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The NHS is restricting people’s ability to be assessed for attention deficit hyperactivity disorder in order to save money but not telling GPs or patients, despite soaring demand for the service.
More than half of the NHS’s 42 integrated care boards (ICBs) in England have imposed limits on how many people can be assessed for ADHD during 2025-26, freedom of information responses show.
Of the 22 ICBs who have imposed limits, 13 had not told GPs and 12 had not informed patients awaiting an ADHD assessment.
The charity ADHD UK, which obtained the figures, said the NHS’s lack of communication showed it was trying to hide that “cruel” curbs on assessment were being widely used to help it cope with a squeeze on its budget.
Henry Shelford, ADHD UK’s chief executive, said: “Waiting times for assessments are already horrendously long and it’s shocking to see how the NHS is further rationing people’s care to save money. It’s cruel but increasingly widespread.
“We’re seeing ICBs curb patients’ access to ADHD assessment without telling GPs or patients that they are doing this, and without having made any assessment of the consequences.
“The NHS should be ashamed of itself for such secrecy and hiding the fact that they are depriving people of this vital type of care.”
Adults and children awaiting an ADHD assessment in many parts of England already faced long delays – of up to eight years – in getting an appointment. Limiting access to assessments will force affected people to wait even longer, Shelford said.
The government’s ADHD taskforce warned in a report in November that people with ADHD who have not been assessed can be left struggling to work or attend school. The lack of support costs £17bn a year as a result of crime, educational underachievement, drug misuse, suicide and mental ill-health, it said.
“People with suspected ADHD desperately need to have a full assessment as soon as possible so they can get treatment and get on with their lives,” Shelford said.
“And family doctors need to know whether a patient on their waiting list, desperate to know if they have ADHD or not, is going to be assessed or not. If they don’t know what’s going on, how can they properly advise and care for their patients?”
North Central London ICB confirmed in its FoI response to ADHD UK that it had introduced indicative activity plans (IAPs) – which cap the number of appointments it will pay for – for both ADHD and autism assessments.
While it had undertaken an impact assessment, it had not drawn up any communications to either GPs or patients explaining the move. In all, 8,583 people across the five London boroughs it covers were waiting to be assessed for ADHD and 1,306 for autism at the time it responded last October.
However, 10 ICBs said they had informed family doctors and affected patients.
Other ICBs – regional NHS bodies – that have curbed access but not told GPs or patients include those in Kent and Medway, Bedfordshire, Luton and Milton Keynes.
The Guardian revealed on Monday that the NHS spending on ADHD services is over budget by £164m this year amid record demand for assessments.
NHS England said people seeking an ADHD assessment could still join the waiting list, despite the widespread use of IAPs.
A spokesperson said: “The claims that the payment scheme proposals are designed to restrict patient choice and access to ADHD services are incorrect, and GPs can continue to make referrals when it is clinically appropriate to do so.
“As we work to put ADHD services on a more sustainable footing, these proposals are designed to the right to choose for patients, improve consistency and quality of care, and ultimately deliver fully funded and effective pathways for all patients across England.”
The reasons behind the rise in recent years in diagnoses of ADHD, autism and mental illness will be examined in a review ordered last month by Wes Streeting, the health secretary.
