GPs Express Skepticism Over Adult ADHD Diagnoses, Citing Overdiagnosis and Private Clinic Influence

Seven in ten general practitioners (GPs) believe that adult Attention Deficit Hyperactivity Disorder (ADHD) is over-diagnosed, according to a recent poll. Some doctors reported that they have never encountered a private provider who rejected an ADHD diagnosis. This sentiment emerges amid rising demand for ADHD assessments, which has led to extended waiting times for National Health Service (NHS) evaluations and consequently pushed patients toward private clinics.

Patients may pay over £1,000 for private consultations, while others can obtain NHS referrals to assessors of their choice, with public funds covering the cost. A diagnosis of ADHD can also facilitate claims for benefits, such as personal independence payments, which have seen a notable increase in recent years. Family doctors estimated that more than 80% of patients referred for specialist assessments ultimately receive an ADHD diagnosis.

GPs responding to a survey by the publication Pulse raised concerns about the perceived superficiality of some assessments, warning that conditions like trauma and other mental health issues might be overlooked. One GP from Berkshire stated that out of over 1,000 referred patients, only one did not receive a positive ADHD diagnosis. Other respondents indicated that diagnosis rates appeared higher through private providers compared to NHS routes.

A Dorset-based GP commented, "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." This situation precedes the expected publication of a government-commissioned review into the escalating demand for ADHD, autism, and mental health services. Professor Peter Fonagy, who is leading the review, is anticipated to propose a shift towards providing support based on individual needs, irrespective of a formal diagnosis.

Health chiefs have cautioned that the costs associated with meeting the "soaring" demand for autism and ADHD services in England have become "unsustainable." The NHS Alliance reported that spending on ADHD and autism has increased up to tenfold annually in some areas. One integrated care board (ICB) saw its monthly expenditure rise from £146,000 in 2024/25 to £1.5 million in the past year. Another ICB's spending on adult ADHD services is projected to increase from £11 million in 2023/24 to £51 million in the current financial year.

The surge in demand has been partly fueled by the "Right to Choose" policy, which allows individuals seeking a diagnosis for themselves or a child to select any qualified provider. However, the rapid proliferation of new providers has also raised concerns among ICBs regarding quality assurance and regulation. Rebecca Gray, the NHS Alliance's mental health network director, described the situation as challenging for local health leaders, who are balancing patient distress from long waiting lists with escalating, uncontrollable costs.

One ICB reported having 80 providers within its jurisdiction, while another noted that the number of providers submitting invoices had grown from 12-14 two years ago to 48 currently. Concurrently, the Parliamentary and Health Service Ombudsman (PHSO) has documented a more than 200% rise in complaints related to ADHD and autism services over the last five years.

The Pulse survey, which included responses from 829 GPs, found that 410 consider adult ADHD "very over-diagnosed," and an additional 173 believe it is "slightly over-diagnosed." Another GP expressed concern that ADHD is sometimes viewed as a more socially acceptable diagnosis than conditions like PTSD. They also noted instances of "superficial" assessments that paid little attention to significant histories of trauma or adverse childhood experiences, which could otherwise explain a patient's difficulties.

Dr. Liz Clarke, a Greater Manchester GP partner, suggested that the current system, which focuses on single pathways for diagnosing single conditions, does not allow for holistic patient assessment. This, she warned, creates a risk of overdiagnosis by narrowing the focus solely on identifying or ruling out one specific cause. She also raised concerns about potential patient harm from misdiagnosis, such as being prescribed incorrect medications or undergoing inappropriate psychological interventions.

The government has stated that Professor Fonagy's final report will be published shortly and will inform a new national approach to these services.