OUR AUTISM & ADHD SERVICES
Guide to NHS ICB Frameworks and Local Pathways
If you’re trying to access an Autism or ADHD assessment through the NHS, you may be told that services depend on local NHS pathways or an ICB framework.
The NHS structure can feel overwhelming. Our goal is to handle the complexity behind the scenes so that you can focus on what matters: getting the right support for you or your family.
These services are available via:
NHS
What is an Integrated Care Board (ICB)?
An Integrated Care Board (ICB) is the NHS organisation responsible for planning and funding healthcare services in a local area.
Each ICB:
- Manages the NHS budget for its population
- Decides which services are needed locally
- Commissions services from NHS trusts and approved independent providers
Being part of an NHS framework means Provide Wellbeing has passed quality and safety checks. It is our promise to you that the care you receive meets the highest national standards.
What is a local NHS pathway?
A local NHS pathway is a service that:
- Is funded by the NHS
- Is commissioned by a local Integrated Care Board (ICB)
- Is only available to people who reside in the area and are registered with a local GP practice.
- Requires a GP referral
Local pathways are not part of the national Right to Choose scheme. They are designed to support local demand and reduce waiting times within a specific NHS area.
These local partnerships allow us to tailor our Autism and ADHD services specifically to the needs of families in Essex, ensuring the support we provide is relevant to your local schools and community services.
What does “being on a framework” mean?
When an ICB sets up a service, it often creates a framework or approved provider list.
This means:
- Providers have met the ICB’s clinical, governance, and quality requirements
- GPs can only refer to providers that are approved on that framework
- The ICB has agreed exactly what the service includes
Being “on a framework” does not automatically mean:
- The service is open everywhere
- Right to Choose applies
NHS activity limits for local pathways
When an ICB commissions a local NHS pathway, it also agrees how the service will be delivered within NHS capacity, funding, and waiting time arrangements.
These arrangements are known as Indicative Activity Plans (IAPs).
IAPs help ICBs:
- manage demand across services
- ensure waiting times remain safe and reasonable
- deliver services within agreed NHS standards
In practice, this means that local NHS pathways may operate within:
- waiting time limits
- agreed levels of activity over a set period
This can affect how referrals are managed and how services are scheduled.
We will provide information on any activity limits we must adhere to on our website and when you use our service.
You can also read more about how NHS activity limits work here:
How NHS Activity Limits Work (Indicative Activity Plans)
Why services differ between areas
Each ICB decides:
- Who the service is for (children, young people, adults)
- Which conditions are included (Autism, ADHD, or both)
- Whether the pathway includes:
- assessment only, or
- assessment plus treatment, medication, or follow-up
- How referrals, prescribing, and shared care work
This means that:
- Two NHS services can look different, even if delivered by the same provider
- Some areas may include ADHD medication and monitoring
- Others may commission assessment and diagnosis only
These differences reflect local funding decisions and population needs, not differences in quality.
Why GP location matters
Local NHS pathways are based on where your GP practice is registered and where you live.
This means:
- Two families living in the same town may have access to different services if their GPs belong to different ICBs
- A provider can only accept referrals from GPs in areas where an NHS contract is active
- GPs are not able to refer into services that sit outside their local commissioning arrangements
Your GP practice can confirm which ICB they belong to and which providers are availble.
How local NHS pathways differ from Right to Choose
Although both are NHS-funded, local pathways and Right to Choose work differently.
Local NHS pathways:
- Are limited to specific geographic areas
- Can only accept referrals from local GPs
- Are commissioned to meet local service needs and so what exactly is offered can differ based on your ICB
Right to Choose:
- Is a national NHS right
- Allows eligible patients to choose an approved provider anywhere in England
- Can only be offered by providers with a live, qualifying NHS contract
You can learn more here: Understanding NHS Right to Choose
What this means for families
In practice, this can mean:
- A service is available in one area but not another
- You may be offered a local NHS pathway rather than Right to Choose
- Waiting times and service elements can differ by ICB
We understand that these rules can feel complicated. Our team is here to help you navigate this; we work closely with lCB’s and local GP practices to ensure the referral process is as smooth as possible for you.
What to do if you’re unsure
If you’re not sure which routes apply to you or your child/young person, it may help to:
- Start Here: How to Access Our Services
- View Our Assessment Pathways
- Speak to your GP about local referral options
These steps can help you understand what’s available now, and what may become available later.
TALK TO US TODAY ABOUT
Neurodevelopmental Services
Call 0300 303 9966, email
provide.wellbeing@nhs.net
or complete the form below…
Support you can trust
Our team provides actionable insights, no matter where you are on your journey, and offers expert advice to help you or a family member on your road to a diagnosis. Our ASD and ADHD services are suitable for children and young people seeking a diagnosis.
