Primary legislation is required to enable the transfer of NHS England’s functions, powers and responsibilities formally to the Department or out to the wider system. Primary legislation is subject to the will of Parliament, and the Government welcomes parliamentary scrutiny of these provisions. The bill will be introduced in Parliament when parliamentary time allows.

Currently, NHS England is responsible for publishing the NHS Payment Scheme, with the relevant legislation set out in schedule 10 of the 2022 Health and Care Act. Under NHS England’s Scheme of Delegation, responsibility for approving the NHS Payment Scheme rests with the Chief Executive Officer of NHS England, delegated to the Chief Financial Officer of NHS England.

During development of the NHS Payment Scheme, NHS England engages with a wide range of stakeholders, including the Department. The 2026/27 NHS Payment Scheme was published on 26 March 2026 and incorporates a number of changes following consultation.

The full responsibility for developing and setting the National Tariff, which is a set of rules, prices, and guidance that determine how providers of National Health Service funded healthcare are paid for the services they provide, was given to NHS England through the Health and Social Care Act 2012. The Health and Care Act 2022 confirmed this responsibility and renamed the ‘National Tariff’ to the ‘NHS Payment Scheme’. The legislation relating to the NHS Payment Scheme is set out in schedule 10 of the 2022 Act.

Under NHS England’s ‘Scheme of Delegation’, responsibility for approving the NHS Payment Scheme rests with the Chief Executive Officer of NHS England, delated to the Chief Financial Officer of NHS England. Ministerial agreement of the consultation is not currently a requirement of the regulations set out in the act.

NHS England will continue to work with policy teams at the Department and wider stakeholders to further develop currencies and consider appropriate payment options for attention deficit hyperactivity disorder and autism, in line with the overall direction set by ministers.

NHS England was advised by a number of clinicians, policy professionals, commissioners, and providers of attention deficit hyperactivity disorder (ADHD) and autism diagnostic assessment services prior to the publication of the NHS Payment Scheme consultation. All National Health Service providers, commissioners, and independent sector providers of NHS-funded autism and ADHD services were invited to an NHS Payment Scheme engagement session in September.

The statutory consultation for the NHS Payment Scheme 2026/27, which closed on 16 December 2025, provided an opportunity for all stakeholders to review the consultation guidance and provide comments and feedback. This consultation was open to the public, but NHS England specifically reached out to all NHS providers, commissioners, and independent sector providers of NHS-funded autism diagnostic assessment services and ADHD services to ensure they were aware and were able to respond to the NHS Payment Scheme consultation.

NHS England are currently reviewing this feedback to inform the final 2026/27 Payment Scheme.

NHS England was advised by a number of clinicians, policy professionals, commissioners, and providers of attention deficit hyperactivity disorder (ADHD) and autism diagnostic assessment services prior to the publication of the NHS Payment Scheme consultation. All National Health Service providers, commissioners, and independent sector providers of NHS-funded autism and ADHD services were invited to an NHS Payment Scheme engagement session in September.

The statutory consultation for the NHS Payment Scheme 2026/27, which closed on 16 December 2025, provided an opportunity for all stakeholders to review the consultation guidance and provide comments and feedback. This consultation was open to the public, but NHS England specifically reached out to all NHS providers, commissioners, and independent sector providers of NHS-funded autism diagnostic assessment services and ADHD services to ensure they were aware and were able to respond to the NHS Payment Scheme consultation.

NHS England are currently reviewing this feedback to inform the final 2026/27 Payment Scheme.

The statutory consultation for the NHS Payment Scheme 2026/27, which closed on 16 December 2025, provided an opportunity for all service providers to review the consultation guidance and provide comments and feedback. Further information is available at the following link:

https://www.england.nhs.uk/publication/2026-27-nhsps-consultation/

NHS England is currently reviewing this feedback to inform the final 2026/27 Payment Scheme. This consultation was open to the public, but NHS England specifically reached out to all National Health Service providers, commissioners, and independent sector providers of NHS-funded autism diagnostic assessment services and attention deficit hyperactivity disorder (ADHD) services to ensure they were aware and were able to respond to the NHS Payment Scheme consultation and were invited to an NHS Payment Scheme engagement session in September 2025.

Prior to the publication of the consultation, NHS England undertook broad engagement with a number of clinicians, policy professionals, commissioners, and providers of ADHD and autism diagnostic assessment services prior to the publication of the NHS Payment Scheme consultation.

In addition to the engagement that was undertaken as part of the wider NHS Payment Scheme consultation, the following engagement took place on this policy area prior to consultation:

• engagement with the Independent Healthcare Provider Network (IHPN), representing independent sector providers; and
• engagement with healthcare policy professionals, clinicians, patient representative organisations, commissioners, and providers.

