The contractual basis for NHS Right to Choose Indicative Activity Plans (IAPs) is outlined in the NHS Standard Contract 2025/26, which grants Integrated Care Boards (ICBs) authority to set Indicative Activity Plans.

The below principles were considered in making this decision: 

• The legal requirement for Integrated Care Board’s to achieve financial balance over the year 2025/26 and to set affordable Indicative Activity Plans (IAPs) accordingly
• Understanding the impact these decisions will have on waiting lists and patient risk and working collaboratively with providers to mitigate risks
• Completion of a Quality Impact Assessment supported by the Mental Health, Learning Disability & Autism, and Children’s Care Senior Leadership Team
• Reviewing the system transformation plan to ensure it supports the reduction of waiting lists and patient risk in the longer term
• Keeping new developments under review and revisiting this decision should there be any material changes

There is no specific commissioning policy in place for ASD/ADHD assessments, however, NHS Hampshire and Isle of Wight have a transformation programme in place to redesign the pathway. This includes:

• Support before diagnosis: We’re expanding services that offer advice and guidance around Autism and ADHD, including new ways to access help sooner. This includes using digital tools and improving how you receive support from services, as well as making it easier to get advice on medication. We will shortly publish details of how and when people can access these services on our website.
• Strengths and Needs Assessments: By March 2026, every child in Hampshire and the Isle of Wight will have access to a joined-up team of professionals who can offer tailored advice and support. These teams will work across education and healthcare and will be available to anyone with concerns – helping to meet needs while waiting for a diagnosis.
• Redesigning the diagnostic pathway: We’re working to improve how assessments are carried out, including using new technology and making the process of prescribing and reviewing medication more efficient. We will talk with local groups and people who have real-life experience to help shape the design. A new assessment pathway will be designed by March 2026.

While we make these improvements, we are not yet able to give a specific timeframe for when you, your child, or the person you care for will be seen. We know many of you have already been waiting a long time, and we are truly sorry for the delay.

Private assessment can speed up diagnosis, but NHS-funded treatment is not guaranteed afterward.

A private diagnosis is not automatically accepted by the NHS. NHS clinicians may require an NHS assessment before starting treatment, even if you have a private report. This is because the NHS clinician takes legal responsibility for prescribing and ongoing care. Some GPs will accept a private diagnosis under a Shared Care Agreement, but this is at their discretion, and not guaranteed.

Private providers may offer diagnosis only, leaving medication titration and monitoring to the NHS. NHS services, including GPs, are not required to prescribe medication recommended by private providers. This decision will always be based on clinical judgement and NHS prescribing guidelines. If the GP declines Shared Care, you may need to pay privately for prescriptions and follow-up care, which can be costly. NHS guidance states that private and NHS care should remain clearly separate — NHS resources cannot subsidise private care.

NHS Hampshire and Isle of Wight Integrated Care Board (ICB) follow national rules that make sure more money is spent on mental health services as overall NHS funding increases. This means there is a protected budget each year specifically for mental health care.

Autism is only included in the Mental Health Investment Standard (MHIS) when there is a co-occurring mental health need. Services for autistic people without a diagnosed mental health condition are not counted under MHIS spending and therefore do not receive the same level of ring-fencing.

As part of the NHS planning cycle we will review all of our priority areas to ensure available funding is allocated to where it is needed most. In addition to diagnostic assessment services, supporting patients prior to their diagnosis and after diagnosis is a key priority area and we have a number of transformation programmes underway to greater meet these needs.

A significant focus in recent years has been on the Autism diagnosis pathway, and we are moving to a needs-led approach to provide early help and a holistic approach to improving outcomes.

For Children & Young People:

• By March 2026 every child in Hampshire and the Isle of Wight will have access to the following universal offer:
• Single point of access; Front door to an Integrated Multidisciplinary Team (MDT) with expertise in Neurodivergence, who are accessible and open to anyone who has a concern.
• Information and advice: Different levels of information (self-help) and advice (options and pathways) with all messages and information managed by the Neurodivergent MDT.
• Early identification and support (parents / carers); Parental support, ND online platform and toolkit, contact line, small group training and workshops, peer support.
• Early identification & support (professional & wider workforce); ND profiling tool, training and development, Autism in Schools project, Partnership for Inclusion of Neurodiversity in Schools, whole-school audits, ND Champions, community of practice

For Adults:

• There is an existing Autism and ADHD information, advice, and guidance service across Hampshire and the Isle of Wight, delivered by Autism Hampshire. This service currently includes a community hub in Southampton.
• In addition, two community hubs in have been piloted since October 2024, providing support, advice, and resources to adults regardless of diagnostic status — including those who are pre-diagnostic, without a formal diagnosis, and those with a confirmed diagnosis.
• The hubs are located in Andover (Our Community Hub | More Education) and Havant (ADHD and Autism Support Service – Havant & East Hants Mind).
• The Integrated Care Board has agreed to adopt the community hub model for autistic people, individuals with ADHD, and those who are otherwise neurodivergent — including people without a formal diagnosis — across Hampshire and the Isle of Wight. We have just concluded a procurement exercise to secure a more consistent offer across the Hampshire and Isle of Wight, which will commence April 2026.
• We are working to improve the visibility and promotion of these services.

There is no protected national funding for the provision of services to autistic/neurodivergent people. However, such services being a key local priority for Hampshire and Isle of Wight, a dedicated budget has been allocated to help improve them. In 2025/26 £1m of this new money has been invested in establishing strengths and needs assessments aimed at providing individualised support for children, young people and their families across education and healthcare. During the same period the ICB has funded a 167% rise in spending on diagnostic services for autistic people and those with ADHD

Any patient with a co-occurring mental health need and therefore being supported by our mental health services will have a named co-ordinator and/or responsible clinician if appropriate. We have also expanded our Learning Disability and Autism Key-worker service in 2025/26. This means that any individual on our Dynamic Support Register up to the age of 30 will be allocated a named Key-worker or Intensive Support Practitioner.