Seven in ten GPs believe adult ADHD is over-diagnosed and some say they have never known a private provider reject a diagnosis.
Increased awareness of the condition has driven up waits for NHS assessments and in turn pushed patients towards private clinics.
Some patients pay more than £1,000 for a consultation while others are able to secure an NHS referral to an assessor of their choice, with taxpayers footing the bill.
The diagnosis can aid benefits claims, such as personal independence payments, which have soared in recent years.
Family doctors estimated that more than eight in ten patients referred for specialist assessments ultimately received an ADHD diagnosis.
Those responding to a poll by GP publication Pulse raised concerns about ‘superficial’ assessments and warned that trauma and other mental health problems could be overlooked.
A GP from Berkshire revealed that of over 1,000 patients they had referred, only one did not receive a positive ADHD diagnosis.
Other respondents said they perceived the diagnosis rate for those referred to private provider routes was higher than via NHS routes.
A diagnosis of ADHD can aid benefits claims, such as personal independence payments, which have soared in recent years
A Dorset-based GP said: ‘Occasionally NHS services do not make a positive diagnosis, but I don’t think I have ever seen a private provider not give a positive diagnosis.’
It comes ahead of the publication of a government-commissioned review into the rising demand for ADHD, autism and mental health services.
Professor Peter Fonagy, the clinical psychologist leading the review, is expected to recommend providing more support based on people’s needs, without requiring a formal diagnosis.
The costs of meeting the ‘soaring’ demand for autism and ADHD services in England have become ‘unsustainable’, health chiefs have warned.
The NHS Alliance said that spending on ADHD and autism has risen by up to ten-fold over the course of a year in some areas, citing one integrated care board (ICB) which reported its monthly spend had risen from £146,000 in 2024/25 to £1.5m last year.
Another reported an increased spend on adult ADHD services from £11m in 2023/24 to a projected £51m this financial year, Pulse reported.
The sharp increase in demand has led to an influx of new providers, fuelled by the Right to Choose, which allows people seeking diagnosis for themselves or a child to opt for any qualified provider.
But the NHS Alliance said that the rapid expansion of new providers has also prompted concerns from ICBs about quality assurance and regulation.
Rebecca Gray, the NHS Alliance’s mental health network director, said local health leaders were ‘caught between a rock and a hard place’.
‘They understand the anguish and frustration caused by long delays in the system as people wait for assessments, treatment and support,’ she said.
‘But in working to meet rising demand they face soaring costs that are running out of control.
‘The current situation is unsustainable and delivers a bad deal for patients and taxpayers.’
One ICB told the NHS Alliance it now has 80 providers on its patch, while another said that two years ago it had received invoices from 12 to 14 providers, a figure which has now risen to 48.
Meanwhile, the Parliamentary and Health Service Ombudsman (PHSO) said there has been a more than 200 per cent rise in complaints about ADHD and autism services over the past five years.
The Pulse survey of 829 GPs found 410 consider adult ADHD ‘very over-diagnosed’ and 173 consider it ‘slightly over-diagnosed’.
Another GP, based in Devon, who responded to the survey, said: ‘ADHD seems to be considered a more socially acceptable diagnosis than, for example, PTSD.
‘I am stunned by how superficial some assessments are, and how little reference is made to some patients’ significant history of trauma or adverse childhood experiences, which would in themselves be an adequate explanation for the patient’s difficulties.’
Greater Manchester GP partner Dr Liz Clarke, who responded to the survey, said the current system of having single pathways for the diagnosis of single conditions does not provide a holistic patient assessment and ‘creates the risk of overdiagnosis because the focus is to diagnose or exclude only one cause’.
She also raised concerns of ‘harm’ that could be caused to patients as a result, ‘as they can be put on the wrong medications or have the wrong psychological interventions when neurodiversity is not recognised, as well as vice versa’.
The Government said: ‘Professor Fonagy’s final report will be published shortly, and will inform our new national approach in this area.’
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