In addition, the following engagement took place on this policy area post-consultation:

• further engagement with the IHPN, representing independent sector providers;
• engagement with integrated care boards;
• engagement with independent sector providers;
• engagement with mental health trusts; and
• engagement with clinicians.

NHS England was informed by a variety of sources when developing the policy and associated guide prices, for instance:

• the National Institute for Health and Care Excellence’s (NICE) clinical guidelines CG142, CG128, and CG170, and NICE’s quality standards, which are available at the following link: https://www.nice.org.uk/Guidance/QS51;
• NHS England’s published National framework and operational guidance for autism assessment services, available at the following link: https://www.england.nhs.uk/publication/autism-diagnosis-and-operational-guidance/;
• NHS England’s published reports of the ADHD taskforce, available at the following link: https://www.england.nhs.uk/mental-health/adhd/;
• local integrated care board service specifications;
• pricing information in a sample of contracts for provision of autism diagnostic assessment services and ADHD services; and
• a number of relevant academic papers, including, in particular, Realist evaluation of Autism ServiCe Delivery (RE-ASCeD): which diagnostic pathways work best, for whom and in what context? Findings from a rapid realist review, which contains autism diagnostic assessment costs.

The statutory consultation for the NHS Payment Scheme 2026/27, which closed on 16 December 2025, provided an opportunity for all service providers to review the consultation guidance and provide comments and feedback. Further information is available at the following link:

https://www.england.nhs.uk/publication/2026-27-nhsps-consultation/

NHS England is currently reviewing this feedback to inform the final 2026/27 Payment Scheme. This consultation was open to the public, but NHS England specifically reached out to all National Health Service providers, commissioners, and independent sector providers of NHS-funded autism diagnostic assessment services and attention deficit hyperactivity disorder (ADHD) services to ensure they were aware and were able to respond to the NHS Payment Scheme consultation and were invited to an NHS Payment Scheme engagement session in September 2025.

Prior to the publication of the consultation, NHS England undertook broad engagement with a number of clinicians, policy professionals, commissioners, and providers of ADHD and autism diagnostic assessment services prior to the publication of the NHS Payment Scheme consultation.

In addition to the engagement that was undertaken as part of the wider NHS Payment Scheme consultation, the following engagement took place on this policy area prior to consultation:

• engagement with the Independent Healthcare Provider Network (IHPN), representing independent sector providers; and
• engagement with healthcare policy professionals, clinicians, patient representative organisations, commissioners, and providers.

In addition, the following engagement took place on this policy area post-consultation:

• further engagement with the IHPN, representing independent sector providers;
• engagement with integrated care boards;
• engagement with independent sector providers;
• engagement with mental health trusts; and
• engagement with clinicians.

NHS England was informed by a variety of sources when developing the policy and associated guide prices, for instance:

• the National Institute for Health and Care Excellence’s (NICE) clinical guidelines CG142, CG128, and CG170, and NICE’s quality standards, which are available at the following link: https://www.nice.org.uk/Guidance/QS51;
• NHS England’s published National framework and operational guidance for autism assessment services, available at the following link: https://www.england.nhs.uk/publication/autism-diagnosis-and-operational-guidance/;
• NHS England’s published reports of the ADHD taskforce, available at the following link: https://www.england.nhs.uk/mental-health/adhd/;
• local integrated care board service specifications;
• pricing information in a sample of contracts for provision of autism diagnostic assessment services and ADHD services; and
• a number of relevant academic papers, including, in particular, Realist evaluation of Autism ServiCe Delivery (RE-ASCeD): which diagnostic pathways work best, for whom and in what context? Findings from a rapid realist review, which contains autism diagnostic assessment costs.

The statutory consultation for the NHS Payment Scheme 2026/27, which closed on 16 December 2025, provided an opportunity for all service providers to review the consultation guidance and provide comments and feedback. Further information is available at the following link:

https://www.england.nhs.uk/publication/2026-27-nhsps-consultation/

NHS England is currently reviewing this feedback to inform the final 2026/27 Payment Scheme. This consultation was open to the public, but NHS England specifically reached out to all National Health Service providers, commissioners, and independent sector providers of NHS-funded autism diagnostic assessment services and attention deficit hyperactivity disorder (ADHD) services to ensure they were aware and were able to respond to the NHS Payment Scheme consultation and were invited to an NHS Payment Scheme engagement session in September 2025.

Prior to the publication of the consultation, NHS England undertook broad engagement with a number of clinicians, policy professionals, commissioners, and providers of ADHD and autism diagnostic assessment services prior to the publication of the NHS Payment Scheme consultation.

In addition to the engagement that was undertaken as part of the wider NHS Payment Scheme consultation, the following engagement took place on this policy area prior to consultation:

• engagement with the Independent Healthcare Provider Network (IHPN), representing independent sector providers; and
• engagement with healthcare policy professionals, clinicians, patient representative organisations, commissioners, and providers.

