Key facts
- NHS leaders in England have warned that the costs of meeting demand for ADHD and autism services are unsustainable.
- Spending on these services has increased dramatically, with some areas seeing costs rise tenfold in a year.
NHS leaders in England are warning that the costs associated with soaring demand for ADHD and autism services have become unsustainable, with spending in some areas increasing tenfold annually. This surge is attributed to increased demand, a lack of NHS capacity, and the "right to choose" policy, leading to a proliferation of providers and significant price variations.
The escalating costs and demand for ADHD and autism services in England are straining the NHS budget, potentially impacting other healthcare provisions and patient care. The lack of standardized pricing and quality control raises concerns about value for money and equitable access for patients and taxpayers.
NHS leaders in England have issued a stark warning that the escalating costs associated with soaring demand for ADHD and autism services are becoming unsustainable and "running out of control." The NHS Alliance, representing health managers, highlighted that spending in some regions has increased by as much as tenfold over a single year.
The surge in demand, particularly since the COVID-19 pandemic, is forcing some health bodies to close waiting lists and reallocate resources from other services. One integrated care board (ICB) reported its monthly expenditure on these services jumped from £146,000 to £1.5 million. Another ICB projected its spending on adult ADHD services to rise from £11 million in the previous financial year to £51 million in the current one.
The report attributes this situation to increased demand, insufficient NHS capacity, and the "right to choose" policy, which allows patients to select any qualified provider for diagnosis. This has led to a significant increase in the number of providers, with one ICB now working with 80 providers, up from 12-14 two years prior. Concerns have been raised by ICBs regarding the quality assurance and regulation of these numerous, often small and unregulated, providers who may offer assessments but not ongoing care.
While the expanded capacity has helped reduce assessment delays, the absence of a national tariff has resulted in substantial price variations for similar services, exacerbating severe cost pressures. One ICB noted it was paying between £300 and £3,000 for comparable services. Rebecca Gray, director of the NHS Alliance’s mental health network, stated that local health leaders are caught between understanding patient anguish over long waits and facing uncontrollable soaring costs. She emphasized that unplanned overspends disrupt budgets and long-term planning, creating an unsustainable situation for patients and taxpayers.
The NHS Alliance is urging for the implementation of a national mandatory price (tariff) and a consistent service specification for all NHS-funded ADHD and autism providers.