Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the impact of activity management plans on the financial viability of independent providers of ADHD and autism services; and whether they plan to review the national system of spending controls to prevent Integrated Care Boards from pausing referrals to providers who have reached their contracted capacity but have the clinical capacity to treat more patients.

It is the responsibility of integrated care boards (ICBs) in England to make appropriate provision to meet the health and care needs of their local population, including providing access to attention deficit hyperactivity disorder (ADHD) assessment and treatment, in line with relevant National Institute for Health and Care Excellence guidelines.

Patients already have the legal right to choose the provider and team who will provide their elective care in certain cases. These rights extend to any provider in England who holds a contract with an ICB, or NHS England, for the service/s the patient requires, as per the NHS Choice Framework. This includes independent sector providers. ADHD services are already in scope of this legislation.

The Medium-Term Planning Framework, published 24 October, was explicit that ICBs and providers are expected to optimise existing resources to reduce long waits for ADHD assessments and improve the quality of assessments by implementing existing and new guidance, as published.

The NHS Standard Contract, used for the commissioning of all non-primary National Health Service healthcare services in England, includes provision for an indicative activity plan to be agreed between providers and commissioners for each contract year.

This plan provides both parties with a useful tool to plan for the expected demand, capacity, and expenditure for any service. An indicative activity plan is not binding on either party, but if activity carried out is higher or lower than the plan, then either party can work through an activity management process and agree a binding activity management plan to bring activity back in line with the indicative activity plan.