Key facts
- Proposals to limit formal ADHD diagnoses are being attacked as healthcare rationing.
- A government review is expected to recommend triaging patients for ADHD support without automatic formal diagnosis.
- Less severely affected individuals may receive holistic assessments and targeted early support instead of a formal diagnosis.
- The review is led by clinical psychologist Prof Peter Fonagy.
- Official figures show 800,000 people are on NHS waiting lists for ADHD assessments.
- The cost of undiagnosed, untreated ADHD is estimated at £17 billion.
Proposals to limit the number of patients formally diagnosed with attention deficit hyperactivity disorder (ADHD) have drawn criticism, with experts calling it "rationing" healthcare and potentially pushing individuals to self-diagnose through social media.
The government's independent review, led by clinical psychologist Prof Peter Fonagy, is expected to recommend a shift away from automatic formal diagnoses. Instead, patients with ADHD symptoms would be triaged and offered support based on a "needs-based" and "holistic" assessment, prioritizing those most acutely affected, such as individuals at risk of self-harm or unable to work. Less severely affected individuals might not be referred to NHS clinics for a formal diagnosis but would receive targeted early support.
The review was commissioned amid concerns over a rise in sickness benefit claims related to mental health, autism, and ADHD diagnoses. Official figures indicate that 800,000 people are currently on NHS waiting lists for ADHD assessments, and complaints about autism and ADHD services in England have more than tripled in five years. The ADHD taskforce calculated that undiagnosed and untreated ADHD costs the UK economy £17 billion annually.
Experts argue that this approach effectively rations health services, as schools and workplaces can already provide early support without a formal diagnosis. Henry Shelford, chief executive of ADHD UK, stated that "there is no ‘mild’ ADHD" and that diagnosis requires evidence of a debilitating impact. He warned that without formal diagnosis, individuals may resort to self-diagnosis via social media. Shelford also highlighted that individuals with ADHD die significantly younger than their peers and that investing in ADHD services yields a high return on investment, citing the NHS spending on a weight-loss drug as a comparable investment in getting people back to work.
Mel Merritt, head of policy and influencing at the National Autistic Society, echoed these concerns, stating that denying people a diagnosis will worsen existing inequalities. A government spokesperson acknowledged the review led by Prof Fonagy, stating that its final report will be published shortly and will inform a new national approach to these conditions.