Neurodevelopmental Service Transformation Project

What is the Neurodevelopmental Service Transformation Project about?

Across the country, there has been a large increase in the number of children, young people and adults asking to be assessed for neurodivergence. At Norfolk Community Health & Care NHS Trust (NCH&C), the Children's Neurodevelopmental (ND) Service is receiving more than 260 referrals a month, which greatly exceeds their capacity. This has resulted in increasing waiting times; children and young people who are waiting for a neurodevelopmental assessment in Norfolk are now waiting more than six years to be seen.

NCH&C is reviewing the Neurodevelopmental Service and introducing some changes to ensure their service is operating both efficiently and effectively, and to improve waiting times for assessment. Norfolk Community Health & Care NHS Trust is part of a system-wide Neurodiversity Transformation Project, working with system partners (Norfolk County Council, Norfolk & Waveney Integrated Care Board, Families, other health providers), which will offer a new way of supporting children, young people, and families as soon as they recognise that they may need some support.

What changes are happening?

In response to this project, NCH&C has some changes happening:

• NCH&C has joined up with Cambridgeshire Community Services to develop a digital library for parents and carers which provides practical support and resources to help understand more about neurodiversity and neurodivergence. This can be found on the JustOneNorfolk.
• From 1 April 2025, there will be a change to the ND clinical pathways - NCH&C is moving from a pre-6 and post-6 pathway to a pre-5 and post-5 pathway. This is to ensure that children access the right clinicians at the right time, with a view to enabling earlier identification and support for younger children.

New initiatives

Digital referral form

From 1 April 2025, NCH&C will be introducing a new digital referral form. This is in development and will provide a more efficient way to refer children and young people into their service for assessment of ADHD and / or Autism. NCH&C urgently requires the support of education colleagues to come forward and test out this new form to ensure it is fit for purpose. NCH&C is running a Teams session for education colleagues who refer children and young people to the service on Tuesday 11 February from 10.30am to 12 noon to demonstrate the draft form and invite feedback from school representatives. If you can offer your time, please contact Mary Cubitt, Project Manager at: Mary.Cubitt@nchc.nhs.uk

NCH&C Neurodevelopmental Service Transformation Project

Please note that all referrers will be able to continue to refer using the existing process while they finalise and establish the new digital form.

Pilot of one day assessment clinics

The pilot of a one-day assessment clinic for Autism assessment in pre-5 children

A small cohort of children under 5 years who are referred to the Community Paediatricians will be reviewed at triage for suitability to participate in this pilot. It is important that we trial a new way of working and evaluate the results to identify whether this could be an alternative and more efficient way of assessing children. All assessments will continue to be NICE compliant.

Not all children will be suitable and there will be a need for referrers to provide additional information to support the assessment process. The additional information referrers will be asked to provide may include the Schedule of Growing Skills (SOGS), Parent Observation Questionnaire (POQ) and Teacher Observation Questionnaire (TOQ).

Families whose child has been identified as suitable for the one-day assessment clinic and who have provided their consent to take part, may contact referrers from early February to ask for additional support in providing the necessary information to support the new assessment process. Without the additional information, a child will not be able to be included in the pilot and will be seen through our existing pathway.

The pilot of a one-day assessment clinic for Autism and ADHD in post-5 children

Similarly to the pre-5 one-day assessment clinic, a limited number of children/young people aged 5 and over will be reviewed to see if they are suitable to take part in this pilot. This pilot is expected to commence 1 May 2025 and will be evaluated to identify whether this can be a more efficient way of assessing some of the children/young people referred into NDS.

Where can you get help?

NCH&C will continue to share regular updates around these proposed changes as they develop. The project team is arranging some engagement opportunities over the next few months for those key professionals who are likely to refer children for neurodevelopmental assessment. Please look out for these.

NCH&C's team can be contacted via telephone: 01553 668712.

Or by email: NDS@nchc.nhs.uk

Further information can be found on NCH&C's website.