This page explains who can and cannot be referred to Paloma Health. Please review it carefully before making a referral to ensure your patient is eligible.
Proudly providing NHS services
NHS Right to Choose Autism Referral
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 our NHS Autism assessment service. Please read through this page carefully before making a referral.
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 our NHS Autism assessment service. Please read through this page carefully before making a referral.
Inclusion criteria
We can accept children registered with any NHS GP practice in England.
When making a referral, you are choosing which autism assessment pathway that child is referred into. Your options are:
Fully remote autism assessment pathway
All three 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
Have no diagnosed or suspected learning disabilities, speech and language conditions or selective mutism (these children must be referred to one of our hybrid pathways)
Hybrid autism assessment pathway in Exeter
Two appointments are conducted remotely, with the child observation appointment held in person in Exeter. We can only accept children to this pathway who are:
Aged between their 5th and 18th birthday
Aged between their 2nd and 5th birthday, and have seen a community paediatrician who has recommended an autism assessment
Willing to travel to Exeter, for one in-person child observation appointment
Hybrid autism assessment pathway in Norwich
Two appointments are remote, with one child observation appointment in person in Norwich. We can only accept children to this pathway who are:
Aged between their 6th and 18th birthdays
Willing to travel to Norwich, for one in-person child observation appointment
We offer autism assessments for children from their 2nd birthday, and ADHD assessment from their 8th birthday. If you would like your patient referred for both conditions, we kindly ask you to provide relevant context for each condition in your referral.
Quick reference guide
As a quick reference guide for what pathway to choose based on the child’s age and medical needs:
- Aged 2nd to 5th birthday: If the child has been seen by a community paediatrician who recommends an autism assessment, they can be referred to our Hybrid autism assessment pathway in Exeter only. In line with NHS best practice, we cannot accept referrals for children aged 2-4 who a community paediatrician has not seen.
- Aged between their 5th and 6th birthday: Hybrid autism assessment pathway in Exeter only.
- Aged between their 6th and 8th birthday: Hybrid autism assessment pathway in Exeter or Hybrid autism assessment pathway in Norwich.
- Aged between their 8th and 18th birthday and who do not have a speech and language disorder, a learning disability, or selective mutism can be seen in our Fully remote autism assessment pathway.
- Aged between 8th and 18th birthday who either have a speech and language disorder, a learning disability, or selective mutism, or who prefer in-person, can be seen in our Hybrid autism assessment pathway in Exeter or Hybrid autism assessment pathway in Norwich.
Exclusion criteria
Please review the following exclusion criteria carefully before proceeding with your referral. These criteria apply to our Remote and Hybrid Exeter autism assessment pathways, and we, unfortunately, cannot accept children who meet any of these conditions. Our Hybrid Norfolk exclusion criteria are shown in the Hybrid Norfolk Referral Form (available on request).
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 and Re-assessments: We cannot accept referrals for children with a previous autism diagnosis unless there are explicit clinical concerns regarding the quality or validity of the original NHS, private, or overseas assessment. For children whose previous assessment occurred within the last 2 years, we will review the clinical appropriateness of a re-assessment and will only accept the referral if there is sufficient new information to warrant it.
- Age Restrictions: Children who are under 2 years of age, or who have reached their 18th birthday or older.
- Specific Criteria for Ages 2–4: We cannot accept any child aged 2–4 years old who has not seen a community paediatrician who recommended an autism assessment, or any child aged 2–4 whose overall cognitive development is below the level expected of a typical 18-month-old child (e.g., ability to walk, pick up objects with a pincer grip, press a button to operate a cause-and-effect toy, or look for a hidden toy they saw being moved).
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/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
Refer to our Remote or Hybrid Exeter Pathway
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.
Refer to our Norwich Pathway
If you are an NHS GP in Norfolk and Suffolk ICB please complete the local referral form available via your Intranet.
If you are an NHS GP located outside of Norfolk and Suffolk ICB wishing to refer to our Norwich pathway please contact our support team at paloma.health@nhs.net
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