Transforming the neurodevelopmental pathway in Lancashire and South Cumbria

Strategic position

Lancashire and South Cumbria ICB has launched a three-year transformation programme to redesign the neurodevelopmental (ND) pathway for children and young people. This initiative addresses key challenges such as:

  • Long waiting times for autism and ADHD assessments
  • Fragmented services and inconsistent post-diagnostic support
  • Inequitable access based on location or diagnosis status

The new model is needs-led and person-centred, focusing on early intervention, multi-agency collaboration, and consistent quality across the region.  This does not mean children and young people will not be assessed, but that needs will be met from the earliest possible stage without a diagnosis being necessary to access support.

Programme structure and governance

The transformation programme is coordinated through an neurodevelopmental programme board and an all-age steering group. Five multi-disciplinary workstreams support the programme:

  • Transformation and waiting list initiative
  • Needs-led support
  • Digitalisation
  • Training and education
  • Communication and engagement

Each workstream includes professionals from health, education, social care, and parent/carer forums.

There are also some short-term task and finish groups:

  • Complex cases and escalation routes
  • Sensory offer development
  • Profiling tool development
  • Development of a Pathological Demand Avoidance (PDA) position statement
  • Digital referral form and pilot

Key developments

1. Service specification and diagnostic hub

  • A draft service specification outlines a single point of referral, triage, and assessment by a multi-disciplinary team
  • A set of minimum standards for assessment and diagnosis have been agreed across the system.
  • A diagnostic hub model is being piloted with integration into primary care and provider systems

2. Digital front door and profiling tool

  • A digital app is being developed to streamline referrals and embed a profiling tool that generates support plans
  • Pilots are due to begin in Blackpool

3. Needs-led support and voluntary sector hubs

  • Voluntary sector support hubs coordinated by Spring North are being commissioned
  • These hubs will act as single points of access and integrate with local authority offers

4. Training and workforce development

  • A multi-agency training strategy is being developed to set minimum standards and upskill professionals
  • Mapping of current training is being completed and joint commissioning is being explored

5. PDA and complex case workstreams

  • A co-produced PDA position statement is in progress, informed by national best practice and lived experience
  • A complex case escalation system has been piloted and is being scaled up

Data and performance monitoring

  • A data dashboard is being implemented to track referrals, waiting times, and outcomes
  • Monthly reporting will support local accountability and inform commissioning

Communication and engagement

  • A central neurodevelopmental webpage has been launched to provide updates and resources
  • Public-facing position statements will be developed to improve transparency

Challenges and risks

  • Funding pressures due to ICB reforms and NHS England scrutiny
  • Procurement law compliance in engaging private providers
  • Variation in local delivery models and provider capacity
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