Over the past year, a surge in demand for attention deficit hyperactivity disorder (ADHD) diagnoses in England has highlighted significant flaws in the National Health Service (NHS) system. An investigation by the *Guardian* reveals that the NHS is on track to exceed its budget for ADHD services by £164 million this year, as a fragmented marketplace pushes patients toward costly private sector alternatives.
The investigation, which began in August 2023, was led by Sarah Marsh, the *Guardian*’s consumer affairs correspondent, and focused on the overspending of NHS services designed to assist individuals seeking ADHD diagnoses. As reported, this growing demand has created a scenario where patients often find themselves navigating a chaotic system that ultimately fails to provide timely support. Many are left with no other option than to seek help from private clinics, which can be expensive and inconsistent in quality.
The financial implications of this trend are stark. Analysis of data from 32 of England’s 42 integrated care boards (ICBs) indicates that NHS England’s projected spending for ADHD services is set to reach £314 million by April 2026, more than double its annual budget of £150 million. This budgetary gap raises concerns about how local health bodies will manage the shortfall.
The investigation revealed that funding for private ADHD services has skyrocketed, with expenditure more than tripling in just three years, from £16.3 million in 2022-23 to £58 million last year. Many patients are opting for the “right to choose” system, which allows them to bypass long waiting lists, yet this has resulted in a chaotic, under-regulated marketplace that is often perilous for vulnerable patients.
Concerns have been raised about the regulation of private providers, with reports indicating that some clinics conducting NHS-funded assessments are not registered with the Care Quality Commission. Marsh pointed out that while there are guidelines in place, the lack of a cohesive national framework means that standards for ADHD assessments vary widely, leading to confusion for both patients and healthcare providers.
Throughout the investigation, it became clear that individuals seeking ADHD diagnoses are not doing so lightly. They often face considerable challenges, and the lack of timely assistance can push them into the hands of private clinics, where they may encounter a disjointed system that fails to support their ongoing care.
“People are not seeking help on a whim. They are seeking it because they are struggling,” Marsh explained. She noted that many accounts reveal a pattern of rushed or superficial assessments and inadequate follow-up care, leaving patients in limbo once they receive a diagnosis. For many, the aftermath of diagnosis can be just as daunting as the initial process.
The political landscape surrounding ADHD diagnoses has also grown complex. In November 2023, Richard Tice, deputy leader of Reform UK, voiced controversial opinions about what he termed a “crisis of overdiagnosis” of neurodiverse conditions. This sparked a polarized response, with some advocating for more stringent regulations and others warning against stigmatizing those genuinely in need of support.
Health Secretary Wes Streeting has called for a clinical review of the diagnosis of mental health conditions, including ADHD, acknowledging the urgent need for improvement in how individuals are assessed and treated. He emphasized the devastating impact of inadequate support on mental health, drawing from his own experiences and conversations with clinicians.
Marsh expressed hope that the investigation’s findings would prompt a critical examination of the current system. “The next question is: ‘How can we make it better?'” she said. The emphasis must be on understanding why so many individuals feel compelled to navigate a flawed system in search of help.
As the NHS grapples with these challenges, the impact on patients remains profound. The ongoing discussions around ADHD and the regulatory framework governing its diagnosis will be essential in determining how effectively the healthcare system can respond to the needs of those affected.
The hope is that increased awareness and scrutiny will not only highlight the financial inefficiencies within the NHS but also lead to actionable changes that provide better care for individuals with ADHD.
