Access Pathway
What an Access Pathway is
The Access Pathway is the route for children and young people (up to their 18th year), where support has already been accessed and tried, but further multi-disciplinary discussions may be required. This informs any extra intervention or specialist assessments needed, for example Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD).
This includes children and young people with needs across:
- speech
- language and communication
- social interaction
- learning difficulties
- sensory difficulties
- neurodevelopmental difficulties
You may also see social, emotional and mental health difficulties alongside these.
Referral and next steps
Referrals to the Access Pathway can be made from any health, education or social care professional. Referrals should be made jointly with you and your child and led by the professional who knows your child the best.
This will ensure that they are able to provide an accurate picture of your child and their needs, including detailed information on what support has been put in place for them since the concerns were first noticed. For example, if you and your child are involved with Early Help, it is likely that your Families First Practitioner will support you through the referral process.
If your child is accessing the School Nursing Service, the School Nurse may do this. Additionally, if your child is accessing education, it may be a professional within the nursery, school, or college who knows your child best.
If you are unsure who may be the best person to support you with this referral, please contact the Access Pathway Team on the details below and they will be able to provide additional guidance and advice.
The professional who completes your Access Pathway referral can access the Access Pathway Referral Form (Word, 315KB) .
If your child’s needs have already been discussed at panel and the recommendations have been implemented, however the concerns still remain you may request a review. In the first instance it may be helpful to discuss this with the author of your original referral.
If they are no longer involved with you and your child, any professional who knows your child well can request a review at Panel. You can also contact the Access Pathway Coordinator for advice or to request this review yourself.
The professional requesting the review can do so by completing the Access Pathway Review Form (Word, 25KB) .
- Your referral screened. This happens within two weeks of us receiving it.
- A letter confirming referral status sent out to you. This happens within three weeks of referral coming into the inbox. The new referral form asks for a preferred method of communication, such as email which may mean correspondence is quicker than via the post.
- The approximate average waiting time from receiving the referral, to panel is 22 weeks.
- Letter confirming panel date is sent out to Parent/Carer. You will receive this within two weeks of your panel date.
- Pre-panel consultation completed with parent/carer or young person one to two weeks prior to panel. This is either completed via an electronic questionnaire sent via email or via telephone consultation.
- Contact made with parents by author or representative at panel with the recommendations following panel. AP coordinator if no author.
- Letter of recommendations sent out to parent. This is done within two weeks after panel. Copies are also sent to services involved with children and young people and family.
- Any onward referrals made within two weeks after panel.
As with any service, the length of time it takes us to move through the process is affected by demand and the number of referrals that we receive. If any parent or professional would like an update regarding the status of a referral please make contact with the team who will respond to you within five working days. Contact (01472) 323998 or email access-pathway@nelincs.gov.uk.
We have been working with parent carers on an ongoing basis to improve the Access Pathway.
We updated the referral form and Access Pathway section on the NELC Local Offer to clearly articulate ‘What happens and when?’ and to signpost to local support services. Support services are also advertised on the Local Offer.
We appointed an Access Pathway Coordinator (ACP) to help navigate referrals, information, advice and guidance Access Pathway information is included as a banner on the Local Offer home page and all pages to make it easier to find.
There’s a lot more. Read about what we’ve done on the Access Pathway, You said, We did document.
Check the Access Pathway Access Pathway. You said, We did (Word, 22KB)
If you would like to work with us then please email nelccg.fmhd@nhs.net.
Frequently asked questions
No. If your child has a need that can be met via a single service e.g. Young Minds Matter for support with a mental health issue, a direct referral to that service should be made and you do not need to go via the Access Pathway.
No, currently you cannot self-refer. However, we are working to develop an enhanced model which will include a parent carer referral option.
We would advise you to follow these four steps before making a referral
- Raise concerns about child/ young people with a significant professional (Health Visitor/ SENCO/ Class Teacher). This should be professional that knows the family well, as they will have to provide information in the referral, if and when you feel that is appropriate.
- Or If Parent carers do not feel comfortable speaking with a significant professional or feel that they would not support the request for a referral please contact the Access Pathway Team on 01472 323998 or email access-pathway@nelincs.gov.uk for further advice.
- The significant professional should support the parent/carer to access additional help and support through the local offer where you can find information and advice about common difficulties such as sleep support and together commence the implementation of the graduated response starting with universal provision (cycle 1). The graduated approach aligns the assess, plan, do and review process with the expectations from the SEND Code of Practice.