In addition, the following engagement took place on this policy area post-consultation:

• further engagement with the IHPN, representing independent sector providers;
• engagement with integrated care boards;
• engagement with independent sector providers;
• engagement with mental health trusts; and
• engagement with clinicians.

NHS England was informed by a variety of sources when developing the policy and associated guide prices, for instance:

• the National Institute for Health and Care Excellence’s (NICE) clinical guidelines CG142, CG128, and CG170, and NICE’s quality standards, which are available at the following link: https://www.nice.org.uk/Guidance/QS51;
• NHS England’s published National framework and operational guidance for autism assessment services, available at the following link: https://www.england.nhs.uk/publication/autism-diagnosis-and-operational-guidance/;
• NHS England’s published reports of the ADHD taskforce, available at the following link: https://www.england.nhs.uk/mental-health/adhd/;
• local integrated care board service specifications;
• pricing information in a sample of contracts for provision of autism diagnostic assessment services and ADHD services; and
• a number of relevant academic papers, including, in particular, Realist evaluation of Autism ServiCe Delivery (RE-ASCeD): which diagnostic pathways work best, for whom and in what context? Findings from a rapid realist review, which contains autism diagnostic assessment costs.

NHS England has engaged with providers and commissioners as part of the development of the currency models and guide prices for autism assessment services and certain attention deficit hyperactivity disorder (ADHD) services prior to their inclusion within the NHS Payment Scheme.

The statutory consultation for the NHS Payment Scheme 2026/27, which closed on 16 December 2025, provided an opportunity for all service providers to review the consultation guidance and provide comments and feedback, with further information avaiable on the NHS.UK website. NHS England is currently reviewing this feedback to inform the final 2026/27 Payment Scheme. The NHS England Payment Team invited all known ADHD and autism service providers to a pre-consultation webinar which set out the overall changes to the payment scheme. NHS England will continue to engage service providers as part of the next phase of development following the publication of the NHS Payment Scheme 2026/27.

As set out in the NHS Payment Scheme consultation, we have used a range of existing local prices agreed between commissioners and providers as the basis for the guide prices in the consultation. The payment scheme consultation provides the opportunity for providers to comment on the proposed guide prices, and we will consider all the responses received before finalising the payment scheme for 2026/27. These proposals for 2026/27 represent the first stage of planning pricing development for autism assessment services and certain ADHD services.

NHS England has set out what is included within assessments for ADHD and autism within a supporting document to the NHS Payment Scheme 2026/27 statutory consultation. This guidance also links to clinical guidance from the National Institute for Health and Care Excellence and other guidance which may support the commissioning and provision of these services. Guidance setting out the all age autism assessment pathway intended to help integrated care boards deliver improved outcomes in all age autism assessment pathways was written by NHS England in April 2024 and is available on the NHS.UK website.

NHS England has engaged with providers and commissioners as part of the development of the currency models and guide prices for autism assessment services and certain attention deficit hyperactivity disorder (ADHD) services prior to their inclusion within the NHS Payment Scheme.

The statutory consultation for the NHS Payment Scheme 2026/27, which closed on 16 December 2025, provided an opportunity for all service providers to review the consultation guidance and provide comments and feedback, with further information avaiable on the NHS.UK website. NHS England is currently reviewing this feedback to inform the final 2026/27 Payment Scheme. The NHS England Payment Team invited all known ADHD and autism service providers to a pre-consultation webinar which set out the overall changes to the payment scheme. NHS England will continue to engage service providers as part of the next phase of development following the publication of the NHS Payment Scheme 2026/27.

As set out in the NHS Payment Scheme consultation, we have used a range of existing local prices agreed between commissioners and providers as the basis for the guide prices in the consultation. The payment scheme consultation provides the opportunity for providers to comment on the proposed guide prices, and we will consider all the responses received before finalising the payment scheme for 2026/27. These proposals for 2026/27 represent the first stage of planning pricing development for autism assessment services and certain ADHD services.

NHS England has set out what is included within assessments for ADHD and autism within a supporting document to the NHS Payment Scheme 2026/27 statutory consultation. This guidance also links to clinical guidance from the National Institute for Health and Care Excellence and other guidance which may support the commissioning and provision of these services. Guidance setting out the all age autism assessment pathway intended to help integrated care boards deliver improved outcomes in all age autism assessment pathways was written by NHS England in April 2024 and is available on the NHS.UK website.

The consultation on the Payment Scheme proposed requiring commissioners to set a payment limit for elective services, and all services paid for on an activity basis, based on the value of planned levels of activity. Providers would not be paid for activity above this limit.

Following consideration of consultation feedback, this proposal has not been implemented. As in previous years, providers will be paid prices for all activity delivered, subject to any activity management restrictions contractually applied by commissioners.

