Cheshire and Merseyside neurodevelopmental pathway for children and young people: GP Practice Update

Below is an update from Cheshire and Merseyside ICB regarding the neurodevelopmental pathway for Wirral children and young people.

Key Messages:

The current Cheshire and Merseyside Neurodevelopment Pathway for Children and Young People

The Cheshire and Merseyside Neurodevelopment Pathway for Children and Young People was launched in June 2025 and is in the process of being rolled out across Cheshire and Merseyside. Wirral Place are further on with this work as the most progressed early adopter site, with the other 8 Places at varying stages of progress. Each Place is now working with partner agencies and key stakeholders to establish a programme of work to drive forward implementation of the new pathway and supporting tools.
Under the new pathway, the aim is that all children and young people with neurodiversity will be supported, through their educational setting and/or key professional, to access an early help offer (commissioned by the ICB and Local Authority), using the Cheshire & Merseyside ‘This Is Me’ profiling tool. This is currently being rolled out across Cheshire and Merseyside during the 25-26 school year and will be completed by the educational setting and/or key professional with the child/young person and their family to develop a shared understanding of the child’s needs and strengths across up to 10 dimensions.
Not all neurodivergent children will meet thresholds for an individual neurodevelopmental diagnosis, so the new pathway will focus on meeting needs first without waiting for diagnostic assessment.
Most children will have their needs reviewed every 12 weeks. Where the child/young person needs a diagnostic assessment, they can be referred for a neurodevelopmental assessment by their educational setting or key professional and the ‘This Is Me’ profiling tool, once rolled out, will form part of the referral documentation. Within each Local Authority area, referrals will be triaged to see where and how their needs are best met. Community support will continue to be offered throughout the pathway whether children are progressed to assessment or not.
All Cheshire & Merseyside NHS Providers are now utilising a standardised stratification/prioritisation tool to ensure those children/young people are seen earlier for assessment who may be impacted the most by a possible diagnosis..
In addition, all NHS Providers are streamlining their assessment processes to ensure that assessment is proportionate to need and to enable more children to be seen in a timely way.
In 2026/27, to release specialist capacity within NHS secondary care providers, Cheshire and Merseyside ICB will be looking to transition the annual reviews for children and young people stable on ADHD medications into primary care, supported by the appropriate funding.

Wirral Place

Wirral have been an early adopter of the This is Me Tool and it is now starting to be implemented as part of Graduated Approach. Training is being provided to all Wirral schools, many of which have already attended. It is expected all schools to have received training by the end November 2025. Rollout across early years settings and non-educational settings is planned during 2025/26.

A Neurodevelopment (ND) Hub is being developed which will provide information and guidance to professionals, parents and carers on support available. Further information will be available on the hub in the coming weeks. Neurodiversity Hub Wirral.

Right to Choose

We understand that some educational settings have started to promote the use of referral via their GP to Right to Choose as an alternative to the above pathway. Whilst speed of access to a diagnosis may be the suggested benefit, due to levels of demand this is unlikely to be the actual experience. In addition, evidence from both Cheshire and Merseyside and elsewhere demonstrates that ensuring a robust graduated response approach to understanding needs early and then providing support to meet those needs, will reduce the number of children and young people going on to need an assessment/diagnosis. This in turn frees up NHS specialist clinical capacity to focus on our children and young people with the greatest need and/or levels of complexity.
A further complication of Right to Choose Providers is that some offer only an assessment/diagnosis with no follow-up if ADHD medication is required. Alternatively GP practices may be reluctant to enter into shared care arrangements with Right to Choose Providers. Both these scenarios means that as a result families may be left struggling to access ongoing follow-up medication support within the NHS.
Where a parent/carer requests a referral to a Right To Choose (RTC) provider of Neurodevelopmental assessments and the provider has a standard NHS Contract with an ICB, the shared care element will transfer to the locally commissioned service if required.
Some Right to Choose providers only offer care remotely, with no face-to-face appointment option offered that can more robustly carry out an assessment with a child, young person and family.
We therefore request your support in ensuring that where families are requesting Right to Choose referrals, they are aware of the local offer in each place, the new Cheshire & Merseyside commissioned pathway being rolled out and the potential issues they may encounter with Right to Choose providers.

Details of the new Cheshire and Merseyside pathway are here:

Cheshire and Merseyside neurodevelopment pathway – NHS Cheshire and Merseyside