By Ben Potts
I’m a diagnostic radiographer, working in the X-ray service of a major trauma centre, and the doctoral researcher behind the NEEDs Project. In this post, I reflect on what inspired the project, the lessons learned from working with community members, and how the project aims to make emergency care accessible, inclusive and neurodivergent-friendly.
What is the NEEDs Project?
NEEDs (Neurodivergent patient Experience of Emergency Departments) is a participatory, mixed-methods research project within City St George's Research Radiographer Group (CRRAG), in the Department of Allied Health, City St George’s, University of London in collaboration with UCL's GRRAND. The project focuses on understanding the challenges faced by autistic, ADHD, and AuDHD adults when attending emergency departments in the UK, exploring solutions co-created with them, and driving real change and improvement. By centring the voices of autistic, ADHD, and AuDHD people, and including the perspectives of service leaders and frontline healthcare professionals, NEEDs aims to produce actionable strategies that enhance how emergency care is delivered and experienced. This project is supported by Dr Christina Malamateniou (Associate Professor in Radiography) and Dr. Themis Karaminis (Lecturer in Psychology), Dr Emily Skelton (Lecturer in Radiography) and Dr Georgia Pavlopoulou (Associate Professor in Psychology). The project is funded through a studentship awarded by the School of Health and Medical Sciences, City St George’s, University of London.
Why I Created This Project
After a long history of severe mental ill-health, my recovery journey led me to begin a diagnostic radiography degree in 2020. Receiving a diagnosis of ADHD in 2021, followed by an autism diagnosis in 2023, brought the bittersweet journey of self-discovery commonly experienced by late-diagnosed neurodivergent people. It also revealed to me the inequalities that we face. As I progressed through my training and spent more time in clinical practice, I developed an interest in how to improve the experiences of the neurodivergent patients in my care.
The stark absence of research in emergency department practice compelled me to think more deeply about how care can be adapted in situations where patients often have no warning or time to prepare. Consequently, emergency radiography and trauma imaging were becoming a real professional passion, leading me to choose a major trauma centre for my first qualified role.
I view NEEDs as my way of leveraging both my neurodivergent lived experience, professional insider knowledge and my academic skills to platform and broadcast the realities for neurodivergent patients. It is about using the power and privilege I hold to amplify the voices of my community and drive real change.
Before launching the NEEDs Project, I authored or worked on several related publications, including on improving support in education neurodivergent radiography students , the language used when discussing autistic or ADHD people and work to understand how neurodivergent people are cared for in radiography services .
Why This Research Matters Now
Autistic adults face more than twice the rate of avoidable mortality following emergency admission, and both autistic and ADHD adults face higher rates of mortality. Despite recognition of these inequalities in past NHS policies (9), more recent national reports demonstrate that major gaps persist. Current policy priorities (2025/2026) have again highlighted the inequalities in care of neurodivergent patients, along with needed improvements in emergency care. Thus, a UK-specific evidence base is urgently needed to inform practical, implementable change. This research is not just timely; it is essential.
Autistic adults face significant barriers to healthcare access:
One-third avoid medical care even for serious conditions, and 80% find it difficult to visit their GP.
Long wait times for ADHD adults accessing mental health services:
40% of ADHD adults wait at least two years to access NHS mental health services.
Learning and Changing from Collaboration
Co-production is a key tenet of this project. I held the initial coproduction meeting in March funded by GRRAND, where the attendees were open and generous in sharing their thoughts and experiences. This was a huge learning experience both about the ED experiences of others, but also, about how to facilitate authentic co-production.
I learned the value of creating a safe environment and giving people space to express themselves. Rather than steering discussions towards my original plan, I focused on listening and being open to change. I wanted the attendees to have the power to shape the project, and this resulted in them shifting in the project’s aim. The NEEDs Project will now use a participatory action research approach, intending to actively contribute to solutions, rather than my original design of focusing entirely on understanding experiences.
Their insights shaped several other key areas of the project. The first study, a national survey, will be expanded to explore avoidance of ED, capturing experiences of those who needed emergency care but feel unable to attend, or have attended but left before receiving care. Additionally, the second stage, a study using focus groups, will include groups of emergency department staff, utilising their professional knowledge and experience to ensure the recommendations are practical and actionable in today’s NHS. To ensure the data reflects the community’s diversity, we will also ensure to capture people who have different intersecting minorised identities.
The discussions about disclosure were also particularly notable. Many participants shared that disclosing their neurodivergence sometimes improved care, but often led to encountering stigma, false assumptions about their competence, and paternalism from staff. While some participants shared that disclosure of neurodivergence could improve care, many reported experiences of stigma, false assumptions, or patronising treatment. Others highlighted the frustration of having to disclose just to receive basic accommodations. These insights will form a value theme in the project’s ongoing work.
Moving Forward Together
The lessons learned thus far reinforce the value of co-production and the necessity of centring neurodivergent voices in both research and practice. As the project continues to evolve, it will maintain the critical focus of amplifying autistic, ADHD and AuDHD voices, striving to create emergency departments where all individuals, regardless of neurotype, can expect equitable and just care.
Emergency departments are built for urgency, speed, and high-stakes decision-making - but too often, they are not built for us. For autistic, ADHD, and AuDHD adults, what should be a place of safety can feel inaccessible, overwhelming, or even harmful.
The NEEDs Project is my response to that injustice. It exists because lived experience is powerful, and because research rooted in community voices can reshape systems. It’s a commitment to listening, learning, and building better - not just for the sake of policy, but for the real people who walk into emergency departments every day and deserve care that sees and respects them fully.
As this project grows, I remain grounded in the stories that started it, and the people it’s for.
You can read my latest paper here:
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