Redesigning neurodevelopmental care at Derbyshire Healthcare NHS Foundation Trust
Challenge
Across England, neurodevelopmental services are experiencing unprecedented demand, with referrals for autism and ADHD assessments continuing to rise faster than services can expand capacity. At Derbyshire Healthcare NHS Foundation Trust (DHCFT), this challenge had become increasingly acute. By March 2025, 2,690 children were waiting for a community paediatric assessment, with average waits reaching 30 months. Demand exceeded commissioned capacity by 38%, creating significant pressures for both clinicians and families.
The pathway was hindered by several structural inefficiencies. More than 80% of referrals arrived from schools via inconsistent paper-based forms, often incomplete and requiring further clarification before they could be processed. Clinicians spent substantial time gathering information that was not available ahead of appointments, with assessments averaging 75 minutes and a further 90 minutes required for documentation and reporting. Around one third of children required a second appointment because key information had not been available during the initial consultation.
For families, the experience was equally challenging. Children and young people often waited years for assessment with little structured support during the waiting period. Parents were expected to recall months or years of observations within a single appointment, while schools and other professionals struggled to contribute information consistently. The result was a pathway that was time intensive, stressful and increasingly difficult to sustain as demand continued to grow.
Solution
To address these challenges, DHCFT partnered with EnrichMyCare to explore how the neurodevelopmental pathway could be redesigned around the needs of children, families and clinical teams.
EnrichMyCare’s Clinical Pathway Transformation Methodology takes a whole-pathway approach — Discover, Design, Transform, Optimise and Scale — combining pathway redesign, workflow improvement, clinical change and digital and AI-enabled tools where these can add value. Rather than starting with technology, the approach begins by understanding how the existing pathway works, where pressure and inefficiency occur, and what needs to change.
The initial work with DHCFT focused on understanding the existing assessment pathway and testing how better information could support clinical consultations. This informed a pilot deployment of the EnrichMyCare family app and clinician dashboard. Families were able to contribute structured symptom diaries, behavioural logs, videos and supporting documents while waiting for assessment. Clinicians could review this information ahead of appointments through a single dashboard, creating a richer and more comprehensive understanding of each child before they entered the clinic.
Insights from the pilot informed the design of the next phase of pathway transformation, including structured digital referrals and AI-assisted clinical summaries. Digital referral forms help improve the quality and completeness of information submitted by schools, GPs and other referrers, while AI-assisted summaries bring together information from multiple sources into structured clinical decision-support outputs. Importantly, all AI-generated content is used solely as decision support. Clinicians remain responsible for reviewing, amending and approving outputs, and all clinical decisions continue to rest with the treating professional.
The pathway approach also shifts support earlier in the patient journey. Instead of families waiting passively for assessment and diagnosis, EnrichMyCare enables earlier access to needs-led support, personalised resources and structured engagement throughout the waiting period. This helps families, schools and clinicians build a more complete picture of a child’s needs while reducing uncertainty and anxiety.
Impact
Early evidence from the deployment at Derbyshire Healthcare NHS Foundation Trust demonstrates meaningful improvements for both families and clinical teams. During the Stage 1 pilot, assessment times fell by 40%, reducing average appointment duration from 75 minutes to 45 minutes per child. Importantly, children with more complex presentations who may previously have required up to three appointments were often able to complete their assessment within a single consultation.
The availability of structured longitudinal data transformed the nature of clinical consultations. Rather than spending valuable appointment time on fact-finding, clinicians were able to focus on interpretation, decision-making and diagnosis. Dr Jehan Labatia, Consultant Community Paediatrician and Neurodevelopmental Service Lead at DHCFT, reported that clinicians were able to start appointments better informed and make earlier, more confident decisions as a result of the data available through the platform.
Family experience improved significantly. Satisfaction scores increased from 6.3 to 9.1 out of 10, while more than 90% of families reported positive experiences. Parents reported feeling better prepared for appointments, more able to communicate their child’s challenges and more confident in advocating for their needs. Structured data collection over time reduced the pressure of trying to explain complex behaviours during a single consultation and helped ensure important information was not missed.
The current phase of deployment is expected to build on these outcomes. Based on validated DHCFT pathway modelling, the introduction of digital referrals and AI-assisted clinical summaries is projected to save approximately 992 clinical and administrative hours annually through efficiencies in triage, reporting, administration and appointment management. These projections are now being assessed through a formal NIHR-funded evaluation, which will provide a larger evidence base across a wider cohort of families.
Together, these results demonstrate the wider principle behind EnrichMyCare’s Clinical Pathway Transformation Methodology: sustainable improvement does not come from introducing technology into an unchanged pathway. It comes from discovering where the pathway is under pressure, designing a better model of care, transforming the way the pathway operates, continuously optimising performance and creating the foundations to scale what works.
Through this approach, EnrichMyCare is helping transform neurodevelopmental services from a reactive, diagnosis-focused model into a more proactive, needs-led pathway. By enabling earlier support, improving the quality of information available to clinicians and reducing inefficiencies across the pathway, the service is creating a more sustainable approach for NHS organisations while delivering a better experience for children, young people and their families.
