NHS services providing ADHD and autism assessments are under growing pressure as specialist staff move to private clinics serving a large and expanding demand for diagnoses.
The departures have affected psychologists, psychiatrists, nurses and other professionals. In one English NHS trust, staff losses led to temporary restrictions on access to its neurodevelopmental service for children and young people.
Staff losses add to long waits
About 810,000 children and adults in England are waiting for an ADHD or autism assessment. NHS services have faced increased demand, long waits and substantial backlogs, creating opportunities for private providers that can often offer appointments more quickly.
The Herefordshire and Worcestershire Health and Care NHS Trust said its neurodevelopmental staffing had been significantly reduced, with most leavers taking roles with independent-sector and Right to Choose providers.
Right to Choose allows NHS patients to receive an NHS-funded ADHD or autism assessment from a private provider. The trust limited access for under-18s to people with the most serious or urgent symptoms after the staff departures. It said it would return to a normal service on Monday. A total of 1,298 people had already waited at least two years for an assessment with the trust.
Thea Stein said the NHS becomes weaker and more pressured when staff move to private operators. Some professionals remain in NHS work part-time, she said, while others leave entirely. The NHS Alliance also said staff departures were continuing and that one ADHD workforce was increasingly divided between NHS and private providers.
Regulation of private assessments
The Care Quality Commission has announced that it will begin inspecting private clinics that offer diagnostic assessments for ADHD and autism. The move is intended to close a gap in oversight: the CQC already regulates services providing diagnosis and treatment, but non-NHS clinics offering diagnostic assessments alone will also have to register.
The change followed a government-commissioned review of mental health and neurodiversity, which urged ministers to ensure that all service providers are properly regulated. The review raised concerns about a “wild west” of private firms offering diagnostic tests. These concerns, including the possibility that financial incentives could encourage incorrect diagnoses or unnecessary treatment, are presented as risks rather than established findings.
Adrian James, the CQC’s interim inspector of mental health care, said the new responsibility would give people greater confidence in the services they receive. Health Secretary Yvette Cooper said tighter regulation should support confidence in assessment quality and help ensure the NHS is not overcharged by independent or private providers.
The exact date when inspections will start has not been provided. The source also reports that 83% of Independent Healthcare Providers Network members delivering ADHD and autism assessments are rated good or outstanding, according to Sean Phillips.
Why the change matters to families
For people waiting for an assessment, the growth of private provision creates a complicated choice. Private services may offer faster access, but the movement of staff from NHS teams can reduce the capacity of the public services many people rely on.
Stein warned that inequalities could widen if NHS services cannot retain fully staffed teams or expand them to meet demand. People who can afford private care may receive support more quickly, while others remain in NHS queues.
New CQC registration and inspections are intended to strengthen oversight of private diagnostic providers. They do not, by themselves, resolve the workforce shortages, long waits or wider pressure on NHS neurodevelopmental services.
AI tools were used to assist with the preparation of this article.
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