A recent poll of over 800 general practitioners suggests a growing consensus that adult ADHD is being over-diagnosed. As patients bypass long NHS waiting lists for private assessments, medical professionals are raising alarms about the accuracy and cost of these rapid evaluations.
The £51 million projected spike in ADHD spending
The financial strain on the NHS regarding neurodiversity services has reached a critical point. According to a report by the GP publication Pulse, one integrated care board (ICB) saw its monthly expenditure jump from £146,000 in the 2024/25 period to £1.5 million last year. Another ICB is facing a massive budgetary expansion, with adult ADHD service costs projected to climb from £11 million in 2023/24 to £51 million this current financial year.
This surge in spending is partially driven by the link between formal diagnoses and the ability to claim benefits, such as Personal Independence Payments (PIP), which have seen a significant rise in recent years. As the demand for these assessments grows, health chiefs have warned that the current level of spending is becoming "unsustainable" for the taxpayer.
The near-100% success rate of private clinics
A significant discrepancy appears to exist between the diagnostic outcomes of the NHS and those of private providers . A Dorset-based GP noted in the Pulse survey that while NHS services occasionally decline to make a positive diagnosis, they have never seen a private provider fail to do so. This sentiment was echoed by a GP in Berkshire, who claimed that out of more than 1,000 patient referrals, only a single individual did not receive a positive ADHD diagnosis.
The report says that these high success rates in the private sector have fueled a perception that the diagnostic process may be more focused on confirming a condition than investigating its cause. This has led to concerns that the private route is being used to bypass the more rigorous,though slower, NHS assessment protocols.
Dr. Liz Clarke’s concerns over trauma-blind assessments
Clinical accuracy is being called into question by medical professionals who fear that complex mental health histories are being ignored. Dr. Liz Clarke, a GP partner in Greater Manchester, warned that the current system’s focus on single-condition pathways creates a high risk of over-diagnosis. She argued that these "superficial" assessments often fail to account for significant trauma or adverse childhood experiences, which might otherwise explain a patient's symptoms.
Dr.. Clarke and other respondents expressed concern that treating ADHD without a holistic view of a patient's history could lead to significant harm.. This includes the risk of patients being placed on incorrect medications or receiving psychological interventions that do not address the underlying issues, such as PTSD or other mental health struggles.
The 200% rise in PHSO complaints
The rapid expansion of the private sector, fueled by the "Right to Choose" policy,has left regulators struggling to keep pace with demand. The Parliamentary and Health Service Ombudsman (PHSO) has reported a more than 200 per cent increase in complaints regarding autism and ADHD services over the last five years. While the "Right to Choose" allows patients to select their own qualified providers, the NHS Alliance has raised concerns about the lack of quality assurance and regulation for the influx of new players.
As the government prepares to publish a review led by clinical psychologist Professor Peter Fonagy, several critical questions remain. It is still unclear how the government will regulate the 48 providers now operating in some local areas, or whether Professor Fonagy's recommendation to provide support without a formal diagnosis will actually reduce the financial burden on the NHS. The central tension remains: how to meet the anguish of waiting patients without sacrificing clinical integrity or fiscal stability.
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