- After the first cycle of assess, plan, do and review if no progress is evident targeted provision should be implemented which may include working with Specialist SEND practitioners such as Specialist Advisory Services, Educational Psychologist and Mental Health Services.
- Following intervention (Cycle 2) where concerns remain a multi-agency discussion maybe required by the access pathway to provide an individualised plan of support and further recommendations for CYP, Parent/Carer and significant professionals. The Panel may also suggest further intervention or specialist assessments, for example Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD).
No. GPs have reported that in their limited time with the child and their family, it can be hard to make the decision to refer for an assessment. Some GPs also acknowledge that they do not have in-depth understanding of neurodevelopmental disorders or know the child well enough to complete the referral form.
Consider following these 4 steps before making a referral
- Raise concerns about child/ young people with a significant professional (Health Visitor/ SENCO/ Class Teacher). This should be professional that knows the family well, as they will have to provide information in the referral, if and when you feel that is appropriate.
- Or If Parents/carers do not feel comfortable speaking with a significant professional or feel that they would not support the request for a referral please contact the Access Pathway Team on 01472 323998 or email access-pathway@nelincs.gov.uk for further advice.
- The significant professional should support the parent/carer to access additional help and support through the local offer where you can find information and advice about common difficulties such as sleep support and together commence the implementation of the graduated response starting with universal provision (cycle 1). The graduated approach aligns the assess, plan, do and review process with the expectations from the SEND Code of Practice.
- After the first cycle of assess, plan, do and review if no progress is evident targeted provision should be implemented which may include working with Specialist SEND practitioners such as Specialist Advisory Services, Educational Psychologist and Mental Health Services.
- Following intervention (Cycle 2) where concerns remain a multi-agency discussion maybe required by the access pathway to provide an individualised plan of support and further recommendations for CYP, Parent/Carer and significant professionals. The Panel may also suggest further intervention or specialist assessments, for example Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD).
Paediatricians have reported that they have limited time with a child and their family, to coordinate a referral for the access pathway. Paediatricians also acknowledge that they do not know the child well enough to complete the referral form and provide the evidence or supporting information required.
We suggest the following 4 steps have been implemented before a referral is coordinated.
- Raise concerns about child/ young people with a significant professional (Health Visitor/ SENCO/ Class Teacher). This should be professional that knows the family well, as they will have to provide information in the referral, if and when you feel that is appropriate.
Or If Parents/carers do not feel comfortable speaking with a significant professional or feel that they would not support the request for a referral please contact the Access Pathway Team on 01472 323998 or email access-pathway@nelincs.gov.uk for further advice.
- The significant professional should support the parent/carer to access additional help and support through the local offer where you can find information and advice about common difficulties such as sleep support and together commence the implementation of the graduated response starting with universal provision (cycle 1). The graduated approach aligns the assess, plan, do and review process with the expectations from the SEND Code of Practice.
- After the first cycle of assess, plan, do and review if no progress is evident targeted provision should be implemented which may include working with Specialist SEND practitioners such as Specialist Advisory Services, Educational Psychologist and Mental Health Services.
Following intervention (Cycle 2) where concerns remain a multi-agency discussion maybe required by the access pathway to provide an individualised plan of support and further recommendations for CYP, Parent/Carer and significant professionals. The Panel may also suggest further intervention or specialist assessments, for example Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD).
If a referral form is declined by the Access Pathway, the Access Pathway team will advise you on the next steps for the family. This may be a single service referral; early help support, signposting to other services or advising a period of watchful waiting before progression is made to the Access Pathway
The timeline will vary throughout the year according to how many referral forms are submitted e.g., the average timescale last year (20/21) where referral forms are submitted with relevant information and additional information to be discussed at the multi-agency panel was 22 weeks. We have also seen referral increases by up to 48% over the last two years during the pandemic.
Please bear in mind that this timeline starts once the referral form is complete and all information has been collated and you have received an accepted letter. If the referral form is not complete or there is information missing when it is submitted, team the author/ lead professional will be advised that they need to provide this information before a decision can be made on whether the referral needs to go to Access Pathway and this will take additional time.
Waiting times vary and can increase due to several reasons:
- high number of referrals
- increase in requests for reviews
- unforeseen circumstances
Additional panels are held over the year to cover the ones that do not take place during the school holidays which may impact on a temporary fluctuation in waiting times throughout the year.
