An independent government review commissioned in December is expected to propose a restructured approach to ADHD diagnosis and treatment in the UK’s National Health Service. The review, led by Prof Peter Fonagy of University College London, will recommend that not all patients with ADHD symptoms receive formal diagnoses, but instead be assessed and supported based on individual needs without requiring formal diagnostic status.
Under the proposed system, patients would be triaged to identify those most severely affected by the condition, including individuals at risk of self-harm or unable to work. Those with less acute symptoms would receive targeted support through what the report calls a “holistic” assessment approach. Support options could include one-to-one assistance for students, accommodations in educational settings, parental support classes, and workplace flexibility measures. Formal diagnosis would be reserved primarily for those who would benefit from medication or other clinical interventions.
The review responds to significant pressure within the NHS system, where 800,000 people currently wait on assessment lists and complaints about ADHD services have more than tripled over five years. The government initiated the review amid concerns about rising sickness benefit claims related to ADHD, autism, and mental health diagnoses. An estimated 100,000 adults with ADHD are on health-related benefits, while the ADHD taskforce calculated that undiagnosed and untreated ADHD costs £17bn.
Critics argue the proposals constitute healthcare rationing and would undermine essential support structures. Henry Shelford, chief executive of ADHD UK, contended that formal diagnosis is clinically necessary and that the changes would leave people relying on social media for self-diagnosis. Representatives from the National Autistic Society and Centre for Mental Health raised concerns that restricting diagnoses could worsen inequalities and delay critical support. A government spokesperson indicated the final report would inform a new national approach to ADHD, autism, and mental health support.
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