Following our joint updates in November 2023 and March 2024 with Surrey County Council and Surrey Heartlands ICB and various engagement events that have been running, below are some frequently asked questions about support for children and young people (CYP) with Neurodevelopmental Needs.

What is the joint approach being implemented across NHS Surrey Heartlands, Surrey County Council, and Mindworks to address the needs of CYP with neurodiversity? 

The approach is underpinned by a service delivery model called the THRIVE Framework for System Change (Wolpert et el, 2019.)  Its main emphasis is on giving children and young people a central voice in decisions about their care which takes a needs-led approach. This means a shift away from seeing the presenting issue through the lens of a problem and looking at what support and help the child/young person requires to be able to Thrive and feel supported with their neurodevelopmental needs. This needs-led approach is personalised to the individual child or young person through working with them to understand what support they need and what is important for them to develop trusting relationships so support can be provided appropriately in order to achieve the desired goals.  

A helpful video to explain that further is available here: Our THRIVE approach

What support is available for parents and children/young people? 

Mindworks continues to provide parental support through our partners to achieve the following: 

  • To help understand their child’s needs in life (with or without diagnosis), the impact of this in their day-to-day, support for the family, and the provision of practical and emotional support, advice, information, and strategies.
  • Empowering parents and carers with efficient strategies and understanding of communication skills and effective behaviour techniques in their support for Children and Young People (CYP) with neurodevelopmental (ND) needs, ADHD and AS
  • Supporting the CYP to feel empowered to manage their own needs using support, developing peer networks, and integrating strategies into their day-to-day life in school and at home.

Information on support and resources available for social communication differences, attention, activity, and other behaviours are provided through the Mindworks website: Mindworks Neurodevelopmental Needs. There are several characteristics that can look like neurodivergent needs. Whether they are or not, we have created some resource packs to help with these needs.

Why needs-led instead of diagnosis-led approach? 

All legislation across SEND and Children Services primarily focusses on the identification of need and the importance of intervening early, and in the least intrusive way. 

By taking a needs-led approach we are better placed to be able to intervene early and put the right support in place at the right time without the need for a diagnosis. This means action we take is in response to the emerging and presenting needs. This has been a key message from our Children and Young People (CYP), our families, and our teams working with CYP – to help make a change early so the experience for CYP improves. 

This approach works in synergy with diagnostic pathways and provides clarity that there is no requirement for an individual to have a diagnosis to be able to access timely help and support. 

What is the update from Mindworks Surrey about the Neurodevelopmental assessment pathway since the last update on March 24?

School Consultations

As you would have read in previous communications, access to the neurodevelopmental pathway, including assessment and diagnosis (where indicated), is available via a school consultation. The consultations bring together the child or young person (where appropriate) with the individuals around them to consider their needs and the best approaches and interventions to enable them to thrive. School staff and Mindworks Surrey neurodevelopmental spoke clinicians all have advice and expertise to offer. Schools can contact the Neurodevelopmental team to request a formal consultation in the following situations: 

  • Where the school is supporting a child or young person experiencing high levels of distress, that is impacting their behaviour and ability to participate in school.  
  • Where the school is supporting a child or young person whose attendance is below levels which trigger a safeguarding referral) and has been referred to (or has self-referred to) Early Help and where support has been offered.  
  • Where the school is supporting a child or young person who is already known to mental health and specialist services and whose neurodevelopmental needs require more urgent interventions. 

What happens after a consultation has taken place? Consultations will help to review and evaluate the help and support in place in addition as well as considering alternative approaches to supporting a child or young person’s needs. A joint agreement may result in the child or young person progressing to the waiting list for a neurodevelopmental diagnostic assessment. 

To book a consultation Mindworks have listened to schools, and this can be done by email or telephone, schools have the necessary information to be able to do this.

I would like to request a consultation with SPOKE what should I do?

Please refer to information on this page: Forms for requests for support (referrals)

Once accepted for a full diagnostic assessment how long is this waiting time?The team are currently assessing young people who have waited between 2 and 2.5 years, which has seen some improvement since the changes where CYP were waiting closer to 3 years. With the current changes that are taking place and additional capacity being bought in by Psicon (an independent provider), Mindworks hope to soon see a further decrease in the waiting times. For children presenting with comorbid ADHD and ASD waiting times are longest due to the requirements of the clinical assessment and diagnostic pathway.

