Private ADHD Assessments Creating Crisis in NHS Waiting Lists
A major NHS trust has issued a stark warning that waiting lists for attention deficit hyperactivity disorder (ADHD) services in England are becoming critically congested. This congestion is being driven by a growing number of patients who, after initially seeking assessments through private clinics using NHS funding, are now requesting to be transferred back to National Health Service care.
Systemic Failures in Private Sector Provision
The trust revealed that many private clinics, while capable of diagnosing ADHD, frequently fail to meet the rigorous guidelines established by the National Institute for Health and Care Excellence (Nice). Furthermore, these private providers often lack staff with the necessary qualifications to support ongoing medication prescribing, creating dangerous gaps in patient care.
One particularly concerning aspect involves shared care agreements, where general practitioners collaborate with private providers to continue prescribing medication. These arrangements are increasingly breaking down, leaving patients in precarious situations. Some individuals now face prescription costs exceeding £200 per month after their GPs terminated these agreements.
Real-World Consequences for Patients
The human impact of these systemic failures is severe. One father described how his son's shared care agreement was abruptly withdrawn after three years of successful treatment. "With no warning, the GP practice announced they would stop prescribing within six months because the provider was 'out of area'," he explained.
His son has been referred to local NHS services through the Midlands Partnership University NHS Foundation Trust (MPFT), but faces waiting times exceeding six months, guaranteeing a dangerous treatment gap. "My son holds down a responsible job and has bought his own home. None of this would have been possible without medication," the father stated. "Without it, he struggles to focus at work, can't manage daily organisation and experiences overwhelming anxiety."
NHS Trusts Struggling Under Increased Pressure
In correspondence obtained by the Guardian, MPFT acknowledged significant challenges in managing the growing influx of patients returning from private clinics. The trust confirmed this trend is contributing directly to lengthening waiting lists, reducing capacity for new and complex cases, and increasing risks of treatment delays and dangerous care gaps.
This warning follows revelations that the NHS in England is overspending by approximately £164 million annually on ADHD services, with an increasing proportion directed toward poorly regulated private assessments. Demand has reached unprecedented levels as awareness of ADHD has grown, leaving NHS services overwhelmed with more than 500,000 people currently awaiting assessment.
Fragmented System and Regulatory Gaps
The current system operates through the "right to choose" pathway, allowing English patients to select private providers for assessment, diagnosis and initial treatment. Patients can subsequently apply for shared-care agreements where their GP continues prescribing alongside the private provider. However, this system remains fragmented and lacks clear clinical standards.
A letter from MPFT, written in December 2025 by customer service facilitator Megan Cann based on comments from mental health transformation lead Upkar Jheeta, highlighted these systemic issues. "There is limited regulation surrounding private ADHD providers, and this case highlights the issues we often encounter," the correspondence stated.
The letter continued: "Private providers can establish services and request to be providers of ADHD diagnoses. However, it has been found that at times their assessments do not comply with Nice guidelines, and there may be challenges in ensuring the availability of appropriately skilled staff to support prescribing."
Government Response and Future Measures
Health Secretary Wes Streeting recently admitted during a BBC Radio Oxford interview that the government is struggling to manage the volume of referrals for both autism and ADHD services. In response to these concerns, local integrated care boards have begun implementing vetting services for right to choose providers.
A spokesperson for NHS Staffordshire and Stoke-on-Trent Integrated Care Board stated: "We are committed to ensuring that patients receive the care and medication they need. We are working with our partners to review this case and our wider processes for working with private providers."
The situation underscores urgent needs for better regulation of private ADHD services, clearer clinical standards, and more robust systems to prevent vulnerable patients from falling through gaps in care during transitions between private and NHS provision.
