Thousands of Britons pursuing an assessment for ADHD and autism could face delays of up to two years, thanks to strict restrictions on treatment for the condition imposed by local health chiefs.
An estimated 2.5 million people in England are thought to have ADHD, including around 741,000 children and young people.
But only around 680,000 have a formal diagnosis, meaning that roughly three in four remain undiagnosed.
Local NHS chiefs in West Yorkshire, North East and North Cumbria and Somerset have imposed minimum waits of up to two years, according to a new analysis.
In Greater Manchester, patients will no longer be seen on a first come, first served basis, and providers will only assess those with the ‘most urgent clinical need.’
Meanwhile, in Hampshire and the Isle of Wight, assessments have been restricted to patients who meet strict ‘priority’ criteria.
Overall, according to the analysis by campaign group Finally Seen, 15 of England’s 36 NHS bodies – known as integrated care boards, or ICBs – are now capping, pausing or slowing ADHD or autism assessments.
Health leaders say they have been forced to implement the restrictions because they cannot afford to meet surging demand for diagnoses.
Cases of ADHD have risen around 20-fold over the past two decades, while referrals for specialist assessments increased by a further 20 per cent in the past year alone.
More than 960,000 people are currently waiting for an ADHD assessment and another 295,000 awaiting one for autism.
Last month, the NHS Alliance warned that the costs of meeting soaring demand for ADHD and autism services were ‘out of control and unsustainable’, with spending rising ten-fold in some areas in a single year.
Patient advocacy groups have described the delays as ‘dangerous’, warning that they pose a serious threat to children’s education and increase the risk of mental health problems and even suicide.
In practice, the restrictions mean patients can join a waiting list but may not receive an assessment for several years.
The charity ADHD UK said it is ‘scandalous’ that an NHS body should impose such waits.
‘This is the health service denying people care they need – and care that is available – and slamming the door shut on people who need an assessment that can unlock essential care,’ Henry Shelford, the charity’s CEO, said.
Meanwhile a spokesperson for the National Autistic Society added: ‘Autistic people are three times more likely to die by suicide than non-autistic people and are more likely to be detained in mental health hospitals, have their physical health needs missed, and be denied mental health support.’
Longer waiting times and restricting access to a diagnosis would push more people into crisis, they added.
The Government’s long-awaited review of ADHD and autism services is expected to be published early next month – and is anticipated to recommend that patients at greatest risk are prioritised for assessment.
It was commissioned after a separate review raised concerns that ‘institutional incentives’ in the education and welfare systems could encourage families to seek a diagnosis.
The surge in demand has been fuelled by the Right to Choose scheme, which allows patients seeking a diagnosis to choose any qualified provider – with the NHS obliged to foot the bill.
Independent healthcare providers argue the answer is to make greater use of private sector capacity, while NHS leaders say rising demand has left some local services with little choice but to ration assessments.
The Independent Healthcare Providers Network is urging the NHS to let private clinics offer as many appointments as were available to increase capacity.
The network’s head of policy, Sean Phillips, said: ‘For someone struggling with suspected ADHD or autism, those extra months or years without diagnosis and support can have a profound impact on their mental health, education, work, and family life.
‘With more than a million people already waiting, we should be using all available capacity to get people the support and treatment they need as well as ensuring that their legal right to choose the best provider for them is being upheld.’
Rebecca Grey, director of the NHS Alliance’s mental health team acknowledged that rationing is now being used, with some waiting lists even being closed in a bid to balance costs with soaring demand.
But she said the alliance was ‘keenly aware of the deep frustration caused’ and was doing all it could to address it.
‘The current situation is unsustainable and delivers a bad deal for patients and taxpayers.’
