Four NHS integrated care boards across England have established minimum waiting periods before people can access assessments for attention deficit hyperactivity disorder and autism, with some regions requiring waits of up to two years. These policies stem from financial pressures, as 15 ICBs collectively serving 19 million people have implemented various rationing measures including capping the number of annual assessments funded and using clinical prioritization criteria to limit access to those with the most severe presentations of neurodiversity.
The restrictions come ahead of a major government-commissioned review examining the dramatic increases in diagnoses of mental health conditions, ADHD, and autism in recent years. The report, led by Professor Peter Fonagy, was initially scheduled for publication but was postponed. According to sources familiar with the review, it documents how surging demand has left affected individuals struggling to obtain timely NHS care and increasingly turning to private providers. The report highlights up to 24-fold increases in neurodiversity prevalence among boys since 2000, including autism rates rising from 0.2% to 4.7% among seven- to 18-year-olds between 2000 and 2025.
The minimum wait policies effectively restrict patients’ legal right to choose private providers for assessment. West Yorkshire’s decision imposed a two-year minimum for its 2.4 million covered population, following costs that escalated from £7m to £21m in recent years. Other regions have established varying minimum periods, ranging from 14 weeks in Devon to approximately 78 weeks in the North East and North Cumbria. Currently, 960,000 people in England await ADHD assessment and 295,000 await autism evaluation.
Patient advocacy groups have strongly criticized these policies. ADHD UK’s chief executive characterized the measures as “heartless and dangerous,” warning they deny people necessary care and obstruct access to diagnoses that unlock essential support for employment and education. Organizations tracking NHS restrictions describe minimum waits as a form of rationing that circumvents patients’ legal rights to choose alternative providers.
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