The demand for autism and ADHD assessments in Norfolk has skyrocketed, with new figures revealing a dramatic 130% increase in referrals over the past four years. In 2024, 5,719 children were referred for assessments, compared to just 2,795 in 2021, according to NHS officials.
This surge in demand has created a significant backlog, with some children waiting more than six years for a diagnosis—almost half their time in education. This has raised questions about the causes of the increase and whether the conditions are becoming more common, or if greater awareness and demand for support are driving the trend.
Experts suggest that the rise in referrals may be attributed to better recognition of these conditions by parents and teachers, who are eager to secure support for children with special educational needs and disabilities (SEND). The COVID-19 pandemic, which saw some services suspended, may also have contributed to the current backlog.
However, there is debate among some professionals who believe that conditions like autism and ADHD are becoming overdiagnosed.
The surge in referrals is placing considerable financial pressure on Norfolk County Council, as a diagnosis often qualifies children for extra SEND support, which the council is legally required to provide. Despite this, council leaders emphasize that children can receive support based on their needs, even without a formal diagnosis.
A report by Norwich North Labour MP Alice Macdonald has drawn attention to the delays in assessments, urging the government to reform a system that she describes as “broken.” The report highlights the growing backlog, based on feedback from nearly 100 constituents in her area. Norfolk County Council is already issuing more Education, Health, and Care Plans (EHCPs) than most other regions in the country, with the number of EHCPs rising by more than 1,000 last year.
Growing Pressure on NHS Services
The NHS Norfolk and Waveney Integrated Care Board has noted the strain placed on its diagnosis services, which have seen a 130% increase in referrals over five years. Between 2021 and 2024, the James Paget University Hospitals NHS Foundation Trust saw referrals double from 1,271 to 2,599. Similarly, the Norfolk Community Health and Care NHS Trust reported an increase from 1,524 to 3,120 referrals over the past three years.
Lisa Nobes, Executive Nursing Director at the NHS Norfolk and Waveney Integrated Care Board, acknowledged the increased demand and backlog, stating, “We are working closely with Norfolk County Council and other partners to introduce a new, holistic, needs-led support offer for children and their families.”
A recent survey by Macdonald found that 88% of respondents had experienced significant delays in obtaining diagnoses or EHCPs. The council aims to issue EHCPs within 20 weeks of a request, but it is currently only meeting this target in 62% of cases, though this is an improvement from 56% and is better than the national average.
Frustration Among Parents
Macdonald has spoken to parents who reported distressing experiences, with some children left without a diagnosis for up to five years, leading to issues such as bullying, social isolation, and deteriorating mental health. To bypass the lengthy wait times, some parents have turned to costly private assessments.
“Families are being left in limbo, and we need a whole system reset,” Macdonald said, emphasizing the need for reform. Her report includes recommendations for long-term, sustainable funding for SEND services, increased specialist provision in Norfolk, and improved communication between the council and parents.
Financial Impact on Norfolk County Council
The increase in demand for SEND support has had a significant financial impact on Norfolk County Council. The number of children with EHCPs has risen sharply, contributing to an expected debt of £180 million by next year. Council leaders argue that the government is not providing enough funding to cover these costs, and promised reforms to the system have been delayed until next year.
The issue of SEND funding is a growing national concern. The government has recently announced an additional £3 billion to create more SEND places, funded in part by cancelling some planned free schools. However, the announcement did not address the existing debt faced by Norfolk County Council.
Penny Carpenter, Norfolk County Council’s Cabinet Member for Children’s Services, said, “We agree the national system isn’t working, and we have been lobbying for reform. It’s crucial to stress that a diagnosis or EHCP is not required for children to receive support in mainstream schools.”
Carpenter also noted that the council has introduced more support for parents through its SEND and Inclusion Support Line and is working to improve services and communication. However, she called for urgent national action to address the growing need for SEND services and to adapt mainstream education to better support children with special needs.
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