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Meeting: |
Executive |
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Meeting date: |
7 October 2025 |
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Report of: |
Peter Roderick, Director of Public Health |
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Portfolio of: |
Councillor Lucy Steels-Walshaw, Executive Member for Health, Wellbeing and Adult Social Care |
Decision Report:
A City that Works for All:
York’s
All-age Autism and ADHD Strategy 2025-2030
Subject of
Report
1. This report presents to Executive a strategy for York which we hope will improve the lives of Autistic people and people with ADHD, of all ages. Produced with extensive input from people with direct experience as well as a wide range of partners, this document will provide a framework for action on the things which would ensure York is a city that works for all.
2. The National Autism Strategy, together with accompanying statutory guidance (see Background Papers), requires local authorities and health commissioners to respond in partnership with appropriate plans. This strategy fulfils this requirement.
3. Alongside this Strategy, Executive will receive the York Inclusion and Belonging Strategy which covers children and young people with Special Educational Needs and Disabilities (SEND). These two strategies have been developed in tandem, with shared opportunities for engagement and consultation, and aim to complement one another.
Benefits and Challenges
4. The approval of an all-age Autism and ADHD strategy will enable work to move forward across health, care and civic partners to strengthen polices, pathways and practice, as well as improve systems and promote awareness of neurodiversity in York so that the experience of living in the city as a neurodivergent individual is no different to that of someone who is neurotypical.
5. This journey will not be without challenge. It is appropriate to recognise that neurodivergent people have historically faced stigma, discrimination, lack of understanding, and barriers to accessing services, which will not disappear overnight. They require a whole society approach to overcome, although certain sectors such as education and health will have an outsized impact. In addition, many of the changes which need to be made – again most particularly in relation to education and health – require resource and capacity in sectors which are currently stretched. Whilst aspirations for action should remain high, inevitability resource constraints will at times limit or delay access to, for instance, diagnosis and support.
Policy Basis for Decision
6. This strategy aligns with several elements of the Health and Wellbeing Strategy 2022-32, including ambitions to make York a Health generating city and a mentally healthy city.
7. The National Autism Strategy, together with accompanying statutory guidance (see Background Papers), requires local authorities and health commissioners to respond in partnership with appropriate plans. This strategy fulfils this requirement.
Financial Strategy Implications
8. The approval of this strategy has no direct financial implications. All commitments made in the strategy which would have a financial implication on City of York Council will be funded from existing budgets.
9. The assessment, diagnosis, care and support systems for Autistic people and people with ADHD are under significant strain, including the SEND system across the Local Authority and education, and the adult Autism and ADHD assessment and diagnosis pathway in the NHS. A whole-system strategy which is presented here should have a positive impact in improving society and settings, making them more inclusive, improving communications and getting more decisions about care and support right first time, with positive benefits to public resource in the long term.
Recommendation and Reasons
10. Executive are asked to approve York’s All-age Autism and ADHD Strategy 2025-2030, ‘A City that Works for All’.
Reason: To fulfil our statutory duty to arrange plans and policies in response to the National Autism Strategy, and progress key partnership working to improve the health and wellbeing of people in York who are Autistic and/or have ADHD.
Background
11. Autistic people and people with ADHD are a core and vital part of our community in York. Their health needs, their well-being, their access to good high-quality services constitute an important part of our ambition to make York a ‘health-generating city’ and to fulfil the aims of our Health and Well-being Strategy around reducing inequalities.
12. It is clear that a combination of under-resourcing and a rising number of people coming forward for Autism and ADHD diagnosis and assessment has meant that services are in this area – from health to social care to education and beyond – are very stretched. This means that individuals and their families frequently report feeling under-supported.
13. Additionally civic society – from our public spaces to our shops, amenities, criminal justice system and beyond – has not kept pace with what we have learned enables an inclusive and equal public sphere for Autistic people and people with ADHD.
14. All partners have a role to play in building a more inclusive society and in providing services in a high-quality manner which serve neurodivergent individuals well. In particular, health services and council services have a duty in statutory guidance to plan services, develop partnerships and commission together in response to the national autism strategy, one of the few health-specific strategies named in law.
15. The Health, Housing and Adults Scrutiny Committee (HHASC) considered a paper in November 2024 presenting early findings of a Health Needs Assessment (HNA) covering Autism and ADHD in York, and the comments of members as well as input from public speakers led to a further refinement of that HNA which has now been published (see background papers).
16. The HNA shows clearly that the health of Autistic people and those with ADHD is worse than the general population. There is nothing inherent in neurodiversity which would mean this group in society should experience significantly poorer health, however Autistic people and people with ADHD have a larger number of mental and physical health conditions, have higher levels of homelessness, have on average 5 years less life expectancy than the general population, higher rates of addictions, and experience significant barriers to full inclusion in society.