Queries should be directed to the author/ lead professional (the professional who is helping your family to complete the referral form). They can help to guide you through the process and answer any queries you have. If they are unable to answer your query, the author/ lead professional can contact Access Pathway Business Support on access-pathway@nelincs.gov.uk or 01472 323998
No, whilst the panel is for professionals, the voice of the child or young person and the family is very important. Therefore, we recommend that you express your views and concerns to your lead professional as part of the referral form.
The Access Pathway Team will also contact you up to two weeks before the panel meeting to gather any additional information or views that you or your child/ young person would like to share with the panel.
The author/ lead professional is invited to attend the panel and can put forward anything that you would like them to know about your child or family. The recommendations of the panel will be shared with you following the meeting.
Panel members receive the referral and additional information prior to panel taking place. Panel members spend a significant amount of time reading an reviewing this prior to panel.
The length of the discussion varies depending on the individual case and the complexities and needs of the individual child or young person. 30 minutes is allocated per case however where more complex cases are presented discussions will last longer.
At the end of the discussion the chair asks the author to feedback the discussion and recommendations of the panel to parent carers as soon as possible.
The decision and recommendations of the panel are written up and sent to parent carers via email/post as they have requested.
For the panel to make an informed decision and work towards the best outcome for your child/young person, it is really important that they have as much information as possible. This will include the voice of the child and family as well as any recent reports from schools or professionals that work with your family. The panel will make recommendations to access support or highlight a need for further observation or assessment.
It is also very important that the recommendations suggested by panel are followed up by the family in partnership with the author/lead professional.
No. Support is available for families, and you don’t need a diagnosis to access it. As part of the process of collecting information, the author/ lead professional may suggest sources of support for your child or family. Parents and families can ask for advice from the Access Pathway team or access the drop-in sessions at the Family Hubs.
No.
Your child will be the same child after any neurodevelopmental assessment as she or he was before, with the same individual strengths, personality, and challenges.
The main focus following a diagnosis is to enable children/young people and their families to understand how a neurodevelopmental disorder impacts on their daily lives and how to use strategies to support them more effectively.
In NEL we have a range of support programmes you can access whilst you are waiting which can be found on the local offer.
Information about where you may get advice and support from is available the Access Pathway webpage which is part of the Local Offer website.
Yes. The special educational needs and disability code of practice: 0 to 25 years, (January 2015) provides statutory guidance on duties, policies and procedures and relates to children and young people with special educational needs (SEN) and disabled children and young people. It states that:
6.1 – All children and young people are entitled to an appropriate education, one that is appropriate to their needs, promotes high standards and the fulfilment of potential. This should enable them to:
- Achieve their best
- Become confident individuals living fulfilling lives, and
- Make a successful transition into adulthood, whether into employment, further or higher education or training
6.2 – Every school is required to identify and address the SEN of the pupils that they support. Mainstream schools must use their best endeavours to make sure that a child with SEN gets the support they need – this means doing everything they can to meet children and young people’s SEN; for example, a diagnosis does not tell you what help a child with social communication difficulties may need at school. All children are unique individuals in terms of their strengths and needs, and those with additional difficulties are no different.
It is the school and other SEN services who can provide the right help, by assessing the child’s learning needs and putting in place strategies based on these. Children do best when schools and parents work closely together – the school’s Special Educational Needs Coordinator (SENCo) is usually the main point of contact between parents and schools.
No.
All schools receive extra funding to help make special educational provision for children with additional needs and should be making every effort to meet individual needs.
EHC Plans were brought into the SEN system to support children and young people with significant additional needs, regardless of whether they have a diagnosis or not. Having a diagnosis for your child will not guarantee they are granted an EHCP. More information about your school’s policies can be found on their individual website.
Further information on EHCPs can be found on NELC Send Local Offer or alternatively the Council For Disabled Children have developed a user friendly clip.
No.
The Department for Education (DfE) for primary school pupils, and the Joint Council for Qualifications (JCQ) for secondary school pupils, publish detailed regulations and guidance on examination access arrangements and reasonable adjustments for pupils with identified needs.
Schools use these regulations and guidance and their knowledge of their pupils, to determine whether special arrangements need to be made for specific individuals. A diagnosis is not necessary in order to make such decisions.
If support is in place on a daily basis for a child, it is expected that this will be considered, but it is not automatically guaranteed in a test setting/situation.
No.
As part of the specialist assessment process, it is important to understand what strategies are being used to support your child and how they may help.
