Black Country Autism Spectrum Condition Pathway – Briefing Note

Context: The Black Country Healthcare NHS Foundation Trust (BCHFT), as Lead Provider/Commissioner for Mental Health and Learning Disability and Autism (MH/LDA), has been working with partners to review Autism Spectrum Condition (ASC) diagnostic pathways. This has been driven by the need to address very long waits, variation in pathways across the Black Country, and to make sure children and young people with the greatest clinical needs get timely, safe support.

This note sets out the current position, the rationale for the proposed change, and the safeguards we are putting in place as well as our commitment to work in partnership with PCFs.

Current challenge: CAMHS services are increasingly drawn into ASC-only diagnostic assessments, which is diverting specialist clinicians away from children with severe and complex mental health difficulties.
Risk: This diversion is impacting safety, quality, and waiting times for children who need CAMHS most urgently.
Equity: Families are waiting too long across the system, and the current model is not sustainable.

CAMHS focus: CAMHS would return to its original role — supporting children and young people with mental health needs. CAMHS will therefore provide ASC assessments only where a child has both ASC and significant mental health concerns, as defined in national guidance.
Alternative options: For children with ASC-only presentations, assessments will be available through other providers, including those accredited under the national “Right to Choose” process. The ICB is currently implementing via a local accreditation process, RTC providers who will include face-to-face options delivered locally for those children who require it. RTC providers are NICE complaint and are a recognised NHS pathway subject to the same terms & conditions that our NHS owned providers are.
Continuity of care: Children with the most complex presentations (ASC with significant mental health needs) will continue to be seen within CAMHS by our most experienced clinical teams.

Local involvement: The proposals are not final. Each Place (Dudley, Sandwell, Walsall, Wolverhampton) has task and finish groups reporting into Place-Based Partnership Boards. These groups will work through the local implications with partners and parent representatives.
System process: Because this change impacts more than just CAMHS, it will go through the system’s service change process. That includes full engagement with Health Overview and Scrutiny Committees (HOSCs) and continued dialogue with PCFs.
Additional capacity: Accreditation of new providers is progressing, which will increase access points for families and reduce waits. These providers will offer face-to-face assessment options in the Black Country, giving families more choice.
Shared commitment: Our goal is not to reduce support, but to ensure that children are seen in the right service, by the right professional, at the right time.

Continued engagement with PCFs and local SEND partnerships to shape how this works in practice.
Clear communication with families so they understand their choices and the rationale for the changes.
Formal service change proposals, including local mitigations, will be taken through HOSC and system governance.

Key message

This change is about protecting specialist CAMHS capacity for the most vulnerable children, while widening choice and access for children needing an ASC-only assessment. We will continue to involve parents, carers, and young people in shaping the future pathway to ensure it is safe, sustainable, and responsive.

Update Report to Dudley SEN/D Partnership Board from BC ICB

Sally Roberts, Chief Nursing Officer/Deputy Chief Executive Officer

3rd October 2025

Last updated: 08/10/2025

Black Country Autism Spectrum Condition Pathway – Briefing Note

Why change is being considered

What is being proposed

How we are addressing concerns

Next steps

Key message