How to Get an Autism Assessment Faster on the NHS

Getting an autism assessment through the NHS can feel like standing at the back of a very long queue with no clock on the wall. Waits of two, three, even five years are no longer unusual in some parts of England. If you are a parent who suspects your child is autistic, or an adult seeking your own diagnosis, that wait can be genuinely harmful: to mental health, to school support, to self-understanding.

The good news is that the queue is not always as fixed as it appears. There are legitimate, underused routes that can significantly reduce your wait. As a GP, I want to explain what they are and how to use them.

Why Are NHS Autism Assessment Waits So Long?

Demand for autism assessments has grown substantially over the past decade. Awareness has increased, referral criteria have broadened, and more adults are seeking late diagnoses. NHS diagnostic services have not expanded at the same pace. The result is a backlog that varies widely by region: some Integrated Care Boards (ICBs) are managing waits of under a year; others are quoting four years or more.

Waits also differ depending on whether the referral is for a child (typically routed through CAMHS or paediatrics) or an adult (usually via Community Mental Health or a specialist neurodevelopmental service). In almost every area, demand outstrips capacity.

Step One: Get the Referral Right First Time

The single most common reason for delay is a referral being rejected or bounced back. This wastes months.

When you speak to your GP, come prepared. Bring specific examples of the behaviours or difficulties you have observed, ideally across more than one setting (home and school, for example, or home and work). Vague descriptions like "struggles socially" are harder to act on than concrete ones: "has significant difficulty with transitions, becomes overwhelmed in noisy environments, has no peer friendships, and teachers have raised concerns in writing."

If you have any supporting evidence from school, an educational psychologist, or a previous professional, bring it. The more your GP can include in the referral, the less likely it is to be returned.

Ask your GP to confirm the referral has been sent and to give you a reference number or written confirmation. Follow up after two weeks if you have not heard anything.

Step Two: Know Your Right to Choose

This is the most powerful tool available to people in England, and the most underused.

Under the NHS Right to Choose (RTC) policy, patients referred for certain NHS services have the legal right to choose which approved provider carries out that treatment. This right is enshrined in the NHS Constitution and regulations made under the Health Act 2012, and it can apply to autism assessments for both adults and children in many parts of England.

In practice, this means you may be able to ask your GP to refer you directly to an RTC-eligible independent provider rather than joining your local NHS waiting list. Several providers have significantly shorter waits, sometimes measured in weeks rather than years.

How RTC applies in practice does vary by area, commissioning arrangements, and the specific pathway involved. Always confirm with your GP and your local ICB whether RTC is available for your situation before assuming it applies.

How to use it:

1. Ask your GP specifically: “I would like to exercise my Right to Choose for this referral.”
2. Name a specific approved provider. Your GP cannot do this for you; the choice must come from you.
3. The provider must be registered with NHS England as an RTC provider for this pathway.
4. If your GP is unsure, ask them to check with your ICB or contact PALS for guidance.

Step Three: Contact Your ICB Directly

Your Integrated Care Board is the NHS organisation responsible for commissioning services in your area. Most ICBs have a Patient Advice and Liaison Service (PALS) and a dedicated pathway for people waiting for neurodevelopmental assessments.

It is worth contacting your ICB to:

• Confirm you are on the waiting list and get your approximate position
• Ask whether any additional capacity has been commissioned (this happens periodically and is not always communicated to patients)
• Confirm whether Right to Choose applies to your specific referral pathway
• Request written confirmation of your wait time, which can be used to support applications for Educational Health and Care Plans (EHCPs) in the meantime

Being proactive does not jump the queue, but it ensures you are not lost in the system and that you have a paper trail.

Step Four: Do Not Wait to Access Support

A diagnosis is not a prerequisite for support in most settings, but many families do not know this.

In schools, a child does not need a formal autism diagnosis to receive reasonable adjustments, to be placed on the SEND register, or to have a request for an EHCP considered. The legal test for an EHCP is whether a child has special educational needs, not whether they have a diagnosis.

Similarly, many local SENDIASS (Special Educational Needs and Disability Information, Advice and Support Service) teams can support families on the waiting list. They are free, independent, and often highly knowledgeable about local provision.

For adults, reasonable workplace adjustments under the Equality Act 2010 can be requested based on functional difficulties, not diagnosis alone.

Document everything while you wait. Keep copies of school reports, teacher emails, GP letters, and any assessments. This evidence base supports both the eventual diagnostic appointment and any applications for support in the interim.

Step Five: Write the Right Letter

Whether you are writing to your GP to request a referral, to your child's school to request an EHCP assessment, or to your ICB to escalate a wait, the content and tone of the letter matters.

A well-structured, factual letter that describes specific difficulties, references the relevant legal frameworks, and makes a clear ask is more likely to get a response than a general expression of concern. It does not need to be aggressive or legalistic, but it does need to be precise.

Many families find this hard to do, particularly when they are exhausted and dealing with a child in distress. That is exactly what refEarly was built for.

How refEarly Can Help

refEarly is a free tool built by a GP to help families and individuals navigate the neurodevelopmental pathway. It provides ready-to-use letter templates for the most common situations: requesting a referral, chasing a wait, requesting an EHCP assessment, escalating to a school, and more.

Each template is designed to be factual, appropriately assertive, and based on the actual legal frameworks that apply in England. You can personalise it with your details and refine the language using built-in AI assistance, then download or copy it in seconds.

It will not get you seen overnight. But it can help you ask the right questions, in the right way, to the right people, and make sure nothing important falls through the gaps while you wait.