A government review due next week is expected to say people with ADHD symptoms in England should be triaged and offered support without automatically getting a formal diagnosis. The plan would mean only patients who would benefit from diagnosis, including those needing medication, would be sent to ADHD clinics.
Official figures show 800,000 people are on NHS waiting lists for assessment, with patients waiting years to be seen. In December, Wes Streeting commissioned the independent review of mental health conditions, autism and ADHD, and it now appears set to recommend a needs-based route instead of a diagnosis-first system.
Prof Peter Fonagy review
Prof Peter Fonagy, the clinical psychologist and psychoanalyst at University College London who led the interim review, concluded that the system forces children and adults to get a formal diagnosis in order to access support. The final report is expected to push that logic further by allowing targeted help before diagnosis, based on how well a person is coping at school, college, work or other settings.
Under that approach, patients could be offered early support without waiting for a clinic appointment. Experts said that support could include one-to-one help for children to cope with lessons, quiet rooms in schools, classes to help parents support children with ADHD symptoms, and employers being encouraged to offer flexible hours.
Max Pemberton says ADHD is a social construct and has argued for a different approach to diagnosis, while Dr Max Pemberton backs The Great Adhd Myth? on 18 August.
Henry Shelford response
Henry Shelford, chief executive of ADHD UK, called the proposal “rationing”. He said, “There is no ‘mild’ ADHD.”
He added, “Diagnosis requires evidence of a debilitating impact on your life.” Shelford also said, “We already have a clinically drawn line of need.”
His objection goes to the practical split in the review: support without diagnosis for many patients, but formal referral only for those with the clearest clinical need. He said, “Without a formal diagnosis, it appears we will be left to self-diagnose via social media,” and, “Schools and businesses shouldn’t be forced to rely on TikTok to know when to put in adjustments and support.”
England ADHD clinics
The review is being published against a wider service backlog. Complaints about autism and ADHD services in England have more than tripled in five years, and about 100,000 adults and young people with ADHD are on health-related benefits due to their condition. The ADHD taskforce calculated the cost of undiagnosed, untreated ADHD at £17bn.
The remaining question is how sharply the new triage system will limit referrals into ADHD clinics. For patients in England, the change would shift the first step away from diagnosis and toward support, with the review due next week to set the terms of that switch.
Dr Max Pemberton Probes 200% ADHD Rise in The Great Adhd Myth Documentary.
