learn more about their own empathy style.
- Helps people learn how aware they are of the emotions of others.
- Gives a better understanding of social awareness and how someone relates to others.

Things to keep in mind:
- Cultural differences can change how people answer empathy-based questions.
- Having low empathy does not mean someone is autistic.
- This tool is for self-understanding only. It does not diagnose autism.

Top tips:
This test should be used in addition to the AQ-50 Autism Spectrum Quotient (AQ-50)  as they look at different things and can be more helpful when used together to give better understanding.

Link to the tool:
Empathy Quotient (EQ)

Trusted resource: Embrace Autism

Details:
Embrace Autism is a website created by autistic people and experts. It includes quizzes, articles, and stories. This can help people learn more about autism. For lots of people, hearing other's stories can be helpful.

Good things about it:
- The website is friendly and easy to use.
- It offers trusted information and resources to help with self-understanding.

Things to keep in mind:
- It is not a diagnosis tool. It is a website with resources to help with self-understanding.

Link to the website:
Embrace Autism

Trusted tool: The Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R)

Details:
The RAADS-R is a longer survey for adults. It looks at social, sensory, and emotional traits linked to autism.

Good things about it:
- It is well-tested and used a lot. 
- It sees that traits and behaviours linked with autism can look different in men and women.

Things to keep in mind:
- Some questions can be confusing.
- Some traits in the test can also be found in other conditions, like alexithymia (finding it hard to recognise emotions).
- This tool is for self-understanding only. It does not diagnose autism.

Link to the tool:
The Ritvo Autism Asperger Diagnostic Scale–Revised (RAADS-R)

ADHD Self-understanding: For Adults

Trusted tool: Adult ADHD Self Report Scales (ASRS)

Details:
The ASRS is a short set of questions for adults. It helps check for signs of ADHD, such as:

- Trouble focusing
- Restlessness
- Being forgetful

Good things about it:
- Quick and easy to fill in.
- It is used a lot.

Things to keep in mind:
- It may not show the full picture for people who hide or mask their symptoms well.
- There are two ways to score this test, and professionals may use different methods, so different scores could mean different things.
- This tool is for self-understanding only. It does not diagnose ADHD.

Link to the tool:
Adult ADHD Self Report Scales (ASRS)

Trusted tool: Cambridge Neuropsychological Test Automated Battery (CANTAB) for ADHD

Details:
This is a test that uses simple tasks to check memory, attention, and reaction speed; differences in these skills that are often linked to ADHD.

Good things about it:
- Gives clear and accurate results.
- Helps show thinking patterns that may be linked to behaviours and traits sometimes associated with ADHD.

Things to keep in mind:
- Doing the test more than once can change the results.
- This tool is for self-understanding only. It does not diagnose ADHD.

Top tips:
- Works best in a quiet place with no distractions.
- A touchscreen device, like an iPad, gives the best results.

Link to the test:
CANTAB for ADHD

We understand that for some people, getting an assessment is very important. Sometimes it can help with getting help and support.

Across the NHS in England there has been a significant rise in demand for assessments for ADHD and Autism diagnosis since 2019. In our area we have four times as many children and young people and seven times more adults waiting for an assessment than we did in 2019.

NHS services have not been able to grow to meet the increased demand, more people are waiting, and people are waiting longer for an assessment.

We recognise the waiting lists in our region for an NHS assessment for diagnosis are long and continue to increase. 

Working together with all of our partners we have an ambitious programme of work to improve our waiting times and the support available to people waiting, and to ensure that there are good quality alternatives to an NHS assessment.

You do not need a diagnosis to access some kinds of help and support, see the help and support section for more information.

In England if a GP refers an NHS patient to a specialist for a physical or mental health condition, in most cases patients have the legal right to choose the specialist hospital or service, including those for ADHD and Autism assessments.

The Right to Choose is based on a number of criteria which must be satisfied before your GP can make a referral. Referral to a right to choose provider can only be for a first appointment, you cannot have a second opinion or change provider once you have made a choice and had a first appointment.

If your GP supports a referral there are a number of Right to Choose providers offering ADHD & Autism services.

It is important to understand which Right to Choose provider is best for you as they do not all offer the same things as part of their NHS contract.

It can be quicker to get an assessment from a Right to Choose provider but not all Right to Choose providers are able to prescribe medication which may be needed after a confirmed ADHD diagnosis.

If there might be a need for medication (for ADHD) some Right to Choose providers are not able to prescribe ADHD medication and those that are, may require a shared care agreement (SCA) with your GP. 

Not all GPs in our area will enter into a share care agreement, this decision is at their discretion.

Many patients find that a diagnosis is sufficient for obtaining additional support from schools or employers, or they may not need medication at all for managing their condition.

Some patients are able to and choose to pay for medication with private prescriptions.

If you choose to self-refer to a private provider, the Right to Choose will not apply and the NHS will not pay for the assessment and or any recommended treatment.

A right to choose is not a right for a referral, referrals need to be clinically appropriate.

It is advisable to have a conversation with your GP to help understand if Right to Choose is right for you, and which provider can fully meet your needs.

Your GP will have an up to date list of all Right to Choose providers and what they are able to provide on behalf of the NHS.

Further resources:

ADHD & Right to Choose referrals: Visit the ADHD website for more information.

ASD & Right to Choose referrals: Visit the National Autistic Society website for helpful details.

NHS: How you can access NHS mental health services

ADHD medication can only be prescribed by a specialist; GPs are not currently able to prescribe ADHD medication in England.

Shared care is a formal local agreement that enables GPs to accept responsibility for the safe prescribing and monitoring of specialist medicines.

*Guidance issued by the General Medical Council (GMC) states the GP is not obliged to enter into a shared care arrangement with any provider, and GP practices can decline shared care requests on clinical and capacity grounds.

If you are recommended ADHD medication after your assessment, how you get that medication can vary.

It depends on how and where you had your assessment:

• If you had an NHS assessment (through CNTW or TEWV)
• If you were assessed through Right to Choose
• If you paid for a private assessment

Each of these options might have different rules about prescribing and getting medication. Your GP or care team can help explain what’s available in your situation.