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UK adult ADHD services in crisis

Michael Smith, Raja Mukherjee, Ulrich Müller-Sedgwick, Dietmar Hank, Peter Carpenter, Marios Adamou · 2023 · 44 citationsRead the paper

The UK's services for adult attention-deficit hyperactivity disorder (ADHD) are in crisis, with demand outstripping capacity and waiting times reaching unprecedented lengths. Recognition of and treatments for ADHD have expanded over the past two decades, increasing clinical demand. This issue has been exacerbated by the COVID-19 pandemic. Despite an increase in specialist services, resource allocation has not kept pace, leading to extended waiting times. Underfunding has encouraged growth in independent providers, leading to fragmentation of service provision. Treatment delays carry a human and financial cost, imposing a burden on health, social care and the criminal justice system. A rethink of service procurement and delivery is needed, with multiple solutions on the table, including increasing funding, improving system efficiency, altering the service provision model and clinical prioritisation. However, the success of these solutions hinges on fiscal capacity and workforce issues.

What the full text shows

Theory or simulation
  • Significant variation in waiting times for ADHD assessment following referral. — 4 weeks to nearly 4 years (Based on 2018 Freedom of Information request to clinical commissioning groups)
  • Estimated realistic waiting time for newly added individuals if demand remains static and no additional funding is provided. — 5-10 years (In services currently quoting a 2-4 year wait)
Setup
Analysis of UK national health service delivery, referencing 2018 FOI data and NICE guidelines.
How
The authors provide a qualitative analysis and expert consensus on the state of UK adult ADHD services, evaluating five potential strategic options for system improvement.
Limitations
Lack of routinely collected national data · Absence of specific national targets for ADHD waiting times · Fiscal and workforce constraints limiting implementation of proposed solutions

Summarized by Gemma 4 from the open-access full text · 11 Oct 2026. Read it