The NHS Kent and Medway Integrated Care Board has capped assessment activity for autism and ADHD services, meaning patients assessed as lower clinical priority face longer waits, with routine assessments not expected to resume before April 2027.

Families and patients across Kent and Medway have been receiving letters warning them of significant changes to autism and ADHD assessment services, prompting Medway Council’s Health and Adult Social Care Overview and Scrutiny Committee to call NHS Kent and Medway Integrated Care Board (ICB) to account at its meeting on 19 August 2026.

The ICB told the committee that demand for autism and ADHD assessments has risen sharply in recent years, pushing waiting lists to levels that have placed “considerable additional pressure on the NHS and its commissioned services”. Expenditure has also risen quickly, and without intervention the ICB warned that forecast spending during 2026/27 would “significantly exceed the resources allocated to these services”.

What is changing and why

NHS England has asked all Integrated Care Boards to agree with providers the number of assessments they can offer during 2026/27 and the budget within which they must deliver them. In response, the ICB is applying Indicative Activity Plans (IAPs) across all adult and children’s autism and ADHD services, including providers operating through the NHS Right to Choose pathway.

The ICB’s paper states that “routine assessments are not expected to start again before April 2027”. Referrals are not being stopped, but once a provider reaches the maximum activity level set under its IAP, patients will be placed on a waiting list unless they meet priority criteria. The ICB says patients’ places in the queue will be protected under current commissioning arrangements.

A clinical needs-led categorisation approach is being introduced to ensure available capacity is directed first to individuals with “the greatest clinical, safeguarding, educational, social care or vulnerability-related need”. The ICB acknowledged that “some people assessed as having lower levels of need may experience longer waits where capacity is constrained”.

The increased use of the NHS Right to Choose pathway — under which patients opt for referral to independent providers contracted and paid by the NHS — was cited as having “led to a mix of different pathways, inconsistent experiences and clinical outcomes and substantial financial pressure”.

Risks identified by the council

The council’s own report to the committee identified a series of risks arising from the changes. It warned that reduced access to neurodevelopmental pathways “may delay identification of need and access to suitable support” and could “adversely affect educational attainment, school attendance, emotional wellbeing and family resilience”.

The report also flagged that the changes “may have wider implications for the local area’s Special Educational Needs and Disabilities (SEND) system” and that prolonged waiting times could affect how effectively children and young people with SEND are identified — a factor that “may be considered as part of the next Area SEND inspection”.

Financial risks to the council were also noted, with the report warning that additional pressure may be placed on education and social care budgets if waits lengthen and only children and young people with very high needs access pathways.

What the ICB says it will do next

The ICB set out plans to strengthen provider reporting and payment verification, and to develop a longer-term pathway redesign programme to improve triage, support for people while they wait, data quality and pathway consistency across Kent and Medway. The committee was asked to note the update rather than take any decision.

Sources

Top image: illustrative — not a photograph of a Kent or Medway clinic.