Search
The case for end-to-end neurodevelopmental care
Neurodevelopmental pathways across the NHS are facing sustained pressure. High referral volumes, long waits and variations in how services are delivered are creating inequity and increasing avoidable demand across primary and secondary care.
While accurate diagnosis is essential, the full benefit to patients comes from pathways that combine thorough assessments, structured post-diagnostic education, thoughtful medication planning, and regular review. Remote delivery through digital platforms enables these pathways to be delivered safely, at scale and sustainably, supporting the NHS in meeting growing demand.
The system challenge
ADHD and autism services continue to see unprecedented demand. As of mid-2025, more than 230,000 people were waiting for autism assessments, with similarly large ADHD backlogs. Estimates indicate there are around 316,000 children waiting, and many adults face extremely long waits, in some cases over three years to be seen.
National reviews, including the independent ADHD Taskforce, highlight significant variation how services are delivered across the UK. This impacts patient experience, increases rework and makes it harder for systems to plan. NHS England is clear that digitally enabled, scalable and joined up pathways are essential to meet rising need.
Why a diagnosis alone is not enough
Diagnosis is only the first step. Without structured post-diagnostic support, patients and families can experience uncertainty and may need to return to primary care to fully understand their condition and its impact on daily life. Providing comprehensive follow-up helps reduce pressure on services while supporting better outcomes.
The Royal College of Psychiatrists emphasises that post-diagnostic education is central to safe, effective ADHD pathways. Evidence in autism also shows that people strongly prefer practical, ongoing guidance over signposting alone. Without this foundation, expectations become unclear, anxiety increases and shared care arrangements can become unstable. Post-diagnostic education is central to safe, effective ADHD pathways and helps ensure confidence and sustained wellbeing for patients.
Effective neurodevelopmental care pathways should include:
Psychoeducation is a clinically recognised intervention. It helps people understand their condition, develop self-management skills and engage with their pathway with more confidence. It also reduces unnecessary contact with clinicians and improves flow through services.
For autism, research consistently shows that adults benefit from structured, practical information that supports daily routines, communication and emotional regulation. For ADHD, psychoeducation prepares people for medication discussions, monitoring and review. It also prevents repeated requests for basic information and supports smoother transitions between services.
Medication can be effective for many people with ADHD. NICE recognises stimulants as first‑line options when symptoms cause significant impairment, supported by regular monitoring and review. This ongoing oversight helps ensure that the treatment continues to be appropriate and that any adjustments are made in a timely way. However, medication is not the right option for everyone. Decisions should reflect cooccurring conditions, personal preference and how symptoms affect day‑to‑day life.
In autism pathways, medication does not treat autism itself. People benefit instead from clear information, structured guidance and practical strategies that help them navigate daily challenges. When medication is used, the best outcomes are achieved when it is part of a broader plan that also includes education and practical support
Neurodevelopmental needs shift as people move through different life stages. School transitions, employment changes and evolving routines all bring new challenges. Evidence shows that autistic adults and people with ADHD often need guidance as circumstances change particularly around mental health, work and relationships.
Pathways should therefore support capability and confidence across the life course rather than offering one diagnostic moment of clarity with no ongoing support.
Designing end-to-end pathways for safe, scalable and sustainable care
Effective neurodevelopmental pathways support people before, during and after diagnosis. Strong models typically include:
- Coordinated assessments and structured post-diagnostic education in line with NICE guidance
- Clear, structured psychoeducation that reduces anxiety and supports engagement
- Safe and consistent medication reviews aligned with NICE guidance
- Cross-sector collaboration across primary care, secondary care and community partners Digitally enabled delivery that improves access to the same quality of care and reduces system pressure Together, these elements improve flow and strengthen readiness for shared care. They also help people understand their diagnosis and navigate daily life with greater stability.
Expert perspective
Eleanor Norman, Xyla’s Head of Service Development for Neurodevelopmental Disorders and Mental Health, is a registered mental health nurse with more than twenty years of NHS experience across ADHD, autism and community pathways. She describes the importance of clarity and continuity:
“People should not feel like they fall off a cliff after diagnosis. Clear education reduces uncertainty, helps clinicians focus on the work that genuinely needs their input and supports smoother movement through services. Medication can help many people with ADHD, but it should sit within a broader plan that gives people practical strategies for everyday life.”
How Xyla supports NHS partners
Xyla works alongside the NHS to provide end-to-end support across ADHD and autism pathways. We help systems increase capacity, reduce waiting lists and deliver consistent, high-quality care from assessment through ongoing management. Our role is to strengthen statutory services, not replace them, ensuring patients receive safe and continuous support at every stage of their journey. We provide a complete pathway offer that includes:
- Assessment and diagnosis delivered by experienced multidisciplinary clinicians using gold standard tools and NICE aligned protocols disciplinary‑disciplinary
- Medication initiation and reviews where appropriate, supported by clear guidance, monitoring and preparation for shared care pathways
- Structured post diagnostic education for adults, young people and families to support understanding, confidence and self-management
- Psychoeducation and practical strategies for routines, communication, emotional regulation and daily living
- Ongoing support and signposting that helps people remain engaged with their care and reduces avoidable primary care contact
- Digitally enabled care delivery that improves access, protects clinical capacity and reduces demand
Our services integrate seamlessly with local processes through collaborative planning with ICBs, trusts and primary care partners. This alignment ensures our contribution enhances existing pathways and supports system‑wide flow.
The case for investment
End-to-end neurodevelopmental care is better for people and better for the system. Integrating assessment, education, balanced medication planning and ongoing reviews creates safer, clearer and more sustainable pathways. ‑
For ICBs, clinical leads and primary care partners, commissioning structured post-diagnostic support is a practical and impactful way to reduce pressure and improve outcomes.
Learn more about Xyla’s neurodevelopmental services.
Partner with us to improve access to early diagnosis
Connect with our team to explore how insights from established neurodevelopmental services can help you build capacity, strengthen pathway performance and deliver meaningful improvements while demand continues to rise.
Fields marked with an * are required.
Related Stories
Share this article
Contact us
Have any questions about our services? Whether you’re wondering about how we can help your health goals, or assist your healthcare organisation, we’d love to hear from you.
Get in touch