Adult ADHD services across England are facing unprecedented strain, with many areas now closing waiting lists, tightening referral criteria, or restricting who can access support. A recent BBC investigation has revealed just how severe the situation has become — and what it means for the thousands of people still waiting for a diagnosis.
As demand for ADHD assessments continues to surge, experts warn that the current system is becoming unsustainable, leaving many without access to life-changing support.
A Growing Number of Services Are Unable to Accept New Patients
The BBC, through freedom of information requests, surveyed 59 services across England. They found:
- 15 local areas have closed their ADHD waiting lists entirely
- 31 areas have introduced stricter criteria, limiting who can be referred
- In Cheshire, the adult ADHD service has been closed to new patients since 2019
- Some areas serve large regions but have only closed specific localities, creating a postcode lottery
These decisions, while often described as temporary, are leaving thousands of people in limbo — unable even to join a queue for assessment.
Demand is rising so fast that some services say they cannot safely or ethically continue adding to waiting lists that are already many years long.
A System Under Extreme Pressure
NHS England’s own figures already show average adult ADHD waits of around eight years for those who manage to get onto a list. But the latest findings reveal the problem is bigger than previously recognised: many people are no longer able to access a waiting list at all.
Prof Anita Thapar, chair of NHS England’s ADHD taskforce, described the situation as deeply concerning.
She called the findings “disturbing” and emphasised the “enormous risks” faced by patients who go without support. Her taskforce report, released the same week, highlights widespread under-diagnosis and under-treatment, and calls for fundamental changes in how ADHD care is provided across health, education, and even the criminal justice system.
Under-Diagnosed, Under-Treated — and Often Overlooked
ADHD affects how the brain regulates attention, impulse control, and emotional responses. It is estimated to affect:
- 5% of children
- 3–4% of adults
Yet many adults go undiagnosed for decades. Without intervention, ADHD can contribute to:
- Mental health difficulties
- Substance misuse
- Higher unemployment
- Difficulties maintaining relationships
- Greater involvement with the criminal justice system
Experts stress that with proper support — including psychological therapy, medication, and structured strategies — individuals can thrive. But without timely assessment, opportunities for early, effective help are lost.
Why Services Are Struggling to Cope
There are several reasons for the dramatic rise in demand:
1. Greater Awareness
Public conversations, social media, and national reporting have helped more people recognise ADHD symptoms in themselves or their children.
2. Reduced Stigma
People feel more able to seek help and pursue diagnosis.
3. Workforce Shortages
Specialist ADHD teams are small, and many areas rely on limited staff. This makes it difficult to manage demand.
4. Structural Challenges
Historically, ADHD services have often been under-funded or inconsistently commissioned across regions. Adult ADHD provision, in particular, has long been patchy.
Dr Jessica Eccles of the Royal College of Psychiatrists noted that “rising demand is outstripping capacity,” leaving services to make difficult decisions about who they can safely support.
Patients Falling Through the Cracks: Louise’s Story
For the many people seeking answers, the consequences can be profound.
Louise Nichols, from Derbyshire, has struggled with symptoms since childhood. She has faced challenges in school, work, and daily life, and believes an ADHD assessment could help her finally access the right support.
But because her area has no local service, she was placed on a neighbouring region’s waiting list — only to be removed when that trust stopped assessing people from outside its borders.
Louise is one of more than 3,700 people in the county who suddenly found themselves without a route to diagnosis.
“It’s really disappointing,” she said. “I can’t understand why a national health service isn’t across the whole nation.”
Legal Challenges Emerging
In some parts of England, the situation has escalated to the point where legal action is being considered.
One example is Coventry and Warwickshire, where adult ADHD assessments have been temporarily restricted to only those under 25. The Integrated Care Board is now facing potential legal consequences for this decision.
Advocacy groups have warned that restricting access in this way risks leaving adults — who may have struggled for decades without support — with nowhere to turn.
Examples of Innovation Amid the Pressure
While many areas are closing waiting lists, others are exploring new ways to respond to the crisis.
In Surrey, where more than 11,000 adults are waiting, a pilot scheme is training a group of GPs to conduct ADHD assessments and ongoing care. The aim is to expand capacity by equipping more clinicians with the necessary skills, rather than relying solely on small specialist teams.
Experts believe broader involvement from community NHS staff — including GPs and pharmacists — could ease pressure on specialist services, though this will require substantial training and support.
The Human Impact: A Life Transformed After Diagnosis
Sam Stone, 33, knows firsthand the difference a diagnosis can make. After years of mental health difficulties and repeated cycles of antidepressants, his ADHD diagnosis — eventually recognised by the NHS after a long process — changed everything.
He describes the relief as “massive,” like having a long-standing cloud finally lifted.
But his journey also shows how complicated the pathway can be. Despite securing a private assessment through insurance, he had to return to the NHS waiting list to have the diagnosis confirmed — a process many describe as confusing, inconsistent, and exhausting.
Where Do We Go From Here?
The investigation highlights urgent, systemic issues, and the dire need for new infrastructure:
1. Long-Term Investment Is Needed
Demand will not decrease. Services must expand to meet the needs of both adults and children.
2. National Consistency Must Improve
The postcode lottery leaves some people unable to access any pathway to diagnosis.
3. Broader Workforce Involvement Could Ease Pressure
Training GPs, pharmacists, and community clinicians may help build a more sustainable model.
4. Clearer, Simpler Pathways Are Essential
Patients should not have to fight the system simply to be assessed.
A Moment of Reckoning for ADHD Care
ADHD has always been present in the population. What has changed is society’s recognition of how deeply it affects everyday life — and how vital proper diagnosis and support can be.
The current service closures and restrictions are not just administrative issues; they represent real people being left without answers, often during some of the most challenging periods of their lives.
As waiting lists grow and more services reach breaking point, the call for reform is becoming impossible to ignore. The hope now is that awareness, advocacy, and the taskforce’s recommendations will lead to a fairer, more accessible system for everyone who needs it.
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