The Assessment of Need Targeted Waitlist Initiative was introduced by Government in May 2024 to support the delivery of Assessments of Need (AON) to those families who have been waiting the longest for an AON.
Under this Initiative, the HSE procures clinical assessments from approved private providers. These providers are reimbursed by the HSE for clinical assessments undertaken as part of the Assessment of Need process. By the end of 2025, over 7,700 clinical assessments had been commissioned from private providers since the Initiative started in June 2024.
Funding of €20 million is being provided this year to continue the Targeted Waitlist Initiative, enabling the delivery of approximately 6,000 clinical assessments with a specific focus on autism assessments. These assessments will inform the Assessment of Need process and support the completion of AON reports.
The HSE recently established a new panel of 29 service providers to deliver these autism assessments for children and adolescents. This panel became operational in February 2026 and will be in place for one year, with an option to extend for a further year.
While the new panel is now active, there is an ongoing wind down period for Targeted Waitlist Initiative assessments commissioned prior to its activation.
The HSE reports that, in the HSE South West Region, 195 clinical assessments were procured by private providers from January to March 2026 inclusive under the Initiative. These assessments took place under the previous arrangements and the HSE South West region is moving to the new process using the new autism assessment panel.
While it is important to use private capacity to support the completion of Assessments of Need into 2026, we cannot rely on the private sector indefinitely and we must ensure that the public system can meet the clearly growing demand.
This Department continues to work with the HSE to ensure the delivery of actions to support the delivery of Assessments of Need within the public system. This includes improved training for staff involved in the delivery of Assessments of Need, additional administrative supports, and changes to processes where necessary to ensure an efficient and effective system.
As well as these operational measures, officials in the Department are working on potential legislative changes to Part 2 of the Disability Act, which provides for Assessments of Need. The proposed changes are intended to support more effective delivery of Assessments of Need, and to provide clearer guidance and supports so that the process can be made more efficient, reduce delays and allow therapists to spend more time delivering services. Importantly, these changes will not remove any rights for parents to apply for an Assessment of Need for their child. They also will not alter the statutory six-month timeline set out in the Disability Act.
The General Scheme of the Disability (Amendment) Bill has been published on the Department’s website along with an FAQ document, providing information on Assessment of Need and the proposed changes for parents, families and any other interested stakeholders. They are available on the Department website under Publications at: www.gov.ie/en/department-of-children-disability-and-equality/publications/from-subject-received-size-categories-aoife-carragher-dcde-fw-dcde-website-aon-1532-1-mb/
The HSE is also implementing actions to address the wider issue of access to services and supports for children with disabilities including:
• Introduction of a Single Point of Access system by the Health Service Executive in 2026. This should make it easier for families to be referred to the right service or services, whether that is a Primary Care Service, or a Children’s Disability Network Teams and/or a Mental Health Service. It aims to streamline referrals and reduce duplication, so children do not end up on multiple waiting lists.
• Implementation of the Autism Assessment and Intervention Pathways Protocol by the Health Service Executive throughout 2026. The Protocol will provide a standardised assessment process across Primary Care Services, Mental Health and Disability Services. It will be the preferred assessment route for autism.
• The creation of eleven new HSE teams, initially, to support assessment processes, including Assessment of Need, providing clinical guidance and administrative supports.
The delivery of an effective, efficient Assessment of Need system continues to be a priority for the Government.
