Complaints regarding autism and attention deficit hyperactivity disorder services across England have increased substantially, rising from 410 in 2021-22 to 1,257 in 2025-26, according to official data released this week. The parliamentary and health service ombudsman attributed the surge to services operating under significant pressure, with demand far exceeding available capacity. Approximately 562,000 open referrals exist within the NHS system, with more than 60% of adults and children experiencing waiting times exceeding one year.
The ombudsman’s investigation, based on analysis of 3,000 complaints and titled Improving ADHD and Autism Services: Commissioning With Confidence, identified multiple systemic problems affecting patient care. Recurring issues included confusion surrounding patients’ right to select their healthcare provider under NHS choice provisions, inconsistent recognition of diagnoses across NHS and independent facilities, and prolonged delays in receiving assessments and treatment. Paula Sussex, the parliamentary and health service ombudsman, described the current system as overly complex and inconsistent, with many patients unable to access needed care.
Specific cases highlighted in the report demonstrated practical consequences of these service gaps. One patient was removed from a medication adjustment waiting list without notification or justification, resulting in approximately six months without specialist support. Another individual received a 50-minute autism assessment that deviated from national clinical guidance. A third patient, directed to an ADHD service not yet operational, incurred nearly £4,000 in out-of-pocket expenses for private treatment.
NHS South East London and South London and Maudsley NHS foundation trust responded to specific findings regarding their services, with South East London noting that referrals undergo triage review before patients access provider choice options. The ombudsman’s office itself faces operational constraints, maintaining a six-month waiting period for processing complaints due to increased submission volume.
A government spokesperson indicated that an independent review led by clinical psychologist Professor Peter Fonagy was commissioned in December to examine prevalence of and support for ADHD, autism, and mental health conditions, with final findings expected later this summer to inform future national strategy.
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