On Thursday this week, the Health and Social Care Committee sent a letter to Health Minister Stephen Kinnock. It followed an evidence session on autism and ADHD diagnostic pathways for children and young people held the day before. The letter is not long. But it says something that a lot of people working in SEND have been trying to say for years, and have not quite been able to get heard at the right level.
The diagnosis-led model of support is not working. It cannot work when the waiting lists are this long. And children cannot be left to get on with it while the queue moves.
The Numbers
As of March 2025, there were 137,977 children waiting for an autism assessment in children's mental health services. Up to 316,000 were waiting for an ADHD assessment. That is close to half a million children, and these are not children whose needs are invisible. Their teachers can see them. Their parents are raising concerns. Schools are often already making adjustments. They just have nowhere official to put it.
The evidence the Committee heard was blunt. Henry Shelford of ADHD UK made the point that in some parts of the country, ADHD waiting times now run to five years or more. A child referred at seven may reach secondary school, possibly sixth form, before they are ever assessed. That is not a backlog. That is a system that has quietly stopped functioning for a large number of children, and everyone downstream has had to absorb the consequences.
What the Committee Is Actually Saying
The Committee's recommendation is not, at heart, a clinical argument. It is a practical one. Its letter states that “given the current level of need, which is leaving children unsupported on waiting lists, it is clear to us that the current specialist, diagnosis-led model of support is no longer sustainable.” It calls on the government to move towards a needs-led model, one where early detection and support can happen before, and independent of, a formal diagnosis.
It also recommends that DHSC and DfE work together with Integrated Care Boards to better use the existing generalist workforce, and that the NHS workforce plan address the autism and ADHD staffing crisis directly. Mandatory neurodiversity training for all school staff, it says, should be ready to begin implementation in September 2026.
“A diagnosis has never been the legal precondition for support. But in practice, it has often functioned as one. That is what the Committee is pushing back on.”
Dan Howard, CEO & Co-founder — ProvisionIQ
This matters because the Children and Families Act 2014 already requires schools to support children with SEND regardless of whether they hold a diagnosis or an EHCP. The legal duty to identify and respond to need exists. What has happened over time is that the absence of a formal label has become, not always deliberately, a reason to wait. The Committee is saying that cannot continue.
Where This Connects to the White Paper
The Schools White Paper, published in February, is already pointing in the same direction. The proposed three-tier structure — Universal, Targeted, Targeted Plus, and Specialist — is built around the idea that most children with additional needs should be supported in mainstream settings, with or without a diagnosis. The Individual Support Plan sitting below the EHCP level is explicitly designed to capture provision for children whose needs are real but who may not yet have received any formal assessment.
That is the right architecture. The question, and it is one I think about a great deal, is what it takes for a school to actually deliver on it.
The gap that matters
The White Paper creates the policy framework for needs-led support. The Committee's letter makes the clinical and human case for it. What connects the two is whether schools have the practical means to identify need early, record what they're doing, and review it regularly enough to make a difference. That part is operational, not legislative.
What I See in Schools
I visit a lot of schools. What I see is not schools that do not care, or SENCOs who are not trying hard enough. What I see is schools under enormous pressure, managing large numbers of children with unmet needs, doing their best with whatever tools they have, and often recording very little of it in any systematic way.
When a specialist does eventually get involved — an educational psychologist, a speech and language therapist, whoever gets through the door first — they often spend the opening part of the visit asking questions the school has already answered, because no one has a coherent record of what has already been tried. The child's history lives in the SENCO's memory, or in a string of emails, or in the notes from a review meeting that happened two years and one SENCO ago.
That is not a data problem. It is a child problem. When the knowledge disappears, the child starts from scratch. Every time.
The Practical Ask
The Committee's letter is addressed to government. But there are things schools do not need to wait for legislation, workforce plans, or reformed assessment pathways to do.
What schools can act on now
- 01Keep a live record of every child with emerging or identified needs, not in a spreadsheet that only one person understands, and not in a shared drive that does not survive staff turnover. Somewhere consistent, accessible, and structured.
- 02Record what support is already in place, even informally. If a child is on a waiting list, that is information. So are the classroom adjustments already being made. Write them down.
- 03Review provision at regular intervals, not just when a referral is submitted or a diagnosis arrives. Needs change. The record should change with them.
- 04Brief specialists properly. When someone from outside the school does get involved, they should be walking into a current, coherent picture, not starting from zero because the school has nothing organised to share.
- 05Use the ISP transition as a prompt to audit your current practice. Schools that have consistent SEND records now will find the shift to Individual Support Plans far smoother than those that do not.
A Long Time Coming
None of what the Committee has said is new to anyone who has worked closely with children with SEND. The diagnosis-first model has been creaking for a long time. What is new is that Parliament has said it clearly, in a letter that will require a government response.
That creates an opportunity. The Schools White Paper is already moving the system towards a needs-led, mainstream-inclusive model. The Experts at Hand service is beginning to put specialist support into schools in a more systematic way. The ISP is coming. The training investment is coming.
What cannot wait is the bit that happens before any of that — the quiet, daily work of identifying which children need support, recording what is being done, and making sure that knowledge stays with the child rather than walking out of the door with the last person who held it. That is what ProvisionIQ is built for. And it is what I think this moment in SEND reform is really asking of schools.
Sources: Health and Social Care Committee letter to Stephen Kinnock MP, Health Minister, on autism and ADHD diagnostic pathways for children and young people, 26 June 2026, following oral evidence heard 25 June 2026 (UK Parliament). Waiting list figures from NHS England, cited in the Committee letter. DfE Schools White Paper Every Child Achieving and Thriving, February 2026.