Children with suspected autism or ADHD are waiting over a year—sometimes years—for a specialist NHS assessment, with no system to prioritise those most at risk. This matters because the current first-come, first-served referral process cannot distinguish a child in crisis from one with milder needs. Without triage, symptoms worsen, families face mounting stress, and mental health emergencies become more likely. The 12-month pilot will test a digital triage system called VANTAGE, built on the existing HealthTracker platform, within an NHS neurodevelopmental paediatrics service. Parents, teachers, and older children complete validated questionnaires covering ADHD, ASD, anxiety, depression, and self-harm. The software then assigns each referral a priority level—red, amber, or green—based on symptom severity and risk indicators such as suicidality. Clinicians see a real-time dashboard to guide scheduling. If successful, the system could cut waiting times for the highest-priority children while safely deferring lower-risk cases. It would also provide continuous monitoring and psychoeducational resources during the wait. The study will process 250 past cases and 500 new referrals over nine months, measuring triage accuracy, clinician time saved, and safety outcomes. This could offer a scalable model for reducing systemic bottlenecks in child mental health services across the UK.
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Children with suspected neurodevelopmental disorders (NDDs) such as ASD and ADHD are experiencing significant delays in accessing specialist assessment and care across the UK, with average waiting times exceeding 12 months and, in some cases, stretching over years. These delays can exacerbate symptoms, elevate familial stress, and increase the risk of mental health crises. A core issue is the absence of a robust, clinically informed triage mechanism within referral systems, which currently operate on a first-come, first-served basis without adequate risk stratification. This 12-month pilot study proposes implementing and evaluating Virtual Automated Neurodevelopmental Triage & Guidance Engine (VANTAGE) provided by the HealthTracker™ platform, within an NHS Neurodevelopmental Paediatrics service. HealthTracker is a validated digital health platform specifically developed for use in paediatrics that collects patient-reported outcomes, triggers automated alerts, and supports clinical decision-making. The proposed project will test whether VANTAGE can improve clinical workflow, reduce assessment wait times, and enhance patient satisfaction. VANTAGE utilizes responses to the Profile of Neuropsychiatric Symptoms (PONS) and additional validated questionnaires (e.g., RCADS, SNAP-IV, OAS-M) completed by parents, patients (age ?5), and teachers. These data assess symptom severity across domains, including ADHD, ASD, anxiety, depression, disruptive disorders, psychosis, and self-harm. VANTAGE hosted on Microsoft Azure generates a dynamic clinical dashboard summarizing symptom profiles, associated risks, and functional impairments. Expert rule-based thresholds (e.g., those who had very severe scores or multiple comorbid diagnoses) and high-risk indicators (such as suicidality) will classify referrals into priority levels (e.g., Red/Amber/Green). Clinicians receive real-time outputs to guide referral acceptance, triage, and scheduling. This system will process 250 recently assessed cases and 500 new referrals over 9 months. Families will be prompted to complete follow-up assessments every 3 months until their child is seen, allowing continuous monitoring and re-prioritization. In parallel, all families will receive psychoeducational resources during the wait period. Primary outcomes are (1) time from referral to assessment and treatment, (2) triage accuracy (e.g., concordance between algorithm-determined priority and clinical severity), and (3) system efficiency metrics such as throughput and clinician time saved. Safety will be monitored through the incidence of urgent cases requiring emergency care while on the waitlist. Engagement metrics (e.g., response rates to quarterly assessments and uptake of support materials) will also be assessed. Qualitative feedback will be gathered via structured interviews and surveys from families and clinicians, assessing system usability, satisfaction, perceived utility, and potential barriers (e.g., trust in algorithmic decisions and digital literacy challenges). Expected outcomes include significant reductions in wait times for high-priority cases, increased efficiency in clinical triage, and high levels of stakeholder satisfaction. The study will generate real-world data on VANTAGE's feasibility, accuracy, and scalability in NDD services. It could provide a validated model for national implementation and inform the broader use of digital health technologies in addressing systemic bottlenecks in CAMHS.
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