England’s ADHD diagnostic system has become a fragmented marketplace that is costing the NHS far more than budgeted, according to a Guardian investigation. Services are projected to overspend their budgets by £164 million this year, with analysis of data from 32 of England’s 42 integrated care boards showing spending is projected to reach £314 million by April 2026—more than double the annual budget of £150 million.
A growing proportion of ADHD spending flows to private providers as patients use their “right to choose” to bypass long waiting lists. Spending on private ADHD services more than tripled over three years, rising from £16.3 million in 2022-23 to £58 million last year. The under-regulated private market includes providers not registered with the Care Quality Commission carrying out NHS-funded assessments. A significant problem stems from the absence of a consistent national framework defining what constitutes a good ADHD assessment or the qualifications required to diagnose the condition.
Investigation findings revealed recurring problems across dozens of patient accounts. Patients frequently reported being unable to secure shared-care agreements with their GP following private diagnosis, receiving rushed or superficial assessments, and being left without support after diagnosis. As one analysis noted: “For a lot of people, it’s the bit after diagnosis that falls apart. They might have spent months waiting and hundreds or thousands of pounds on an assessment, only to find their GP won’t accept it, or the clinic won’t respond, or their medication isn’t reviewed properly.”
The UK’s health secretary has ordered a clinical review into diagnosis of mental health conditions, autism, and ADHD, citing concerns about rising diagnoses while acknowledging people struggle to access care. The diagnosis of neurodivergent conditions has become politically charged, with debate over alleged overdiagnosis sometimes obscuring the reality that people seeking help are struggling and not simply seeking labels. The investigation emphasizes the need to examine whether current spending is effective and how the system can improve to better serve patients.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://www.theguardian.com/world/2026/jan/14/wednesday-briefing-over-budget-and-under-regulated-the-nhss-adhd-crisis