ADHD and autism costs in England ‘running out of control’, NHS leaders warn
Soaring demand for services has led to tenfold increase in spending in a year in some areas, says NHS Alliance NHS leaders have warned that the costs of meeting soaring demand for ADHD and autism services in England are “running out of control” and have become unsustainable, with spending in some areas rising by up to tenfold over the course of a year. The NHS Alliance, which represents health…
NHS leaders have expressed concern that the costs associated with providing attention deficit hyperactivity disorder (ADHD) and autism services in England are spiraling out of control and unsustainable. Spending on these services has skyrocketed, with some areas experiencing a tenfold increase in just one year. This surge in demand, exacerbated by the COVID-19 pandemic, has forced some NHS trusts to close waiting lists and reassess their provision of other services.
The NHS Alliance, which represents health managers, highlighted the financial strain placed on integrated care boards (ICBs) by the rising costs. For instance, one ICB reported that its monthly expenditure on adult ADHD services rose from £11 million in 2023-24 to a projected £51 million for the current financial year. Another ICB noted that demand for autism services had increased tenfold over the course of a year, with monthly spending soaring from £146,000 in 2024-25 to £1.5 million in the previous year.
The rapid expansion of new providers, fueled by patients' rights to choose any qualified provider, has exacerbated the situation. One ICB now has 80 providers operating within its jurisdiction, while another experienced a surge from invoicing 12 to 14 providers two years ago to receiving 48 invoices in the most recent period. This expansion has raised concerns about quality assurance and regulation, particularly as some new providers specialize in assessments but lack the capacity to provide ongoing care.
Despite the influx of new providers, the lack of a national tariff has led to significant price variations for similar services, ranging from £300 to £3,000. This lack of standardization has added to the cost pressures faced by NHS trusts. Rebecca Gray, director of the NHS Alliance's mental health network, emphasized the dilemma local health leaders face: balancing the need to meet rising demand for assessments, treatment, and support with the urgent need to control costs.
Unplanned overspending on ADHD and autism services can disrupt long-term planning and impact other essential activities.
The NHS Alliance is advocating for a national mandatory price, or tariff, for ADHD and autism services, as well as a consistent national service specification applied across all NHS-funded providers. This proposal aims to bring stability and affordability to a system grappling with unprecedented financial challenges.
Written by urgent.news from Guardian Health's reporting — not their text. Machine-written — may contain errors; check the original before relying on it.
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