The specialist assessment team are highly skilled and trained in working with children and young people with a range of neurodevelopmental disorders and how it presents differently in each individual. However, you may want to consider the added value a diagnosis may or may not bring to your child and your family. If the support is already helping, you may want to consider if the diagnosis will change anything.
Decisions to exclude a pupil are not made on the basis of whether or not a child has a diagnosis, but on a wide range of factors. Schools are required to support children with additional needs by making reasonable adjustments such as adapting the curriculum and learning environment.
There is statutory guidance on the exclusion of pupils from school, which sets out the legal responsibilities of schools, governing bodies, and local authorities. Rigorous processes are in place, and parents/carers have the right of appeal against the decision to exclude, including access to an independent review panel, with the involvement of a Special Educational Needs expert.
However, it is important to acknowledge that some children with a diagnosis may be excluded and it may be that the school environment (for example physical, social, sensory factors) is not appropriate for them.
Yes.
DLA for children and PIPs are awarded based on a person’s needs in comparison to another person of the same age. There are set eligibility criteria and thresholds which apply, regardless of a diagnosis.
Many people with neurodevelopmental disorders would not qualify for these benefits as they are able to go to school/work, take care of themselves and need very little support from others. It is worth checking the criteria to see if your child might qualify given his or her individual circumstances. The following website provides further information: Disability Living Allowance (DLA) for children: Overview – GOV.UK (www.gov.uk)
There should be no reason why a private assessment and diagnosis should not be recognised by health services, the Local Authority and/or education settings, as long as the private/ independent assessment can clearly evidence that it has followed National Institute for Health and Care Excellence (NICE) guidance.
An assessment for a neurodevelopmental disorder usually includes:
- reports for all settings (e.g. school, nursery)
- a medical history that includes developmental and family history
- observations in more than one setting
- communication, behaviour and mental health assessments
- a physical examination
- tests and assessments for other conditions where appropriate
It is recommended practice that the provider for locally commissioned specialist assessments would review a private/ independent assessment to ensure they have followed NICE guidelines.
You do not have to go on a parenting course before a referral is made to the Access Pathway.
We have reviewed the parenting offer in the Family Hubs and the way it is offered. Before you attend a course it is advisable for you to have a conversation with a Families First Practitioner where you can discuss with them any challenging behaviours that are concerning you at home. Jointly you can then agree what support is needed and whether you want to access support on an individual basis, in a group or by attending a structured workshop/ course.
We want to re-assure you that when we recommend an Evidence Based Parenting Programme we are not saying you are a bad parent but that by accessing this resource you may learn new approaches and strategies that maybe beneficial to you and your family.
Whether your child has a neurodevelopmental disorder or not these behaviours will still be present and therefore the knowledge and skills you may gain from these programmes may support your confidence, skills, knowledge and understanding to build a strong and positive family life. And they are a great way to meet other parents in similar situation.
Parents have told us that being part of a workshop group is often invaluable. Learning from others experiences and getting hints and tips from other parents as part of the discussions is ‘wonderful and refreshing’ and other parents get you and know what you are going through.
Parenting programmes can also help you to learn:
- Useful parenting strategies
- Understand how to best support your child’s development
- Help to manage common behaviour problems
- Address common situations that may arise
A range of qualified and experienced professionals from Children’s Services deliver these courses including.
- Family Hubs
- Children’s Disability Services
- Specialist Schools
Once a parenting programme has been completed there needs to be a period of time to use and embed the strategies that have been gained at home (we recommended that this should be approximately 6 weeks after finishing the course).
If there are still ongoing concerns and/or difficulties after this time period, then parent carers should speak to your Families First Practitioner or lead professional who can support you to identify next steps or access further specialist support through the SEND local offer.
Getting support now
There are a range of things that you can use to get support now.
This includes services like the Carers Support Centre who offer a range of interventions, peer support and more, online and face to face training and events as well as help for emotional wellbeing and mental health for both you and your child.
Learn more. NELC SEND Local Offer | Getting support now (nelincs.gov.uk)
Contact us
If you have any queries please contact our Access Pathway Team on (01472) 323998 or email access-pathway@nelincs.gov.uk.
You’ll have a response from us within 5 working days.
Further information
Please see below additional information that may be useful to your and your child.
- Access pathway process explained (PDF, 292KB)
- ADHD Assessment Leaflet (PDF, 100KB)
- Appeals and Feedback process (PDF, 485KB)
- Specialist screening, assessment and diagnostic performance data – Over 5’s for ASD and ADHD (Word, 2MB)