Hundreds of thousands of individuals in England are seeking diagnoses for attention deficit hyperactivity disorder (ADHD). However, the current system designed to assist them has become fragmented and costly, leading to an anticipated overspend of £164 million this year for the National Health Service (NHS). A recent investigation by the Guardian revealed that increasing demand is being diverted into an under-regulated private sector, significantly impacting patient care.
The investigation highlights that services provided by the NHS for ADHD are projected to exceed their budget due to rising demand for diagnoses and treatment. The analysis of data from 32 of England’s 42 integrated care boards (ICBs) indicates that spending could reach £314 million by April 2026—more than double the annual budget of £150 million. This overspend is forcing local health bodies to search for alternative funding sources, raising concerns about the sustainability of mental health services in the country.
Fragmentation and Financial Pressure
The report, led by Sarah Marsh, the Guardian‘s consumer affairs correspondent, reveals a troubling trend: as NHS waiting lists grow longer, patients are increasingly turning to private providers to bypass delays. This shift has resulted in a surge in spending on private ADHD services, which more than tripled over three years, rising from £16.3 million in 2022-23 to £58 million in the past year.
The investigation found that many private companies operating in this space are not registered with the Care Quality Commission, thereby raising alarms about the quality of care being delivered. Campaigners and clinicians are concerned that the lack of regulation allows some private firms—often backed by private equity—to profit significantly from a system that lacks a cohesive framework.
Marsh noted that while the private sector has its merits, numerous reports from patients indicate a range of negative experiences. These include rushed assessments, difficulty securing shared-care agreements with general practitioners, and confusion over the next steps after receiving a diagnosis. Patients frequently find themselves lost in a system that does not adequately support their ongoing care needs.
The Political Debate Over ADHD Diagnosis
The growing discourse surrounding ADHD diagnoses has become increasingly politicized. In November, Richard Tice, deputy leader of Reform UK, characterized the presence of children wearing ear defenders in schools as “insane,” claiming there is a “crisis of overdiagnosis.” This has fueled a contentious dialogue about the validity of ADHD diagnoses, often overshadowing the actual struggles of those seeking assistance.
In response, the health secretary, Wes Streeting, has ordered a clinical review into the diagnosis of mental health conditions, including ADHD and autism. He acknowledged the personal impact of inadequate mental health support and emphasized the need for systemic reforms. Responses to Streeting’s review have been polarized, with some advocating for caution against overdiagnosis while others call for greater understanding of the challenges faced by those in need.
Marsh expressed concern that the focus on overdiagnosis detracts from the critical issue at hand: the growing number of individuals seeking help because they are genuinely struggling. Her investigation raises essential questions about the effectiveness of current spending and the need for a more integrated approach to ADHD care.
“The system is not functioning well,” she stated. “Patients are unable to receive timely treatment due to lengthy NHS waiting lists. When they seek help privately, they often encounter a disjointed system that fails to meet their needs.”
As the investigation sheds light on these pressing issues, it aims to prompt discussions about how to improve ADHD services in England, ensuring that those seeking help receive the support they need.
The findings from the Guardian‘s investigation highlight the urgency of addressing the ADHD crisis within the NHS. With a significant number of individuals left without adequate care, the hope is that increased awareness and scrutiny will lead to meaningful changes in the system.
