Sameer Modha knows the ADHD diagnosis UK system inside out because he’s lived it. He has ADHD, and so do his two children. His own diagnosis went smoothly, but getting help for his daughter turned into a bureaucratic nightmare. A private clinician—a former senior CAMHS director with decades of experience—diagnosed her. Yet the NHS later rejected that assessment for not following NICE guidelines, even though the assessor knew those rules better than most.
Sadly, Modha’s story is common. The NHS now sends patients to private providers it funds—but then throws out their reports. This wastes public money, leaves families without care, and overwhelms mental health teams with repeat cases.
One NHS trust admitted this cycle cripples its ability to treat new patients. People get assessed privately, only to re-enter NHS queues when their reports don’t meet standards. Meanwhile, the NHS spends an estimated £164 million a year on ADHD services—with little progress to show.
Modha finally got the NHS to accept his daughter’s diagnosis—but only after months of persistent follow-up. Even then, coordination broke down. GPs refused to join shared care, stranding the family between systems. “You’re damned if you do and damned if you don’t,” he says. “Go private and risk rejection—or wait two years in the NHS, by which time your child may be dead.”
Health Secretary Wes Streeting recently acknowledged the crisis. When asked if rising autism and ADHD referrals amount to an “epidemic the government is failing to manage,” he replied: “In a nutshell, yes.”
Much of the problem comes from how the “Right to Choose” policy works—or fails. Under this rule, patients with a GP referral can pick a private provider for an NHS-funded assessment. In theory, care returns to the NHS through shared agreements. But in reality, that handoff rarely happens.
Even families who pay privately outside “Right to Choose” hit the same wall: no integration, no follow-up, no continuity.
Trusts are raising alarms. The Midlands Partnership University NHS Foundation Trust reported that private referrals flood back into their system, worsening waits and cutting capacity for complex cases. They noted a key flaw: “Private ADHD providers face little regulation.” Some launch services, diagnose patients, but deliver reports that miss NICE standards.
Instead of easing pressure, the system recycles it. For example, regulators suspended ADHDNet (also called Holistic ADHD Solutions) from NHS work after Norfolk and Waveney ICB found serious gaps in safety oversight and care continuity.
Nowhere feels the strain more than Greater Manchester. Adult ADHD referrals have jumped over 400% since 2022—now exceeding 11,000 a year. More than 25,000 adults wait for autism or ADHD assessments. Without urgent changes, some waits could reach 10 years.
The core issue? Diagnosis has become the only gateway to support—even though many need help long before they get a formal label. To fix this, NHS Greater Manchester will launch a central triage hub. Every adult referral will get an initial face-to-face review. Only those who meet strict clinical thresholds will move to a full NHS-funded diagnosis—a step expected to cut unnecessary assessments by 70–80%.
At the same time, the region plans to expand community-based, non-clinical support so people don’t wait in silence.
But until then, patients bear the cost. One father told The Guardian that after three years, his son’s GP suddenly stopped working with their private provider. The boy returned to the NHS—but with waits over six months, treatment gaps are inevitable. His consultant warned of “predictable harms” if care stops.
The Independent Healthcare Providers Network admits shared care is broken. “Poor coordination creates real risks for patients,” a spokesperson said. Still, they stress the deeper problem: chronic underfunding and too few clinicians. “The biggest challenge remains unacceptably long waiting times.”
For families like Modha’s, the system feels less like healthcare—and more like a gamble with their children’s futures. And as demand grows, the stakes only rise.
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