What happens to my referral when I turn 18 years old? Will I go to the bottom of the wait list in adult services?

No. For diagnostic assessments, if the assessment is outstanding, this is transferred to adult services who honour the original date of the referral. For ADHD medication reviews, your care is transferred to the adult services who will either arrange an initiation appointment or continue with the agreed plan of medication review appointments.

Why is the wait so long for a diagnostic assessment for children (aged 6-18)?

In recent years, the demand for ADHD and Autism assessments has dramatically increased across the country.  Therefore, the number of requests Mindworks Surrey receives every day has significantly increased.  We are working hard to increase capacity across Mindworks to process these requests.

Can a Private Diagnostic Assessment for ADHD for a child that has been confirmed by a Private ASD Diagnostic Service outside of the NHS be recognised by their Local Authority (SEN) and NHS? 

ADHD can only be formally assessed by a UK registered psychiatrist, a specialist ADHD nurse, or “other appropriately qualified healthcare professional” [Nice Guidelines - NICE guideline [NG87]Published: 14 March 2018]. Other appropriately qualified healthcare professionals with training and expertise in the diagnosis of ADHD” include Psychologists. Psychologists can provide an assessment of ADHD; however, they are not able to prescribe ADHD medication. Other mental health professionals, including counsellors, cannot provide a formally recognised diagnosis of ADHD. (Note: For children a Paediatrician may also be able to diagnose ADHD]. At SABP we would need a full Nice Compliant report [Nice Guidelines - NICE guideline [NG87]Published: 14 March 2018] with the following information included to evidence Diagnosis, presentation, Impairment and Impact, and Timescale :

  • full clinical and psychosocial assessment of the young person; this should include discussion about behaviour and symptoms in the two different domains and settings of the person's everyday life.
  • A full developmental and psychiatric history
  • Assessment observations report and assessment of the young person's current and history of mental state. 
  • Rating Scales should be shown to meet thresholds in two different domains and settings of the young person's everyday life. (i.e. education & home)

Do you need an ND diagnosis to have an Education Health and Care Plan (EHCP)? 

A child doesn’t need a diagnosis to receive additional support in school. A child also doesn’t need a diagnosis to request an EHCP.  A diagnosed medical condition, need or disability does not mean a child has additional needs or requires extra support above what a school can provide ordinarily. 

A child or young person has special educational needs if they have a learning difficulty or disability that means they need extra support at school. You can read more information on P13 of this guide: Additional needs and/or disabilities parent and carer guide | Surrey Local Offer and also via this link: A guide for parents and carers of children with additional needs and/ or disabilities (surreylocaloffer.org.uk)

I am concerned that I need a diagnosis to access support at School, what should I do?

Children and young people do not require a diagnosis to receive support at school.  If a child or young person has a need in school, they are entitled to receive support to meet that need. We work together in partnership with Surrey County Council and Surrey Heartlands ICB, if you need any specific information about EHCPs, Right to Choose or Ordinarily Available Provision, please visit their specific websites. 

Exams - Access Arrangements, Reasonable Adjustments and Special Consideration

We have recently received confirmation from JCQ regarding evidence needed for students applying for Access Arrangements, Reasonable Adjustments and Special Consideration including where extra time may be needed. The exam board have confirmed that in order to apply for these arrangements the exam officer or SENCo can use existing correspondence from Mindworks Surrey to support an application. Appropriate evidence may include letters and emails sent to parents/carers from Mindworks Surrey that indicate a child is on the Neurodevelopmental Pathway or receiving healthcare for their emotional wellbeing or neurodevelopmental needs. For students awaiting a school consultation with the Neurodevelopmental Spoke team, the confirmation email may be used as evidence that a child is on the waiting list for consultations. If the child receives support from other services for their school-based needs, this may also be used as evidence for the exam board. In the absence of a diagnosis or confirmation that a child is on the Neurodevelopmental Pathway, the exam officer or SENCo can provide other evidence of a child’s specific needs including comments and observations from teaching and support staff which produces a compelling picture of need.

Unfortunately due to administrative capacity within our Mindworks Teams we are unable to re-issue any documentation including copies of letters, as evidence a child is waiting for a consultation.

Help us improve our website

Please take a moment to share your thoughts and help us enhance our website by completing our short survey here.