Activity management provisions in the Contract will be strengthened, subject to consultation, to allow commissioners to plan affordable activity levels to meet key standards and to manage provider activity in line with their plan. The provisions in the Contract would be much more collaborative than the proposed payment limit. Commissioners would be required to engage with providers to a much greater extent and undertake analysis and discussion before any limits are applied. The escalation route would also ensure that, where needed, impartial expertise will help ensure appropriate plans are put in place.

NHS England has allocated all elective funding to integrated care boards (ICBs) and there will be no additional funding available during the year. Local ICBs are responsible for planning service provision in their local area, including for attention deficit hyperactivity disorder and autism assessments. In doing so, ICBs should take account of waiting lists, considering how local funding can be deployed to best meet the needs of their local population.

The NHS Payment Scheme is a policy of NHS England. NHS England is following standard procedure in its consultation on the NHS Payment Scheme. While the consultation’s objection thresholds apply only to commissioners and providers of National Health Service-funded services, the consultation accepts responses from any interested parties and members of the general public.

On publication, all providers and commissioners affected by the proposals were sent details of the consultation and were asked to respond.

An email to highlight the consultation was also sent to over 4,300 people, including from representative bodies, charities, and other voluntary, community, and social enterprise organisations, who had registered for updates about the payment system or had joined the payment system support, FutureNHS. A reminder was also sent out a week before the consultation closed.

NHS England also promoted the consultation alongside the consultation on the NHS Standard Contract, contacting approximately 2,000 people from NHS organisations, local authorities, voluntary sector organisations, and other interested parties. During the consultation period, NHS England also met with ADHD UK to discuss the proposals.

Of the responses that were received regarding the consultation, 16 were from representative bodies, including health charities and royal colleges.

The NHS Payment Scheme is a policy of NHS England. NHS England is following standard procedure in its consultation on the NHS Payment Scheme. While the consultation’s objection thresholds apply only to commissioners and providers of National Health Service-funded services, the consultation accepts responses from any interested parties and members of the general public.

On publication, all providers and commissioners affected by the proposals were sent details of the consultation and were asked to respond.

An email to highlight the consultation was also sent to over 4,300 people, including from representative bodies, charities, and other voluntary, community, and social enterprise organisations, who had registered for updates about the payment system or had joined the payment system support, FutureNHS. A reminder was also sent out a week before the consultation closed.

NHS England also promoted the consultation alongside the consultation on the NHS Standard Contract, contacting approximately 2,000 people from NHS organisations, local authorities, voluntary sector organisations, and other interested parties. During the consultation period, NHS England also met with ADHD UK to discuss the proposals.

Of the responses that were received regarding the consultation, 16 were from representative bodies, including health charities and royal colleges.

NHS England is following standard procedure in its consultation on the NHS Payment Scheme. While the consultation’s objection thresholds apply only to commissioners and providers of National Health Service funded services, the consultation accepts responses from any interested parties and members of the general public.

On publication, all providers and commissioners affected by the proposals were sent details of the consultation, and were asked to respond.

As well as publishing the documents on NHS England’s website, the consultation was also publicly available on NHS England’s consultation hub, which is available at the following link:

https://www.engage.england.nhs.uk/

An email to highlight the consultation was also sent to over 4,300 people, including those from representative bodies, charities, and other voluntary, community, and social enterprise organisations, who had registered for updates about the payment system or had joined the Payment System Support FutureNHS. A reminder was also sent out a week before the consultation closed.

NHS England also promoted the consultation alongside the consultation on the NHS Standard Contract, contacting approximately 2,000 people from NHS organisations, local authorities, voluntary sector organisations, and other interested parties. Of the responses that were received regarding the consultation, 621 were from the general public, namely individuals who did not specify an organisation.

NHS England is following standard procedure in its consultation on the NHS Payment Scheme. While the consultation’s objection thresholds apply only to commissioners and providers of National Health Service funded services, the consultation accepts responses from any interested parties and members of the general public.

On publication, all providers and commissioners affected by the proposals were sent details of the consultation, and were asked to respond.

As well as publishing the documents on NHS England’s website, the consultation was also publicly available on NHS England’s consultation hub, which is available at the following link:

https://www.engage.england.nhs.uk/

An email to highlight the consultation was also sent to over 4,300 people, including those from representative bodies, charities, and other voluntary, community, and social enterprise organisations, who had registered for updates about the payment system or had joined the Payment System Support FutureNHS. A reminder was also sent out a week before the consultation closed.

NHS England also promoted the consultation alongside the consultation on the NHS Standard Contract, contacting approximately 2,000 people from NHS organisations, local authorities, voluntary sector organisations, and other interested parties. Of the responses that were received regarding the consultation, 621 were from the general public, namely individuals who did not specify an organisation.