Autism assessment backlog

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Patients waiting for autism assessments in Derbyshire are facing some of the longest waits in the country.

Although backlogs and demand for autism spectrum assessments are issues across the country and certainly not isolated to Derbyshire, the county’s experts see themselves significantly on the back foot.

The Derbyshire Healthcare NHS Foundation Trust currently has a 1,200-person backlog for autism spectrum assessments with an average wait of more than a year – 59 weeks.

The trust discloses in its recent board papers that it is commissioned to carry out 26 assessments per month but is receiving 96 referrals per month, vastly outstripping its capacity.

It details that while the waiting list is reducing month on month – and once stood at more than 2,000 people – it is currently processing 59 assessments per month, as of January, which would see it take 20 months – a year and eight months – to clear its backlog entirely, without any new referrals.

The trust says it is currently on track to meet national guidelines to have assessed all patients within three months of a referral by June next year.

All of this sees the trust finding itself ranked fourth worst for the percentage of patients waiting over a year for services at 62 per cent as of January this year.

The trust says the national median is just 0.3 per cent waiting over a year and that the mean average – a different way of calculating an average – is eight per cent.

It hopes to improve its current standards to 14 per cent of patients waiting more than a year by transferring the key causes – backlogs in community paediatric autism assessments and attention deficit hyperactivity disorder (ADHD) into its “mental health services dataset”.

The trust details in its board reports: “Areas where standards are not currently being achieved remain the adult ASD assessment waiting list and waiting times, although the trust continues to significantly exceed commissioned activity levels.

“Activity levels continue to exceed the commissioned target for assessments, with the full year target exceeded by 55 per cent up to the end of January 2025. 

“Waiting times remain very high at around 59 weeks, with demand far exceeding commissioned capacity. 

“The waiting list has reduced over the last three months but over 1,200 people are currently waiting 

“From the latest published data, the trust is likely to be ranked fourth highest (worst) in the country for waits over 52 weeks, at 66 per cent. 

“The national median was just 0.3 per cent (mean 8per cent). 

“The January position has improved slightly to 62% as the planned transition of records starts to have an impact. 

“Further phased improvement through backlog reduction is planned from April 2026. 

“The majority of the long waits are for community paediatric ASD assessment or attention deficit hyperactive disorder assessment. 

“The planned transfer of these waits into the mental health services dataset, in line with other providers, as advised by NHSE, will improve the position to around 14 per cent, presenting a more accurate picture.

“The service is commissioned to deliver 26 assessments per month, but receives around 95 referrals, with demand outstripping capacity. 

“A new model has been implemented to increase productivity and volume of assessments that can be completed within commissioned resources, and for the last 19 months the waiting list has been reducing month on month. 

“Digital solutions to further improve productivity and the volume of assessments that can be delivered within current capacity are currently being explored. 

“Trajectory is on track to achieve national standard for referral to assessment within three months (13 weeks) by June 2027. 

“Neurodevelopmental waits are not expected to be recoverable without significant additional investment. 

“However, the data quality improvement work should result in a significant reduction in the proportion waiting over 52 weeks.”