Autism services for adults

What is autism?

Autism means a person's brain works in a different way. This can make them see, think about, and understand the world differently from other people.

Every autistic person is different. They each have their own strengths, interests, and things they may find difficult.

Autism can affect:

  • How someone talks and communicates with other people.
  • How they understand what other people are thinking or feeling.
  • How they learn, think, and focus.
  • How they react to sounds, lights, smells, tastes, and touch.

More people are learning about autism and asking for assessments and support. Because of this, local services need to change so they can help everyone who needs them.

Current challenges

At the moment, the service mainly focuses on giving people an autism diagnosis. This means some people may not get help with their needs as early as they could.

If this continues, waiting lists will get longer, and people who need the most help may have to wait longer for support.

More people are now being referred for autism assessments.

Being referred for an autism assessment does not always mean you will be diagnosed with autism. The assessment helps understand what may be causing your difficulties. Sometimes the results show that something else may be the cause.

The growing number of people needing assessments costs a lot of money and puts pressure on NHS services.

There are NHS and private organisations that offer autism assessments. This can mean people do not always receive the same type of assessment or support.

Because of these challenges, adult autism services in Cheshire and Merseyside need to change so that we can understand people's needs better and provide the right support.

Our vision

Our plan to improve adult autism services in Cheshire and Merseyside is to:

  • Understand people's needs in a fair and clear way.
  • Help more people get support without needing a diagnosis first.
  • Make sure specialist services are available for people with the most complex needs.

Changes to autism assessments in Cheshire and Merseyside for 2026/27

What's changing about adult autism assessments?

In 2026/27, the ICB will buy fewer adult autism assessments than it did in 2025/26.

Why are things changing?

Across England, more people need autism support than the NHS can currently afford to provide.

The NHS has to make sure it uses its money carefully so that all health services can continue to support people.

Why can't the ICB spend more on autism assessments?

Integrated Care Boards (ICBs) plan and pay for local NHS services.

In 2025/26 spending on adult autism within the independent sector in Cheshire and Merseyside had grown to approximately £7 million (equating to 3,400 assessments). Without mitigation and given the length of waiting lists, this is likely to increase further to over £10 million, representing a significant financial risk as the ICB must work within a set budget. If too much money is spent in one area, there may be less money available for other NHS services.

The ICB must make sure NHS funding is used in the best way possible to support everyone who needs care. The ICB wants to ensure sufficient funding goes into ongoing support and not just on assessment/diagnosis.

What does this mean for people waiting for an assessment?

If you have already been referred for an assessment, you will stay on the waiting list.

However, you may have to wait longer than before.

If you think you may be autistic but have not been referred, you can look at the support listed in the section “What if I am worried about my wellbeing whilst waiting?”.

What if I am worried about my wellbeing whilst waiting?

Being autistic can affect people in different ways. Some people manage well, while others may find things more difficult.

The resources below may help while you are waiting:

Some workplaces, colleges, community organisations, and other services may offer support or make reasonable adjustments even if you do not have a diagnosis.

You can speak to your GP practice or employer to find out what support may be available.

What happens… 

If I am an adult and think I may have autism but have not yet been referred for a diagnosis?

You can speak to your GP, who can discuss whether to make a referral for autism assessment and diagnosis. If you do go on to be referred for assessment, you will be able to choose whether to be referred to an NHS Provider within Cheshire and Merseyside or to a Right to Choose Provider, an independent sector Provider that has a contract with an ICB somewhere in England. Right to Choose Providers often only offer virtual appointments. You can also choose not to be referred and can still access support to manage the symptoms you are experiencing (see “What support is available without a diagnosis”).

Can I contact NHS Cheshire and Merseyside about my waiting time?

We understand that waiting can be frustrating.

We cannot investigate individual cases based only on waiting times.

If your symptoms have changed, become worse, or you are worried about your mental health or safety while waiting, please contact:

  • The clinician who referred you
  • Your GP
  • Another suitable healthcare service

They can give you advice and support based on your needs.

I am autistic. What additional care can I expect to receive?

If you are autistic, in addition to post-diagnostic support you can receive reasonable adjustments, a Care Act Assessment by a social worker, and a Care and Treatment Review if you are at risk of admission to a mental health hospital.

Reasonable adjustments

Autistic people can receive ‘reasonable adjustments’. This means that people working in health, social care, employment, and education should adapt how they work with autistic people to make accessing services easier and engagement with services a more successful and positive experience. 

Some examples of reasonable adjustments are:

  • Offering longer appointments
  • Having a quiet waiting room
  • Providing information in easy read or large print
  • Having a carer or support attend
  • Having a choice of a face-to-face or virtual appointment

Care Act Assessment

If you have been diagnosed with autism, you may be eligible for a Care Act Assessment. This assessment is completed through your local authority. More information about Care Act Assessment eligibility can be found here.

Care and Treatment Review

The 'Transforming Care' strategy states that autistic people and people with learning disabilities should not be inappropriately admitted to hospital, and commissioners and health professionals need to explore all options to keep people at home wherever possible. This process is called Local Emergency Area Protocol (LEAP). Also, the person will be included on the dynamic support register with the appropriate consent.  

If you are an inpatient, you are also entitled to a Care and (Education) Treatment review if you give written consent. You can read more in the NHS Care and Treatment Review Policy.

For further information please visit the NHS England Care and Treatment Reviews website.