18. March 2026
From NHS to Independent Practice: Why I’m Taking the Leap After 35 Years
Ruth Guy, Affirming Autism Director of Operations talks about making the move to independent practice
After 35 years working in the NHS, this month marks a significant personal and professional milestone - I’ve made the decision to step away and focus fully on growing Affirming Autism.
It’s not a decision I’ve taken lightly.
I began my NHS career in 1989, and over the decades I’ve had the privilege of working with hundreds- now thousands of individuals and families. The NHS is full of dedicated, passionate professionals, and I’m incredibly proud of the work I’ve been part of.
But over time, one thing has become increasingly clear.
The demand for autism assessments has grown significantly.
Many people are waiting far too long for answers, support, and understanding.
A Milestone I Didn’t Expect
Recently, I completed my 1,000th autism assessment.
When someone joked that this means I’ve probably hit the “10,000-hour rule” and can officially call myself an expert, it made me smile.
I’m not sure I’ll be putting that on my business cards anytime soon- but it does represent something meaningful.
It represents:
- 1,000 individuals and families
- 1,000 stories
- 1,000 moments of clarity, understanding, and sometimes relief
And that’s what has driven this next step.
Why Affirming Autism?
Affirming Autism was founded alongsideNatalie Hewitt with a clear purpose:
To provide autism assessments that are not only clinically robust- but genuinely affirming and person-centred.
We believe that diagnosis should never feel like a label being applied- it should feel like understanding being gained.
What Happens Next?
With my full-time focus now on Affirming Autism, we are entering an exciting phase of growth.
We are:
- Expanding our services
- Creating new roles in Macclesfield and surrounding areas
- Building partnerships with providers and insurers
- Increasing access to timely assessments
Our goal is simple:
Reduce waiting times. Maintain quality. Put people first.
A Personal Reflection
Leaving the NHS is emotional.
It has shaped my career, my values, and my identity as a clinician.
But this next chapter is about building something that can respond quickly, flexibly, and compassionately to people who need support now—not in years’ time.
And About That “Expert” Title…
Let’s just say this:
After 1,000 assessments, I’ve learned that every person is different and there is always more to learn.
So maybe not an expert. But certainly experienced.