In March 2025, the Health, Social Care and Sport Committee wrote to each of the fourteen NHS Scotland territorial boards to request data about neurodevelopmental pathways and waiting times in each area. This SPICe blog post discusses the responses received, broadly answering the following questions:Â
- Where are neurodevelopmental assessments available?
- How many people are waiting for assessments?
- How has this changed over time?
- How long are people waiting?
Where are neurodevelopmental assessments available?
All health boards offered neurodevelopmental assessments to children who didn’t meet the criteria for referral to Child and Adolescent Mental Health Services (CAMHS) for co-occurring mental health conditions. However, NHS Tayside announced in March 2025 that it was not taking any new referrals for child neurodevelopmental assessments unless they met the CAMHS criteria, due to the length of the waiting list.
As the map below shows, adults who were not eligible for referral to secondary mental health services could only access a neurodevelopmental assessment in certain areas. In NHS Grampian, the provision of service varied between local Health and Social Care Partnerships (HSCPs), due to the disbanding of the Aberdeenshire HSCP Adult Autism Assessment Team in February 2025. This leaves over 1.3 million adults in Scotland unable to access a neurodevelopmental assessment through the NHS, just under 30% of the adult population.
How many people are waiting for a neurodevelopmental assessment?
Thirteen of the fourteen health boards reported the number of children waiting for neurodevelopmental assessments as of March 2025. The exception was NHS Grampian, which was unable provide the number of children on their waiting list.
Across these boards, there were 42,350 children waiting for an assessment. This represents roughly 5% of the total number of children in these areas. The three health boards with the largest populations (NHS Greater Glasgow and Clyde, NHS Lanarkshire and NHS Lothian) had the most children waiting for an assessment. Per 10,000 children, however, NHS Dumfries and Galloway had the largest number of children waiting for an assessment.
Nine health boards provided the number of adults waiting for a neurodevelopmental assessment. 23,339 adults were waiting for an assessment in these health boards as of March 2025, just under 1% of the adult population in these areas. Again, the two health board areas with the biggest populations (NHS Lothian and NHS Greater Glasgow and Clyde) had the longest waiting lists, and these also had the most adults waiting for an assessment per 10,000 population.
How has this changed over time?
Some health boards were able to provide data about how the length of their waiting lists has increased over time. In all cases, the number of children and adults waiting for a neurodevelopmental assessment has increased significantly since 2020. Evidence suggests that this isn’t to do with an increase in the prevalence of neurodevelopmental conditions, but rather a better understanding of neurodivergence and the ways it can present itself.
The sparsity of data means that it is hard to make comparisons between health boards. Instead, grouping together the health boards that have provided data, we can see that in Ayrshire and Arran, Fife, Lothian and Tayside combined, the number of children waiting for a neurodevelopmental assessment increased from 2,475 in 2020 to 14,943 in 2025 – an increase of over 500%.
Similarly, grouping together the number of adults waiting for an assessment in Forth Valley, Highland, Lothian and the Western Isles, we see an increase of over 2,200% (from 543 in 2020 to 12,974 in 2025).
How long are people waiting?
Most of the health boards were able to provide median and maximum waiting times for patients seeking a neurodevelopmental assessment, for both children and adults. The median is a better measure of the ‘average’ waiting time, as it is less affected by outliers than the mean.
For children, median waiting times reported by heath boards ranged from 22-141 weeks, with an average of 76 weeks. The longest waiting time was reported at 342 weeks (over six years) in Ayrshire and Arran. Highland, Orkney and Lothian also reported maximum waiting times of over five years, and were among the areas with the longest median waiting times.
Median waiting times for adults also averaged 76 weeks, and ranged between 24-146 weeks. Greater Glasgow and Clyde, Lothian and Highland reported longest maximum waiting times of over five years, while Tayside, Forth Valley and Shetland had the longest median waiting times.
Neurodevelopmental waiting times are not included in Child and Adolescent Mental Health Services (CAMHS) waiting times data. This means they are not included in the CAMHS target that 90% of patients should be seen within 18 weeks, which was was met for the first time in March 2025. While some have claimed that the only way this target was met was by excluding neurodevelopmental cases, this has been refuted by the Scottish Government, who note that neurodivergence is not a mental health condition and including neurodevelopmental cases in CAMHS targets in inappropriate. The Minister for Social Care, Mental Wellbeing and Sport has stated that:
CAMHS is not the correct service for children who are seeking a diagnosis for neurodevelopmental conditions such as ADHD, unless they have a co-existing mental health condition. For many young people, a neurodevelopmental pathway will ensure that the right help and support is provided.
Minister for Social Care, Mental Wellbeing and Sport (Maree Todd), Portfolio Question Time, 7 May 2025
The National Autism Implementation Team (NAIT) has suggested a 36-week standard for a patient to be seen after a referral for neurodevelopmental assessment. From this data, we can see that more than half of patients are waiting for longer than 36 weeks in the vast majority of health boards.
Other information
Some health boards also reported information about waiting lists of ADHD medication and shared care agreements. This data is available in the SPICe briefing on neurodevelopmental pathways and waiting times.
Scottish Autism (a third sector organisation supporting autistic people in Scotland) has also recently released a report about the experience of obtaining a neurodevelopmental assessment in Scotland, alongside three Autistic People’s Organisations. The report surveyed 624 people across Scotland and highlighted many challenges associated with neurodevelopmental assessments, including the difficulty of getting a referral, the stress and anxiety caused by long waiting lists, and the financial hardship incurred by seeking a private assessment.
More data, please?
The data available paint a stark picture of waiting lists for neurodevelopmental assessments in Scotland. Some of the key takeaways are:
- There were over 42,000 children and 23,000 adults waiting for a neurodevelopmental assessment in Scotland as of March 2025.
- This number has increased dramatically since 2020, with increases of over 500% for children and 2200% for adults in some areas.
- In some areas, adult neurodevelopmental assessments are not available, leaving 30% of adults in Scotland unable to receive a neurodevelopmental assessment without going private.
- Children and adults are frequently waiting multiple years for assessments, with waiting times of over 5 years reported in many cases.
- In almost all health boards, less than 50% of patients are being seen within NAIT’s recommended standard of 36 weeks from referral.
What is perhaps more revealing, however, is what these data don’t show. Many boards are unable to provide data about how the length of their waiting lists have changed with time, making it difficult to understand the changing demand for these services. No data exists about the patients being referred, the co-occurrence of other conditions and the diagnostic rates.
In addition, waiting time data does not reflect the timeliness of support received. The Scottish Government has stated that support should not be dependent on a formal diagnosis, and should be available for those waiting for an assessment or not seeking one. However, data on the number of people accessing diagnosis-independent support is not readily available, either.
This lack of comprehensive data has been lamented by organisations such as NAIT and the Royal College of Psychiatrists in Scotland, who have made clear the importance of data to improving neurodevelopmental pathways. This has been echoed in the Scottish Parliament, with one MSP in a recent debate on neurodevelopmental conditions calling for:
‘a step change in how the Scottish Government collects its data, so that the statistics reflect the experience on the ground’
Paul Sweeney MSP, Debate on Motion S6M-17670 (Neurodevelopmental Conditions), 28 May 2025
A further discussion of data collection and many other issues surrounding neurodevelopmental pathways and waiting times in Scotland can be found in the SPICe briefing on this subject.
Ben Adam, Researcher, SPICe.
Photo by JÉSHOOTS via the Pexels license