Analysis of the impact of socio-demographic or clinical factors on wait times for neurodevelopmental assessments in children, across the Northwest

Purpose This study looked at the impact of socio- demographic factors on the waiting times for children and young people waiting for neurodevelopmental assessments in a region of England. Neurodevelopmental conditions are defined as Autism, ADHD, Foetal Alcohol spectrum disorder, Intellectual disability and Tics/Tourette’s 2019. This study aims to consider what influences wait times to manage demand. Design/methodology/approach This retrospective cohort study was conducted on all Children and Young People (CYP) (aged 0–19) in Cheshire and Merseyside between September 2021 and October 2023. Individual-level data on CYP was captured from routine health-care datasets from NHS Digital Emergency Care Data Sets (ECDS), Secondary Uses Services (SUS) and Mental Health Services Data Set (MHSDS). All data was processed in R (version 3.6.1) for statistical analysis. The relationship between referrals to mental health services, patient demographics and variables (as described above) was evaluated to determine potential risk factors on wait times and additional mental health planned and unplanned events. Findings Girls were found to be referred at a later age for neurodevelopmental assessmentcompared to boys. Those living in a less deprived area and being refeered to a neurodevelopmental team (rather than an autism team) were significantly associated with a shorter waiting time to assessment. Being referred by Local Authority and Public Health Services was found to be associated with being less likely to be seen within 91 days. Of interest is the finding that a higher number of A and E attendance for mental health emergencies was significantly associated with a shorter time to autism or ADHD assessment. Research limitations/implications Limitations include the data quality and access. The code for neuro-developmental team was used differently in different places/ local government areas across the wider health region ICB. Practical implications There were major issues with data quality and diagnoses coded as ID and FASD, which are largely underrepresented in health data sets. While CYP with an ID diagnosis are coded within the primary care LD QOF, the authors found no CYP coded with an FASD diagnosis in the data set included in this work. Originality/value This study has found that socio-economic factors such aslevel of deprication in a specific area, type of assesment, type of team refer to (autism team vs neurodevelopmental team), assesment and the number of presentations for mental health need in A and E departments are significantly associated with having shorter or longer waits for neurodevelopmental assessment.