Autism: regulation and what to ask

How to check a private autism assessment provider is properly regulated before you book

Reviewed by ADHD Scot,

Who regulates private healthcare in Scotland?

In Scotland, certain private healthcare services are regulated by Healthcare Improvement Scotland (HIS) under the National Health Service (Scotland) Act 1978. For providers based in Scotland, HIS is the relevant regulator, not the Care Quality Commission (CQC), which covers England. An England-based provider offering online services to patients in Scotland and already regulated by the CQC is not required to additionally register with HIS; their regulatory oversight sits with the CQC. If you are using a Scotland-based clinic, check the HIS register. If you are using an online-only provider based in England, check whether they hold CQC registration.

You can search the HIS register of regulated independent healthcare providers.

Which services are required to register with HIS?

Not every private autism assessment service is legally required to register with HIS. The requirement depends on the type of service and the clinician involved.

In July 2026 we emailed HIS to ask how the registration rules apply to different private service models. HIS's Independent Healthcare Team replied to our enquiry, quoting the definitions of an independent clinic and independent medical agency set out in the National Health Service (Scotland) Act 1978. The points below reflect that reply:

Services that are required to register include any service where care is provided by, or includes the provision of services by, a medical practitioner, registered nurse, registered midwife, registered pharmacist, registered pharmacy technician, dental practitioner, or dental care professional, and which meets the definition of an independent clinic or independent medical agency. HIS has specifically confirmed that registered mental health nurses, including nurse prescribers, are specified within the legislation. HIS has further confirmed to us that registration is required wherever a registered nurse provides a service, and that "service" here includes consultations, investigations and treatments. In other words, a registered nurse's involvement in assessment triggers the duty to register even where the clinic offers no medication or prescribing at all, so a non-prescribing, nurse-involved assessment service still requires registration, and does not fall outside HIS regulation simply because no drugs are involved.

Clinical psychology-led services. In HIS's exact words to us: "Where a service provider does not employ, engage, or grant practising privileges to any of the healthcare professionals listed above, the service does not meet the definition of either an independent clinic or an independent medical agency and is therefore not required to register with HIS." Because a large proportion of private autism assessments are led by clinical psychologists, the absence of HIS registration is common and is not, on its own, a red flag, provided the service does not also employ, engage, or grant practising privileges to a medical doctor, nurse or other listed professional (if it does, it should be registered).

England-based providers offering online services to patients in Scotland and already regulated by the Care Quality Commission (CQC) are not required to additionally register with HIS. These services fall under CQC jurisdiction rather than HIS.

"Registration in progress" is a legitimate status. Providers that were already operating before the legislation came into force in June 2025 may continue trading while HIS considers their application. Any new service that requires registration must not begin trading until registration has been granted.

A published inspection report is not the same as being registered. When HIS grants registration, the service is assessed against HIS standards. HIS then inspects registered services and publishes the resulting reports, but these inspections run on a periodic cycle, so a recently registered service can be fully registered while no published inspection report yet exists on the HIS site. A missing report does not mean a service is unregistered or has not been checked, so if a provider tells you it is registered, confirm the current position on the HIS register rather than looking only for a published inspection report.

The practical implication: the absence of HIS registration does not automatically indicate a problem. It may mean a service is psychology-led with no doctor or nurse involved (and therefore falls outside HIS regulation), or that it is an England-based online provider regulated by the CQC instead. What matters is understanding who leads your assessment and verifying their individual registration with their professional body, GMC, NMC, or HCPC.

How we obtained this, and its status. The points above summarise a written reply from HIS's Independent Healthcare Team to an enquiry we sent on 12 July 2026. HIS answered our questions, it does not work with, partner with, endorse, or verify ADHD Scot or the content of this website, and HIS told us it is generally unable to review or approve content produced by third-party sites. As HIS states, this information is provided for general guidance only and should not be regarded as legal advice; ultimately, providers are responsible for ensuring they comply with the relevant legislation. A provider who is unsure whether a particular service model requires registration should contact HIS's Independent Healthcare Team directly at his.ihcregulation@nhs.scot.

Types of private provider

Not all private autism providers are the same type of organisation. The distinction matters:

Independent Clinic: a regulated healthcare facility. In Scotland, independent clinics providing medical services must be registered with HIS. Registration means the service is assessed against HIS standards, with ongoing oversight and periodic inspection.

Independent Medical Agency (IMA): provides medical services but is not a registered clinic. An IMA employs or contracts clinicians who are individually regulated through their professional bodies, but the organisation itself may not be registered as a healthcare facility with HIS. This does not automatically mean an IMA is lower quality. Many operate to a high standard, but a different layer of oversight applies.

