UK Government to Crack Down on Private ADHD and Autism Assessments Following Report

The UK Department of Health and Social Care (DHSC) is set to strengthen legislation governing private clinics that conduct ADHD and autism assessments. This move follows a government-commissioned report that raised concerns about the quality and consistency of these assessments, warning that superficial evaluations may be contributing to soaring diagnosis rates.

Independent firms now perform more than half of all NHS-funded ADHD assessments and over a third of autism assessments. However, a review led by clinical psychologist Professor Peter Fonagy found that the current model of care is failing patients and risks harming children through overdiagnosis.

The report highlighted "strong concerns about the consistency and quality of ADHD and autism assessments" carried out by independent providers, as well as the financial incentives linked to these assessments. It noted that a large and rapidly growing use of public money is operating without consistent oversight, transparency, or quality assurance.

The surge in demand has been partly fueled by the "Right to Choose" policy, which allows individuals to opt for any qualified provider at the NHS's expense. Spending on independent-sector ADHD provision has increased by approximately 252% in three years. Some integrated care boards have reported a tenfold increase in monthly spending on ADHD and autism services over the course of a year.

Concerns have been raised by medical professionals about "superficial" assessments, with a perceived higher diagnosis rate among those referred to private providers compared to NHS routes. While the report acknowledges that private providers can help reduce waiting times, it emphasizes that safeguards for quality and value for money have not kept pace.

Variations in pricing for similar services were also noted, with a warning that existing payment structures could unintentionally incentivize firms to conduct combined ADHD and autism assessments for greater financial gain. The report also pointed out that diagnosis can become the beginning of another lengthy wait for treatment, rather than the start of care.

To address these issues, the review recommends that all ADHD and autism assessment providers be regulated by the Care Quality Commission (CQC), with consistent standards for quality, training, data reporting, and oversight. It also calls for all providers to submit comparable information on activity, waiting times, quality, and outcomes as a condition of public funding. Furthermore, the report suggests banning direct-to-public advertising of assessments to ensure access is based on clinical need rather than marketing.

Responding to the report, the DHSC stated it will enhance regulation around assessment practices and review advertising by private providers. Health Secretary Yvette Cooper affirmed that the government will take action to strengthen oversight of mental health and neurodevelopmental services, making all diagnostic assessments for ADHD and autism CQC-regulated. This aims to assure patients of high-quality assessments and prevent the NHS from being overcharged by independent or private providers.