NHS Faces £164 Million Overspend in ADHD Diagnosis Crisis

Demand for attention deficit hyperactivity disorder (ADHD) diagnoses has surged in England, leading to a projected overspend of £164 million for NHS services this year. A comprehensive investigation by the Guardian reveals that the fragmented system, intended to provide support, is failing many patients and pushing them towards an unregulated private sector.

As requests for ADHD assessment rise sharply, the pressure on the NHS has heightened, resulting in a budget shortfall. According to data from 32 of England’s 42 integrated care boards, spending on ADHD services is expected to exceed £314 million by April 2026, more than double the annual budget of £150 million. This significant overspend is prompting local health bodies to seek funding from other areas.

Investigating the ADHD Care System

Sarah Marsh, the Guardian’s consumer affairs correspondent, has focused her reporting on the inadequacies of the ADHD care system. Her investigation, which began in August, was sparked by David Rowland from the Centre for Health and the Public Interest, who scrutinized NHS spending on ADHD services. Marsh and her team conducted extensive research, including gathering data through freedom of information requests and collecting personal accounts from those affected.

The findings reveal a concerning trend: as patients face long waiting lists for assessments, many are turning to private clinics to bypass delays. The investigation disclosed that spending on private ADHD services has more than tripled over three years, increasing from £16.3 million in 2022-23 to £58 million last year. This shift raises alarms among health advocates who worry about the lack of regulation in the burgeoning private sector.

The Impact of a Fragmented System

Marsh emphasizes that individuals seeking ADHD diagnoses are not doing so lightly; they are facing genuine struggles. The current system has left many navigating a convoluted process involving private assessments and unclear pathways to treatment. “A lot of the same issues arose repeatedly in the accounts we collected,” Marsh notes. Patients reported experiencing rushed assessments and difficulties in obtaining necessary shared-care agreements with their GPs.

“For a lot of people, it’s the bit after diagnosis that falls apart,” said Marsh. “They might have spent months waiting and hundreds or thousands of pounds on an assessment, only to find their GP won’t accept it.”

This disarray has had profound consequences for some families. The Guardian previously reported on the tragic case of Ryan White, whose death highlighted the dangers of a system that fails to provide timely and effective care.

The political landscape surrounding ADHD diagnoses has also become contentious. Controversies have emerged around claims of overdiagnosis, with figures like Richard Tice, deputy leader of Reform UK, calling the situation “insane.” In response, Wes Streeting, the health secretary, announced a clinical review into the diagnosis process, acknowledging the challenges faced by those with ADHD and autism.

Marsh warns that the ongoing debate about overdiagnosis obscures the real issue: the urgent need for effective support for those seeking help. “Patients are not seeking help because they want a diagnosis,” she states. “They are struggling, and the system is failing them.”

The investigation raises critical questions about the efficacy of current spending and the overall structure of ADHD services. As the NHS grapples with this crisis, the focus must shift towards ensuring that funds are utilized effectively and that patients receive the support they need.

With the ongoing pressures on the NHS and the increasing reliance on private services, it is clear that significant reforms are necessary to address the ADHD crisis in England. The hope is that this investigation will prompt policymakers to reconsider how ADHD care is delivered and funded.