Psychologist-led practice: a service led by practitioner psychologists or other allied health professionals (such as speech and language therapists), whose clinicians are individually registered with the Health and Care Professions Council (HCPC). There is no service-level regulator for this category: HIS has confirmed that services with no medical practitioners, nurses, or other specified professionals are not legally required to register with HIS, and cannot do so. Oversight sits with each clinician's individual HCPC registration. Many autism assessments in Scotland are delivered by psychologist-led services.

Individual Practitioner: a single clinician working independently, regulated through their own professional body. The level of facility registration varies.

Understanding which type of provider you are booking with helps you know what checks to make.

Checking clinician registration

Regardless of what type of provider you are using, the clinician carrying out your assessment should be registered with their relevant professional body. You can verify this yourself:

Doctors (consultant psychiatrists, associate specialists, specialist doctors, GPs and other medical doctors): GMC Medical Register. Every doctor practising in the UK must be registered and licensed with the General Medical Council. The register is publicly searchable.

Nurses and nurse prescribers: NMC Register. Specialist Nurse Prescribers and other registered nurses must be on the Nursing and Midwifery Council register.

Psychologists: HCPC Register. Clinical psychologists must be registered with the Health and Care Professions Council. Note that the title "psychologist" alone is not protected. Always check for "clinical psychologist" or "registered psychologist" and verify on the HCPC register.

What a thorough autism assessment should include

A credible autism assessment is not a single questionnaire followed by a diagnosis. Based on SIGN 145, Scotland's clinical guideline for autism, a thorough assessment should include:

  • A detailed clinical interview covering your current traits and their impact across multiple areas of life, together with your developmental history
  • Use of validated diagnostic instruments (see below)
  • Collateral history: information from someone who knew you in childhood or knows you well now, such as a parent or partner. This is important because autistic traits must have been present from early childhood, even if they were not recognised at the time.
  • Consideration of other explanations for your experiences (such as social anxiety, trauma, or communication or attachment difficulties)
  • A written diagnostic report

Assessments that rely on a single questionnaire, skip developmental or collateral history, or move very quickly to a diagnosis warrant scrutiny.

The validated tools that should be used

A questionnaire on its own, even a validated one, is never enough for an autism diagnosis. The recognised observational gold standard is the ADOS-2 (Autism Diagnostic Observation Schedule, Second Edition), in which a specifically trained clinician observes and interacts with you through structured and semi-structured activities and conversation. It is usually used alongside a structured developmental interview such as the ADI-R (Autism Diagnostic Interview, Revised), the DISCO (Diagnostic Interview for Social and Communication Disorders), or the 3Di (all suitable for adults and children), conducted with someone who knew you in childhood. Supporting self-report measures include the RAADS-R (Ritvo Autism Asperger Diagnostic Scale, Revised) and, where masking or camouflaging is a factor, the CAT-Q (Camouflaging Autistic Traits Questionnaire). At least one validated observational or interview instrument should be used, and it is reasonable to ask whether the clinician delivering your assessment is formally trained or certified in the tool they use (for example, ADOS-2 certified). Women and girls are especially likely to be missed by standard tools because they often learn to mask or compensate for autistic traits. For a plain-English guide to each of these tools, why some ADOS tasks look unusual, and reassurance that a different combination does not mean a worse assessment, see Assessment tools and what to expect.

Red flags to watch for

  • No named clinician listed on the website
  • No validated observational or interview instrument, a questionnaire alone is not a diagnostic assessment
  • No HIS registration and no clear explanation of why, a purely psychology-led autism service falls outside HIS regulation, but any service involving a doctor or nurse should be registered
  • Very short assessment times with no developmental or collateral history requirement
  • No written diagnostic report included as standard
  • Reluctance to share credentials or registration details on request
  • Promises of a guaranteed diagnosis

Questions to ask before you book

  1. Is the service registered with Healthcare Improvement Scotland? If not, why not, is it psychology-led with no doctor or nurse involved (and therefore outside HIS regulation), or an England-based online provider regulated by the CQC?
  2. Who will carry out my assessment, and what are their qualifications?
  3. Are they registered with the GMC, NMC, or HCPC? (Ask for their registration number so you can check)
  4. What validated instruments are used, is the ADOS-2, or another validated observational or interview tool, included?
  5. Is the clinician formally trained or certified in the tool they use?
  6. What does the assessment involve and how long does it take?
  7. Will developmental and collateral history be gathered?
  8. Is it a single-clinician or a multidisciplinary assessment?
  9. Is a written diagnostic report included?
  10. What is their policy if the assessment is inconclusive?
  11. What is included in the price and what would cost extra?

Trusted further reading

ADHD Scot is an independent, non-clinical information project, and is not affiliated with or endorsed by Healthcare Improvement Scotland. The guidance above reflects HIS's written reply to our enquiry and is general information, not legal advice. We do not endorse or recommend any specific provider, always do your own checks using the official registers above.

Reviewed by ADHD Scot,