Proudly providing NHS servicesNHS Right to Choose Autism and ADHD referrals
Thank you for your trust in our service. At Paloma Health, we are committed to supporting families by providing timely and high-quality care.
Paloma Health provides NHS Right to Choose services only. We can accept referrals from any NHS GP within England. Below is the inclusion and exclusion criteria for both our NHS Autism and ADHD assessment services. Please read through this page carefully before making a referral for both services.
Any NHS GP
We accept referrals from any NHS GP practice in England for our Right to Choose service.
From age 8
Combined referrals run from a young person's 8th to 18th birthday.
One referral
Both conditions assessed by one team, with context for each.
Autism Inclusion criteria
Choosing an autism pathway
We can accept children registered with any GP practice in England. When making the autism referral, you will need to choose which pathway the young person is referred into for their autism assessment. Your options are:
hybrid exeter
Hybrid autism assessment pathway in Exeter
Two appointments are conducted remotely, with the young person observation appointment held in person in Exeter. We can only accept young people to this pathway who are:
Aged between their 8th and 18th birthday
Willing to travel to Exeter, for one in-person child observation appointment
hybrid norwich
Hybrid autism assessment pathway in Norwich
Two appointments are remote, with one young person observation appointment in person in Norwich. We can only accept young people to this pathway who are:
Aged between their 8th and 18th birthday
Willing to travel to Norwich, for one in-person child observation appointment
fully remote
Fully remote autism assessment pathway
All three appointments are done remotely via secure video calling. We can only accept young people to this pathway who are:
Aged between their 8th and 18th birthdays
Have no diagnosed or suspected learning disabilities, speech and language conditions or selective mutism (these young people must be referred to one of our hybrid pathways)
ADHD Inclusion criteria
The ADHD side of the referral
We can accept children registered with any GP practice in England. When making a ADHD referral, please ensure the young person meets the criteria below:
Fully REMOTE
Fully remote ADHD assessment pathway
Both appointments are done remotely via secure video calling. We can only accept children to this pathway who are
Aged between their 8th and 18th birthdays
included as standard
Medication titration and ongoing prescribing
Where medication is clinically indicated after diagnosis, we take it on ourselves. You do not need to enter a shared care agreement.
No separate referral required, it follows on from the assessment
ADHD medication pathway
We provide the medication. No shared care needed.
Select a stage to see what we take on and what, if anything, is asked of your practice.
EXCLUSION CRITERIA
Children we cannot accept
We appreciate your review of the criteria, as we want to avoid any potential disappointment for families if they are ineligible.
Prior diagnoses and age limits
Previous Diagnoses: We can accept referrals where a positive diagnosis was made previously (whether NHS or private, in the UK or abroad) if there are clinical concerns over the quality of the original assessment. For children with a previous assessment within the last 2 years, we will review the clinical appropriateness of a re-assessment and will only accept if there is sufficient new information to warrant it.
Age Restrictions: Children who are 7 years or under, or who have reached their 18th birthday or older.
Medical and clinical pre-requisites
GP physical examination. Physical examination has not been completed within the last 6 months (GPs must screen for potential medical causes for the presentation, such as hearing issues or speech and language conditions).
Excluded conditions. Patients who have Prader-Willi Syndrome, 22q11 Deletion Syndrome, Attachment Disorder, Functional Neurological Disorder (FND), or Severe Tics/Tourette's.
Mental health, crisis, and inpatient care
Acute inpatient care. Currently in hospital under the Mental Health Act (1983), or active or recent admission to an Acute Mental Health inpatient unit, 136 suite, or Psychiatric Intensive Care Unit (PICU).
Severe or untreated conditions. Untreated, severe, or complex conditions such as schizophrenia, severe PTSD, psychosis, or active treatment for a psychotic episode.
Suicidal intent and self-harm. Currently active suicidal intent, severe self-harm, or severe unmanaged mental health disorders requiring urgent intervention. This includes recent (past 6 months) or ongoing self-harm requiring medical treatment, harm to others requiring medical treatment, suicidal thoughts, or suicide attempts without a risk management plan in place or being put in place by their GP.
Neurodevelopmental, cognitive, and hearing or vision needs
Cognitive profile. Diagnosis of a Learning Disability, impaired cognitive functioning, or global developmental delay.
Hearing and vision needs. Severely to profoundly deaf children or those who use British Sign Language (BSL) as their first language (these children should be referred to NHS National Deaf CAMHS services).
Legal, forensic, and safeguarding factors
Legal and court proceedings. Individuals involved in ongoing legal cases, police investigations, child protection plans, court assessments, or court proceedings where intervention is not advised under Home Office guidelines.
Safeguarding. Any active safeguarding concerns requiring a Section 47 intervention. In addition, we cannot accept any child aged 2–4 years old with any active safeguarding concern (even if a risk management plan is in place).
Justice system. Currently serving a prison sentence.
Substance use. Active or recent involvement with Drug and Alcohol Services.
How to refer
Thank you for reviewing our criteria
Create a joint NHS referral
Please use the button below to start your referral process. We will notify parents immediately once we receive the referral and let them know the next steps.
Create a referral →Questions about medication or a complex case?
If you are unsure whether a young person meets the criteria for both services, talk to us before you refer. Contact our support team at paloma.health@nhs.net and we will come back to you.
Contact support
