NHS limiting ADHD assessments to save money despite soaring demand | Attention deficit hyperactivity disorder

The NHS limits the ability of people to be assessed for attention deficit hyperactivity disorder to save money, but does not tell GPs or patients about it, despite growing demand for the service.

More than half of the 42 NHS Integrated Care Boards (ICBs) in England have placed limits on the number of people who can be assessed for ADHD in the period 2025-2026, according to Freedom of Information responses.

Of the 22 ICBs that imposed limits, 13 had not informed GPs and 12 had not informed patients awaiting an ADHD assessment.

The charity ADHD UK, which obtained the figures, said the lack of communication from the NHS showed it was trying to hide that “cruel” restrictions on assessment were being widely used to help it cope with a budget squeeze.

Henry Shelford, chief executive of ADHD UK, said: “Waiting times for assessments are already horribly long and it is shocking to see how the NHS is further rationing patient care to save money. It is cruel but increasingly widespread.

“We are seeing BCIs restricting patients’ access to ADHD assessment without informing GPs or patients of what they are doing, and without assessing the consequences.

“The NHS should be ashamed of such secrecy and hiding the fact that it is depriving people of this type of vital care. »

In many parts of England, adults and children waiting for an ADHD assessment were already facing long delays – of up to eight years – to get an appointment. Limiting access to assessments will force those affected to wait even longer, Shelford said.

The government’s ADHD taskforce warned in a report released in November that people with ADHD who have not been assessed may struggle to work or attend school. Lack of support costs £17 billion a year due to crime, underachievement, drug misuse, suicide and mental health problems, it says.

“People suspected of ADHD desperately need to undergo a comprehensive evaluation as soon as possible so they can get treatment and move on with their lives,” Shelford said.

“And family doctors need to know whether a patient on their waiting list, desperate to know whether or not they have ADHD, will be evaluated or not. If they don’t know what’s going on, how can they properly advise and care for their patients?”

North Central London ICB confirmed in its FoI response to ADHD UK that it has introduced indicative activity plans (IAP) – which cap the number of appointments it will pay for – for ADHD and autism assessments.

Although it has undertaken an impact assessment, it has not produced any communications for GPs or patients explaining this decision. A total of 8,583 people across the five London boroughs covered were waiting to be assessed for ADHD and 1,306 for autism when the study responded last October.

However, 10 ICBs reported informing affected family doctors and patients.

Other ICBs – regional NHS bodies – which have restricted access but not informed GPs or patients include those in Kent and Medway, Bedfordshire, Luton and Milton Keynes.

The Guardian revealed on Monday that NHS spending on ADHD services was £164 million over budget this year, amid record demand for assessments.

NHS England said people seeking an ADHD assessment could still put themselves on the waiting list, despite the widespread use of IAPs.

A spokesperson said: “Claims that the payment scheme proposals are designed to restrict patient choice and access to ADHD services are incorrect, and GPs can continue to refer patients where it is clinically appropriate to do so.

“As we work to put ADHD services on a more sustainable footing, these proposals are designed to ensure patients’ right to choose, improve the consistency and quality of care and ultimately deliver fully funded and effective pathways for all patients across England.

The reasons behind the rise in recent years in diagnoses of ADHD, autism and mental illness will be examined in a study commissioned last month by Wes Streeting, the health secretary.