An ICB decision to limit activity for Right to Choose (RTC) providers has prompted GP concerns about ADHD and autism assessment waiting times.
North East and North Cumbria ICB said it has implemented ‘activity plans’ for RTC providers following ‘exceptionally high levels of demand’ for autism and ADHD assessments.
It said that to manage this pressure, the ICB has ‘temporarily agreed revised activity plans’ and that, as a result, people referred during 2025/26 may experience longer initial waiting times with RTC providers.
Gateshead LMC chair Dr Paul Evans said that practices in his area are reporting distressed patients as the new activity plans meant some providers are declining new referrals.
He said that the plans have ‘essentially put a pause’ on Right to Choose assessments until the end of the financial year.
Dr Evans said: ‘What this means from the GP perspective is that referrals can be made, but some providers are declining them because the activity plan prevents them progressing these referrals to assessments at the present time, and there is no end date for this freeze on activity.
‘Providers have actively started refusing referrals on the grounds that they don’t have any faith that it’s worth accepting them because of the ICB’s current stance, the fact that they’ve not made it clear they will resume at some point. So some providers are simply not taking the risk of accepting these patients at all.
‘Essentially, it’s put a pause on Right to Choose assessments across North East and North Cumbria, so some providers have responded by saying “we’re not taking any referrals for North East North Cumbria ICB patients for the time being”. We’ve had practices reporting distressed patients.’
The ICB said that providers will ‘continue to see anyone with a booked appointment’ and prioritise and assess anyone considered ‘clinically urgent’.
A spokesperson for the ICB said: ‘There has been a huge increase in people being referred for autism and/or ADHD assessment, which is a positive step that indicates people are seeking support.
‘This increase has resulted in NHS autism and ADHD services in our area experiencing significant pressures, which are now having a direct impact on assessment waiting times. This reflects a national picture driven by increased awareness and changes in how people seek and access support.
‘During 2025/26, the number of people receiving an assessment through a Right to Choose provider has doubled compared to the previous year. This means that more people than ever before are accessing assessment and support.
‘However, it also means that there is pressure on demand and waiting times. To help manage this pressure in a fair and responsible way, the ICB has agreed activity plans with RTC providers for new autism and ADHD assessments between January and March 2026. The plans do not affect NHS Trust services and children under the age of six are not impacted.’
The ICB added that the approach is designed to protect ‘existing services’ and ensure that people already in the system ‘continue to receive safe and appropriate care’.
‘New referrals are not being stopped or paused and will continue as normal,’ the spokesperson added. ‘We fully recognise the frustration and distress that longer waits cause for patients and families. Alongside this temporary approach and the immediate actions we are taking, we are working closely with NHS providers and partners to redesign autism and ADHD services so they better meet the needs of our population.’
It comes after a report warned that the NHS has become ‘heavily dependent’ on private ADHD providers, who are pushing ICBs massively over budget with little oversight.
Last month, the Government launched an independent review into rising diagnoses of ADHD and autism, as well as other mental health conditions in England.
It will look at the reasons behind the growing prevalence and the knock-on demand for services in both adults and children.
This story first appeared on our sister title Pulse.
