An exclusive investigation has uncovered a severe financial strain on NHS services for Attention Deficit Hyperactivity Disorder (ADHD), with spending projected to soar far beyond allocated budgets. The findings highlight a growing and costly reliance on private clinics, some of which operate without adequate regulation, raising serious concerns about patient safety and care quality.
Spiralling Costs and Reliance on Private Sector
Analysis reveals that the NHS in England is currently overspending by £164 million a year on ADHD services. Total expenditure is forecast to reach a staggering £314 million by April 2026, which is more than double the £150 million budget originally set aside for this area of healthcare.
The financial data, covering 32 of England's 42 Integrated Care Boards (ICBs), suggests other vital NHS services may face cuts to compensate for this significant shortfall. A deeper look into the figures shows a dramatic shift towards outsourcing, with spending on private ADHD providers more than tripling in just three years—from £16.3 million in 2022-23 to £58 million last year.
Jo Platt, chair of the all-party parliamentary group on ADHD, stated the findings indicate services are "at breaking point". She warned that NHS costs have "soared while private providers profit from poorly regulated systems, leaving too many patients in limbo without proper oversight."
An Under-Regulated Market and Patient Risk
The surge in private provision coincides with record demand for ADHD assessments, driven by increased awareness and overstretched NHS services. More than half a million people are now on waiting lists for an assessment. Many have turned to private providers via the 'right-to-choose' pathway to bypass long NHS waits.
However, research by the Centre for Health and the Public Interest (CHPI) raises alarm bells about this burgeoning market. It found that 14 companies delivering NHS-funded ADHD assessments were not registered with the Care Quality Commission. A further 19 providers, responsible for £1.9 million worth of neurodiversity services over three years, had no formal NHS contract, making it difficult for health bodies to hold them accountable.
The report also notes that one company, recently acquired by a private equity firm, reported profit margins of 33% over two years, primarily from NHS work. The 'right-to-choose' system is described as particularly easy for businesses to access, with no cap on patient numbers or earnings.
Concerns Over Assessment Quality and Care Continuity
Experts have voiced grave concerns about the reliability of some private assessments and the dangerous gaps in care that can follow. In a tragic case highlighted by The Guardian, a coroner issued a prevention of future deaths report following the suicide of 27-year-old Sheridan Pickett.
Mr Pickett died after receiving an online ADHD diagnosis and stimulant medication from a private clinic. When he was later treated in an NHS hospital for an overdose, doctors advised against restarting the ADHD drugs, but this critical information was never communicated back to the private provider, which continued prescribing. The coroner found no formal rules for information sharing between private and NHS teams.
Speaking anonymously, one NHS clinician estimated that 70-80% of private assessments do not meet nationally agreed quality standards. Andrew Jay, founder of the neurodiversity platform Divergence, reported that in a recent audit of assessment reports sent to his service, only 6% met their standards, which are based on UK Adult ADHD Network guidelines.
In response to the crisis, Health Secretary Wes Streeting announced an independent review into the diagnosis of mental health conditions like ADHD last month. An NHS spokesperson acknowledged that patients wait too long for a diagnosis and confirmed an independent ADHD taskforce has been commissioned to improve care models.
A Department of Health and Social Care spokesperson stated: "No one with ADHD should be left without clear clinical oversight... All providers, including those in the independent sector, must meet the same standards for patient safety and quality as the NHS."
