Legal Challenge Planned as NHS Board Halts ADHD Assessments for Adults

A charity advocating for individuals with Attention Deficit Hyperactivity Disorder (ADHD) is preparing to initiate legal proceedings against the Coventry and Warwickshire Integrated Care Board (ICB) following its decision to pause referrals for adults aged over 25. This suspension, effective from May 21, 2025, aims to alleviate long waiting lists for pediatric ADHD assessments but has drawn criticism from advocacy groups and health professionals, highlighting potential consequences for adult patients.

The Coventry and Warwickshire ICB announced the referral freeze as part of an emergency policy to prioritize treatment for children, with over 7,500 minors currently awaiting assessment, some for as long as ten years. According to Dr. Imogen Staveley, Chief Medical Officer at NHS Coventry and Warwickshire ICB, this decision is intended to support the creation of a sustainable, comprehensive ADHD pathway that accommodates all age groups in the future.

Henry Shelford, Chief Executive of ADHD UK, criticized the ICB’s decision, stating, "It’s ridiculous. We know one in ten men and boys and one in four women and girls with ADHD will at some point try to take their own life, so we know there’s a danger... You can’t get ADHD medication unless you have a diagnosis, and this is part of the discrimination we face every day.” Shelford emphasized that this measure could set a troubling precedent for NHS trusts facing financial constraints, potentially leading to further cuts in essential services.

In contrast, the NHS has acknowledged the growing demand for ADHD assessments, which has significantly increased in recent years. A spokesperson for NHS England stated, "ADHD services are under significant pressure from a huge rise in people coming forward, resulting in unacceptably long waits for assessment and treatment, particularly for children and young people." The NHS has established an ADHD taskforce to explore potential service improvements and address these pressing issues.

Anita Thapar, a psychiatrist and chair of the ADHD taskforce set up by NHS England, noted that while ADHD research has advanced considerably over the last two decades, the corresponding services have not evolved at the same pace. "ADHD is under-recognised, under-diagnosed, and under-treated in England," Thapar remarked, emphasizing the need for enhanced training for healthcare professionals to diagnose the disorder accurately.

The implications of the referral halt extend beyond immediate healthcare access. Critics warn of the adverse mental and physical health outcomes associated with undiagnosed ADHD, including obesity, cardiovascular disease, and increased risk of criminal justice system involvement. The current policy may exacerbate these risks, particularly for adults forced to seek private assessments due to the referral freeze.

David Hare, Chief Executive of the Independent Healthcare Providers Network (IHPN), highlighted the capacity within the independent healthcare sector to alleviate the backlog of ADHD assessments. "There is ample local capacity available in the independent sector which can be used to cut the backlog of care and improve access to diagnosis and treatment for all those in need, regardless of age," Hare stated.

The legal challenge, which ADHD UK plans to launch under the 'right to choose' legislation, is rooted in the belief that patients should have the option to select their providers for specific healthcare services when referred by their GP. This legislation was designed to empower patients and enhance access to necessary care, but the current situation raises questions about its effectiveness in practice.

In this context, the need for a balanced approach to healthcare resource allocation is critical. Sarah Walter, Integrated Care System Network Director at the NHS Confederation, acknowledged the tough decisions facing integrated care boards in light of limited financial resources. "Commissioners and providers are having to take a pragmatic approach to respond to the needs identified, which may mean prioritizing certain groups based on age or waiting times," Walter explained.

As the legal challenge unfolds, the future of ADHD services in the UK remains uncertain. Advocates for patients and healthcare professionals alike are calling for a reevaluation of the decision to pause referrals, emphasizing the importance of timely diagnoses and treatments for all age groups. The ongoing discourse highlights a growing recognition of ADHD as a significant public health issue, necessitating a coordinated response from both public health authorities and community organizations.

The case also underscores broader challenges within the NHS, as it grapples with increasing demand for mental health services amid constrained budgets. With ADHD affecting an estimated 3-5% of the population, the need for comprehensive and accessible healthcare services has never been more pressing. Stakeholders will be watching closely to see how this situation develops, as its outcome has the potential to influence ADHD care across the UK and beyond.