NHS ‘overwhelmed’ with ADHD and autism referrals

The NHS is inundated with patients waiting for ADHD and autism assessments, with demand soaring fivefold since before the pandemic.

The Nuffield Trust found there are as many as 1.2 autistic people and 2.2 million people with attention deficit hyperactivity disorder (ADHD) in the UK.

The think tank reported some 172,000 people were waiting for a specialist assessment for a formal diagnosis of autism in December - five times higher than the 32,320 people waiting four years earlier.

More than half of those on the waiting list are children and teenagers, which poses a significant risk to their educational progress as they may not get the extra help and support they need.

As well as the overwhelming waiting list, there are reports of a national shortage of ADHD medications. More than a quarter of patients claimed they had not been able to access their treatment after a drug shortage alert was published in 2023, The Pharmaceutical Journal found.

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Although the National Institute for Health and Care Excellence (Nice) recommends people with suspected autism should be diagnosed within three months of a referral, some 147,070 patients had been waiting at least 13 weeks in December. This is more than six times the 24,250 who had to wait in December 2019.

There was a 146% increase in people aged 30 to 34 being prescribed medication to treat their ADHD.

New analysis of the data by Nuffield Trust found 79% of people who had been waiting 13 weeks or longer had not had their first appointment with a specialist - up from 44% in December 2019.

Services are simply unable to keep up with the overwhelming surge in demands for tests, which experts believe is down to increased public awareness of the conditions leading to more people looking for support.

The Covid-19 pandemic “unmasked” symptoms in a lot of people as they were forced away from normality throughout lockdowns and school and work closures.

There is no common consensus among experts as to whether the increase in diagnoses is down to a rise in children having autism and ADHD, or whether there is a previous unmet need which means people are now reaching out for support.

Thea Stein, chief executive of the Nuffield Trust, said: “The extraordinary, unpredicted and unprecedented rise in demand for autism assessments and ADHD treatments have completely overtaken the NHS’s capacity to meet them.

“It is frankly impossible to imagine how the system can grow fast enough to fulfil this demand.

“We shouldn’t underestimate what this means for children in particular: many schools expect an assessment and formal diagnosis to access support – and children and their families suffer whilst they wait.”

An NHS spokesperson said: “The NHS is fully committed to supporting and improving the lives of those with ADHD and autism which is why we have published new national guidance to help local areas to manage the 50% increase in referrals they have seen over last year.

“NHS England has also begun important work into investigating challenges in ADHD service provision and last month launched a cross sector taskforce alongside government, to help provide a joined-up approach for the growing numbers of people coming forward for support.”