The NHS is secretly restricting access to vital assessments for attention deficit hyperactivity disorder (ADHD) in a bid to save money, without informing family doctors or the patients facing agonising waits, an investigation has revealed.
Widespread Rationing Hidden from Patients and GPs
Freedom of Information responses obtained by the charity ADHD UK show that 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 in the 2025/26 financial year. Of the 22 ICBs implementing these caps, 13 have not informed GPs, and 12 have not told patients on waiting lists.
Henry Shelford, chief executive of ADHD UK, condemned the lack of transparency, stating the NHS was trying to hide "cruel" and controversial curbs. "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," he said.
Devastating Impact on Lives and the Economy
Patients, both adults and children, in many parts of England are already enduring waits of up to eight years for an ADHD assessment. These new, undisclosed limits will force them to wait even longer. A government ADHD taskforce warned in November that undiagnosed individuals often struggle to work or attend school.
The report highlighted that the lack of support costs the UK economy an estimated £17bn annually due to associated crime, educational underachievement, drug misuse, suicide, and mental ill-health. "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 emphasised.
Secretive Caps and a System Under Strain
One ICB, North Central London, confirmed it had introduced 'indicative activity plans' (IAPs) – which cap the number of appointments it will fund – for both ADHD and autism assessments. While it conducted an impact assessment, it created no communications for GPs or patients. Last October, 8,583 people were on its ADHD waiting list across five London boroughs.
Other ICBs that have curbed access without informing GPs or patients include Kent and Medway, and Bedfordshire, Luton and Milton Keynes. This covert rationing comes as NHS spending on ADHD services has reportedly overshot its budget by a staggering £164m this year due to record demand.
NHS England responded to the findings, stating that claims the payment schemes "are designed to restrict patient choice and access to ADHD services are incorrect." A spokesperson insisted GPs can still make referrals and that the proposals aim to improve care consistency and sustainability. However, for thousands stuck on hidden waiting lists, the reality is a system failing to communicate while it quietly closes its doors.
