Private clinics facing crackdown after landmark report warns ‘superficial’ ADHD and autism assessments fuelling soaring diagnoses
Private clinics are facing a crackdown after a landmark report warned ‘superficial’ ADHD and autism assessments were fuelling soaring numbers of people reporting to have the conditions.
The Department of Health and Social Care (DHSC) said it will strengthen legislation in a bid to improve standards and curb over-diagnoses.
Independent firms now conduct more than half of all NHS-funded ADHD assessments and more than a third of autism assessments.
But the government-commissioned review, led by clinical psychologist Professor Peter Fonagy, has raised concerns about the ‘quality and consistency’ of their work.
Spending on independent-sector ADHD provision has risen by around 252 per cent in three years, with the number of clinics offering such services exploding as the NHS struggled to cope with demand.
However, there is currently no requirement for them to be regulated by the Care Quality Commission (CQC) or to share detailed statistics about their caseloads.
They are also allowed to drum up business by advertising their services directly to the public on the likes of social media, unlike with prescription medication.
Led by UCL clinical psychologist Professor Peter Fonagy, the government-commissioned review found the current model of care is failing patients and risks harming a generation of children by overdiagnosing the conditions.
A landmark Government-commissioned report has warned that overdiagnosing conditions such as ADHD and autism could be harming a generation of children
It warned: ‘There are strong concerns about the consistency and quality of ADHD and autism assessments being carried out by independent providers, and the financial incentives associated with assessment activity.’
The authors add: ‘Yet this large and fast-growing use of public money is running without consistent oversight, transparency or quality assurance – commissioners often cannot see what they are paying for. This is not acceptable.’
The sharp increase in demand has led to an influx of new providers, fuelled by the Right to Choose policy, which allows people seeking diagnosis for themselves or a child to opt for any qualified provider at the NHS’s expense.
The NHS Alliance said that spending on ADHD and autism has risen by up to ten-fold over the course of a year in some areas, citing one integrated care board (ICB) which reported its monthly spend had risen from £146,000 in 2024-25 to £1.5million last year.
Medics have raised concerns about ‘superficial’ assessments and said they perceived the diagnosis rate for those referred to private provider routes was higher than via NHS routes.
The report acknowledges that private providers can legitimately help fill gaps and reduce waiting times but stresses that safeguards that could guarantee quality and value for money have not kept pace.
It also found huge variations in prices for apparently equivalent services and warned existing payment arrangements may ‘unintentionally incentivise’ firms to conduct combined ADHD and autism assessments because they would make more money.
Some parents have paid privately for assessments, effectively helping their child jump the NHS queue.
Health Secretary Yvette Cooper (pictured) said the Government ‘will take action to strengthen the oversight of mental health and neurodevelopmental services, and make all diagnostic assessments for ADHD and autism CQC-regulated’
It means children with the most serious mental health issues are facing unacceptably long waits for care because the ‘first come, first served’ system is overwhelmed by soaring demand for ADHD and autism assessment.
The report found the proportion of NHS GPs who accept ‘shared care arrangements’ for prescription drugs initiated by private providers has fallen to around 62 per cent.
This means many families who paid for a private assessment are tied into paying for private prescriptions or must rejoin the NHS queue and be diagnosed again.
The report cautions: ‘For many people, assessment and treatment recommendations do not reliably lead to continuing care.
‘Diagnosis can therefore become the beginning of another wait rather than the start of treatment.’
The review calls for every ADHD and autism assessment provider to be regulated by the CQC, with consistent standards for quality, training, data reporting and oversight.
It also wants all providers to submit comparable information on activity, waiting times, quality and outcomes as a condition of public funding.
And it recommends banning direct-to-public advertising of ADHD and autism assessments, so that access is based on ‘clinical need rather than provider marketing’.
Responding to the report, the DHSC said it will strengthen regulation around assessment and review advertising practices.
Health Secretary Yvette Cooper said: ‘We will take action to strengthen the oversight of mental health and neurodevelopmental services, and make all diagnostic assessments for ADHD and autism CQC-regulated, so people can be confident that assessments are high quality and that the NHS is not being overcharged by independent or private providers.’
