ADHD and autism costs in England ‘running out of control’, NHS leaders warn
Source: Guardian Health ↗
NHS leaders have warned that the cost of providing ADHD and autism services in England has become unsustainable, with some areas seeing spending rise tenfold in a single year. The NHS Alliance, which represents health managers, highlighted that an integrated care board (ICB) saw its monthly expenditure jump from £146,000 in the 2024‑25 financial year to £1.5 million the following year, while another ICB projected adult ADHD spending to climb from £11 million in 2023‑24 to £51 million in the current financial year. The surge in demand, which accelerated after the coronavirus pandemic, is forcing commissioners to close waiting lists and consider cutting other services to fund the escalating costs.
The rapid expansion of providers has been driven by patients’ right to choose any qualified service, leading to a proliferation of new, often small and unregulated, assessment firms. One ICB reported that the number of providers on its remit grew from 12‑14 two years ago to 48 this year, and another now works with 80 providers. While this increased capacity has reduced assessment delays, the absence of a national tariff has created wide price variations—some ICBs pay as little as £300, while others spend up to £3 000 for comparable services. These disparities, coupled with concerns about quality assurance and the ability of many new entrants to deliver only assessments without ongoing care, have intensified financial pressures on the NHS.
Rebecca Gray, director of the NHS Alliance’s mental health network, said local health leaders are “caught between a rock and a hard place,” balancing the urgent need to reduce long waiting times against spiralling costs that threaten other services and long‑term planning. The alliance is urging the government to introduce a mandatory national price or tariff and a consistent service specification for ADHD and autism care, arguing that without such measures the current model delivers a poor deal for both patients and taxpayers.
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