17. York has not had an autism strategy since 2021; a gap in time which is far too long. A further HHASC Committee in May 2025 discussed a draft All Age Autism and ADHD Strategy, as part of a consultation and co-production process which is set out in full in the consultation section below.
18. As part of this work, the multi-agency working group (including a number of members with lived experience who are independent of formal agencies) has met monthly for the last year. More than 20 groups and/or organisations working to support and advocate for Autistic people / people with ADHD have been involved in working through draft priorities and commitments in the Strategy. In July 2025 around 35 people attended open engagement events in person and on line, and between July and August 2025 around 200 people responded to the formal public consultation on the strategy document.
19. The strategy’s vision is that ‘Together, we want to create a society that works for Autistic people and people with ADHD’. It proposes three key areas of focus:
· SOCIETY, the need to remove the barriers that exist in society for autistic people and people with ADHD and the need for more inclusive and sensory friendly spaces.
· ASSESSMENT and DIAGNOSIS, improving and being clear about the stages of getting an autism or ADHD assessment.
· SUPPORT. improving support for autistic people and people with ADHD in every setting and support, whether or not they have a diagnosis.
20. This Strategy is presented for Executive approval today alongside the Inclusion and Belonging Strategy for the city with which it has close links. Close working between officers leading these Strategies has meant they complement one another.
21. Following the publication of the Strategy, partners have agreed that the working group will evolve into an ‘Autism and ADHD Strategy Reference Group’, meeting regularly to form and oversee an action plan. This group will report regularly into the Health and Wellbeing Board through the chair’s report.
Consultation
22. The phases of engagement and consultation are outlined below:
May-November 2024
An Autism and ADHD Health Needs Assessment was produced, using data from health and care services as well as evidence from the literature on the health needs of autistic people and people with ADHD.
October 2024
A strategy working group was formed, including the key partner agencies in York as well as academic, voluntary agencies and lived experience. A full list of steering group members can be found in the strategy.
Nov 24 - Mar 25
'Listening Exercises' were held where members of the strategy group went out to over 20 organisations or boards with three 'conversation starters' on the strategy, and captured feedback. A full list of organisations can be found at in the strategy.
May 2025
An early draft strategy was circulated, and published for public discussion at the council's Health, Housing and Adults Scrutiny Committee.
June-July 2025
Consultation events held on the draft strategy, to further shape and refine.
July 2025
Formal public consultation on the strategy, and comments incorporated.
Autumn 2025
Autism and ADHD Strategy 2025-2030 publication
Consultation Analysis
23. The initial consultation period established a number of key messages from stakeholders, including the need for lived experience to be at the heart of the strategy, a desire from the community to see a ‘wider determinants’ approach which recognised the role of the whole of society in helping autistic people and people with ADHD live life to the full, and, balancing this, a desire for improvement in issues relating to diagnosis, assessment and support. The need for careful language through the strategy. including identity-first ways of referring to Autism and ADHD, was also a key message.
24. Initial engagement was captured and themed, as out of this a number of ‘we heard’ messages were developed and tested with the steering group. Against these, commitments were given by partners to work which could be achieved and contribute to improvements.
25. The second phase involved a large amount of feedback through the coproduction sessions and public consultation. There was positive feedback on the strategy but a number of areas which were identified for improvement including:
· Greater emphasis on how public bodies communicate with neurodivergent residents, with an emphasis on clarity of process, transparency and honesty
· More commitments from primary care partners, as a key ‘first point of contact’ for many people considering their neurodivergence.
· A greater emphasis on the gendered aspects and under-recognition of neurodivergence in females
· Further clarity on the commitments made around assessment and diagnosis by health partners
26. One clear and consistent message we heard was about the role of consultation and engagement itself for people who are neurodivergent in York at this particular point. In the context of the last few years, with a lot of engagement and public conversation having happened in the city on issues facing autistic people and those with ADHD, we heard that constant efforts to engage and consult people who are neurodivergent can leave them exhausted and jaded, especially if these listening exercises don’t result in meaningful change, that one person’s experience of being autistic or having ADHD is not universal, and that care should be taken around highlighting case studies of either good or bad practice, as these may not represent everyone’s experience.
27. Taking this on board, we have decided not to include quotes or case studies in this strategy. We have focused the main section of the document on a series of ‘we heard’ statements which the steering group have distilled from all of the feedback, triangulating the various voices and inputs we’ve received so that we can then respond with ‘we will’ commitments based not just on an individual piece of feedback, but on the weight of voice and sentiment from the community.
Options Analysis and
Evidential Basis
28. The options available to executive are either to approve or decline to approve this strategy. After extensive involvement, engagement and involvement work, members are advised to approve the strategy to maintain the momentum behind this partnership working.
Organisational
Impact and Implications
Financial
The approval of this strategy has no direct financial implications. All commitments made in the strategy which would have a financial implication on City of York Council will be funded from existing budgets.
