The NHS is secretly restricting access to vital assessments for Attention Deficit Hyperactivity Disorder (ADHD) in a bid to save money, without informing the family doctors or patients affected by the controversial policy.
Widespread Rationing Revealed
Freedom of Information responses obtained by the charity ADHD UK show that more than half of the NHS's 42 integrated care boards (ICBs) in England have imposed limits on how many people can be assessed for ADHD during the 2025/26 financial year. Of the 22 ICBs implementing these curbs, 13 have not informed GPs, and 12 have not told patients languishing on waiting lists.
Henry Shelford, chief executive of ADHD UK, condemned the lack of communication as evidence the health service is trying to hide "cruel" and widespread rationing. "Waiting times for assessments are already horrendously long, and it's shocking to see how the NHS is further rationing people's care to save money," he said.
Devastating Impact on Patients and Families
Adults and children already face waits of up to eight years for an ADHD assessment in parts of England. These new, undisclosed caps will force those affected to wait even longer, delaying diagnosis and crucial support.
A government ADHD taskforce warned in November that undiagnosed and unsupported individuals can struggle to work or attend school. It estimated the broader societal cost—through crime, educational underachievement, and mental ill-health—at a staggering £17bn a year.
"People with suspected ADHD desperately need to have a full assessment as soon as possible, so they can get treatment and get on with their lives," Shelford emphasised.
The Mechanism: 'Indicative Activity Plans'
The restrictions are being enforced through 'Indicative Activity Plans' (IAPs), which cap the number of appointments an ICB will fund for conditions like ADHD and autism. North Central London ICB confirmed it has introduced IAPs for both, though it had not communicated this to GPs or the 8,583 people waiting for an ADHD assessment in its boroughs last October.
Other ICBs found to have curbed access without informing doctors or patients include those for Kent and Medway, and Bedfordshire, Luton and Milton Keynes. In contrast, ten ICBs stated they had informed both GPs and patients about the limits.
The revelations follow news that NHS spending on ADHD services has overshot its budget by £164m this year, driven by record demand and the growth of private clinics.
NHS England defended the use of IAPs, stating the proposals aim to improve care consistency and sustainability. A spokesperson said, "The claims that the payment scheme proposals are designed to restrict patient choice and access to ADHD services are incorrect, and GPs can continue to make referrals when it is clinically appropriate to do so."
