FOI 2026/1700

Please provide documents that set out the criteria and decision-making process used in the Greater Manchester CYP ADHD/autism pathway to determine:

1. whether a child or young person will receive a diagnostic assessment 2. whether a child or young person will remain on or be removed from the 3. neurodevelopmental waiting list

This should include any documents describing:

1. the criteria applied
2. how those criteria are interpreted or judged in practice 3. how information from parents, schools or other professionals is considered in making these decisions 4. how decisions are made where information is incomplete or conflicting

Please include any criteria or guidance referred to as “clinically agreed criteria” in public descriptions of the pathway.

This request includes information held within systems, tools or programmes where this is used to support or make these decisions.

For the avoidance of doubt, this request includes information held by the ICB or held on its behalf by partner organisations involved in delivering or supporting the pathway.

If no single document exists, please provide documents sufficient to show:

1. the criteria used
2. how those criteria are applied in practice 3. and how decisions are reached in individual cases

The new Autism and ADHD MDT triage process for children and young people is designed to ensure:

• The needs of families where Autism or ADHD are being considered are properly assessed and supported
• There is good collaboration between agencies and families are not ‘passed around’ from one agency to another
• There is a chance to reflect on what support the family has and could be offered
• Agencies agree whether the child or young person needs an NHS assessment for Autism or ADHD at this point in time and how urgent that assessment is. The team may decide that needs are not high enough to warrant an NHS assessment.
• In the event that an assessment is not deemed the most appropriate form of support at this point in time, alternative available support will be signposted to based on the needs identified in the referral

Triage panels reviewing children and young people’s referrals for Autism and ADHD assessments (0-18) will use clinical judgement to determine the appropriate onward support for children, young people and families.

A new referral form is being developed to ensure that triage panels have enough information about the needs and worries of parents and young people to help guide support. Parents and children and young people who have capacity, need to have consented to the referral and to information being shared at a multiagency forum.

The referral form aims to gather information about needs, strengths, current support, any safeguarding issues, and will ask for relevant information such as what has been provided through the graduated approach in schools, any Early Help or Child in Need (CIN) planning meetings etc.

Referrals will be reviewed by clinicians from assessment services such as CAMHS and Community Paediatrics depending on pathways in local areas and ideally also representatives from social care and education where this can be provided. There is no check list or ‘tick box’ exercise and panels will recognise that assessing need is a dynamic process that should consider a range of factors including:

-diagnostic criteria and level of individual need

-mental health concerns

-risk of placement/home/education breakdown

-social factors

-involvement of other services

-the extent to which a child/young person would benefit from ADHD medication based on their needs

-speech/language needs

-intersectionality

The panels will determine an outcome relating to:

1. Whether or not the child/young person is to be offered an NHS assessment at this point in time

2. If an assessment is deemed appropriate, panels will consider the urgency of the assessment to support prioritisation as well as identifying the right provider to complete the assessment. E.g. where a child/young person requires mental health support then the assessment pathway would be provided by CAMHS.

Outcomes will be communicated to the young person (where appropriate), their family, GP and school. If an assessment is not considered to be the best means of support for a child or young person, based on their needs, appropriate support services will be signposted to within their outcome letter. Should a child/young person’s needs change, then they can be re-referred for assessment.