Seven out of 10 GPs believe adult ADHD is being over-diagnosed, while some say they have never encountered a private provider that rejected an ADHD diagnosis.
Growing awareness of attention deficit hyperactivity disorder has contributed to longer NHS assessment waiting lists, prompting more patients to seek help from private clinics.
Some patients spend more than £1,000 on a consultation. Others obtain an NHS referral to an assessor of their choice, with the cost covered by taxpayers.
An ADHD diagnosis can also support applications for benefits such as personal independence payments, claims for which have risen sharply in recent years.
GPs estimated that more than eight in 10 patients sent for specialist assessment eventually received an ADHD diagnosis.
Doctors responding to a poll by GP publication Pulse expressed concern about what they described as “superficial” assessments. They warned that trauma and other mental health conditions might be missed as a result.
One GP in Berkshire said that, out of more than 1,000 patients they had referred, only one had not received a positive ADHD diagnosis.
Other respondents said they believed the proportion of positive diagnoses was higher among patients using private referral routes than among those assessed through NHS services.
An ADHD diagnosis can support benefits claims, including applications for personal independence payments, which have risen sharply in recent years
A GP based in Dorset said: “Occasionally NHS services do not make a positive diagnosis, but I don’t think I have ever seen a private provider not give a positive diagnosis.”
The findings come before the expected publication of a government-commissioned review examining growing demand for ADHD, autism and mental health services.
Professor Peter Fonagy, the clinical psychologist leading the review, is expected to recommend offering more support according to people’s needs, without making access dependent on a formal diagnosis.
Health leaders have warned that the cost of meeting “soaring” demand for autism and ADHD services in England has become “unsustainable”.
The NHS Alliance said spending on ADHD and autism services had increased by as much as tenfold in some areas over a single year. It cited one integrated care board (ICB), where monthly expenditure rose from £146,000 in 2024/25 to £1.5 million last year.
Another ICB reported that spending on adult ADHD services had climbed from £11 million in 2023/24 to a projected £51 million in the current financial year, according to Pulse.
The surge in demand has attracted a wave of new providers, helped by the NHS Right to Choose scheme. The policy allows people seeking an ADHD or autism assessment for themselves or their child to select any suitably qualified provider.
However, the NHS Alliance said the rapid growth in providers had raised concerns among ICBs about quality control, oversight and regulation.
Rebecca Gray, mental health network director at the NHS Alliance, said local health leaders were “caught between a rock and a hard place”.
“They understand the anguish and frustration caused by long delays in the system as people wait for assessments, treatment and support,” she said.
“But in working to meet rising demand they face soaring costs that are running out of control.”
‘The current situation is unsustainable and delivers a bad deal for patients and taxpayers.’
One ICB told the NHS Alliance it now has 80 providers on its patch, while another said that two years ago it had received invoices from 12 to 14 providers, a figure which has now risen to 48.
Meanwhile, the Parliamentary and Health Service Ombudsman (PHSO) said there has been a more than 200 per cent rise in complaints about ADHD and autism services over the past five years.
The Pulse survey of 829 GPs found 410 consider adult ADHD ‘very over-diagnosed’ and 173 consider it ‘slightly over-diagnosed’.
Another GP, based in Devon, who responded to the survey, said: ‘ADHD seems to be considered a more socially acceptable diagnosis than, for example, PTSD.
‘I am stunned by how superficial some assessments are, and how little reference is made to some patients’ significant history of trauma or adverse childhood experiences, which would in themselves be an adequate explanation for the patient’s difficulties.’
Greater Manchester GP partner Dr Liz Clarke, who responded to the survey, said the current system of having single pathways for the diagnosis of single conditions does not provide a holistic patient assessment and ‘creates the risk of overdiagnosis because the focus is to diagnose or exclude only one cause’.
She also raised concerns of ‘harm’ that could be caused to patients as a result, ‘as they can be put on the wrong medications or have the wrong psychological interventions when neurodiversity is not recognised, as well as vice versa’.
The Government said: ‘Professor Fonagy’s final report will be published shortly, and will inform our new national approach in this area.’