The assessment, diagnosis, care and support systems for Autistic people and people with ADHD are under significant strain, including the SEND system across the Local Authority and education, and the adult Autism and ADHD assessment and diagnosis pathway in the NHS. A whole-system strategy which is presented here should have a positive impact in improving society and settings, making them more inclusive, improving communications and getting more decisions about care and support right first time, with positive benefits to public resource in the long term.
Human Resources (HR)
There are a number of commitments made in the Strategy around public sector organisations as employers, and the Council is committed to making its workplaces inclusive and meeting these commitments through its HR policies and procedures.
Legal
Adults: Relevant legislation includes The Autism Act 2009 and associated Adult Autism Strategy (2015) and statutory guidance (2015); the national strategy for autistic children, young people and adults: 2021 to 2026. The duties under the Care Act 2014 and care and support statutory guidance (2014) and associated regulations including the Care and Support (Assessment) Regulations 2014, apply equally to adults with autism and/or ADHD as with all other adults. In meeting needs consideration may also need to be given to relevant legal safeguards under the Mental Health Act 1983 or Mental Capacity Act 2005.
In relation to children and young people, the general duties under Part III Children Act 1989 apply to all children in need, including children with autism and/or ADHD. The Children Act 2004, section 10, also creates a duty to make arrangements to improve co-operation in relation to the well-being of children.
The proposed All-age Autism and ADHD Strategy for indicates compliance with these statutory duties by addressing training requirements and ensuring a person-centred approach to assessment. However consideration may want to be given to detailing training and assessment requirements (including those in transition from children’s to adults services) further within the proposed strategy should any gaps be identified that specifically require addressing.
Other core duties include preventing needs for care and support, providing information and advice, and safeguarding duties, all of which have been considered within the draft strategy. As above consideration may need to be given to specifically addressing any of these areas further as required.
The draft strategy indicates compliance with the local authorities’ general duties to co-operate and promote the integration of care and support with health services, and to ensure there is a meaningful local autism partnership arrangement between different organisations, services and stakeholders. Further consideration may need to be given to the current restructure of ICBs and any subsequent implications on the delivery of this strategy (this is highlighted in the draft strategy).
Procurement
Whilst there are no direct procurement implications relating to report itself, procurement will be a main tool used to deliver some of the upcoming priorities. Should any priorities requirement procurement, all works and/or services must be procured via a compliant, open, transparent, and fair process in accordance with the council’s Contract Procedure Rules and where applicable, the Procurement Act 2023 and/or Provider Selection Regime 2024. Further advice regarding the procurement process and development of procurement strategies must be sought from the Commercial Procurement team.
Health and Wellbeing
This report and the strategy are in line with the Health and Wellbeing Strategy 2022-32, which recognises the need for effective services to diagnose and support neurodivergent individuals, but also places emphasis on York becoming a ‘health generating city’ where the building blocks of health – for instance, employment, housing and education – support the creation of health in the first place rather than simply tackle illness when it arises.
Environment and Climate action
No climate change implications have been identified
Affordability
This report aims to remove barriers so that residents with autism and/or ADHD can access support, information and facilities in relation to welfare support, housing and good jobs in the same way all residents so that they have the best chance to live healthy lives with positive outcomes for them and their families.
Equalities and Human Rights
An Equalities Impact Assessment has been carried out on this Strategy and is at Annexe B. It finds that the majority of impacts and effects of this Strategy will be positive, especially for autistic people and people with ADHD, and identifies a number of actions.
Data Protection and Privacy
Communications
We will look at where we can use communications and engagement activity to support the outcomes of this strategy. This may be through highlighting support available for individuals, building wider understanding within the community, or supporting the council’s workforce to help deliver the outcomes of the strategy.
Economy
There are no direct economic impacts related to the publication of this report. Autistic people and people with ADHD are talented and skilled individuals and efforts to support people and employers to address the gap in employment in this area will have positive economic benefits for the city.
Risks and
Mitigations
29. There are no direct risks associated with the publication of this strategy; like all strategies, there is a risk resource may not be available from the various partners involved to effectively deliver the aspirations.
Wards Impacted
30. All wards are affected by this decision
Contact details
For further information please contact the authors of this Decision Report.
Author
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Name: |
Jodie Farquharson |
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Job Title: |
Head of Public Health (Healthy Child Service) |
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Service Area: |
Public Health |
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Telephone: |
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Report approved: |
Yes |
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Date: |
16/09/25 |
Co-author
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Name: |
Peter Roderick |
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Job Title: |
Director of Public Health |
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Service Area: |
Public Health |
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Telephone: |
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Report approved: |
Yes |
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Date: |
16/09/25 |
Background
papers
Autism and ADHD in York: A Health Needs Assessment 2025
Annexes
· Annex A: A City that Works for All: York’s All-age Autism and ADHD Strategy 2025-2030
· Annex B: Equalities Impact Assessment (EIA)