Spending on ADHD and autism tests rises tenfold

By the Editorial Team · Friday, August 28, 2026

NHS spending on ADHD and autism assessments has surged dramatically, with some regions seeing costs increase up to tenfold due to a rise in privately funded evaluations under the "Right to Choose" initiative. This rapid growth has led to concerns over unsustainable expenditure, prompting calls for national pricing controls and quality standards to prevent overspending and ensure consistent care.

Spending on diagnosing attention deficit hyperactivity disorder (ADHD) and autism within NHS health trusts has increased dramatically over the past year, with costs rising up to tenfold in some areas, according to a recent report by the NHS Alliance. The surge in expenditure has prompted concerns among NHS leaders that the situation is “out of control and unsustainable,” as private clinics increasingly capitalize on growing demand.

The report, which examined spending across all 42 NHS regional integrated care boards, highlighted a steep rise in funds allocated for ADHD and autism assessments. In one region alone, spending jumped from £1.75 million in 2024-25 to £18 million in 2025-26. In Cheshire and Merseyside, adult ADHD service costs grew from £11 million in 2023-24 to £38 million in 2024-25, with projections reaching £51 million for the current financial year.

Currently, around 800,000 people in England remain on NHS waiting lists for ADHD assessments. Under the "Right to Choose" initiative, patients on these lists have a legal entitlement to be assessed privately, with the NHS covering the associated costs. Last year, the NHS funded 100,000 such private assessments. However, the report identified significant variability in fees charged by private providers, ranging from £300 up to £3,000 per assessment.

The proliferation of private clinics, some owned by private equity firms and offering online diagnostic services, has led to what NHS leaders describe as a “Wild West” market. One NHS trust reported receiving invoices from as many as 80 different clinics. Rebecca Gray, director of the NHS Alliance’s mental health network, warned that the soaring, unplanned costs were contributing to overspending and forcing trusts to cut other vital services. For instance, one trust had to delay implementing a support team for people with learning disabilities to allocate funds toward ADHD assessments.

Gray called for urgent reforms, including implementing a national fixed tariff to cap private clinic charges and establishing a consistent service specification to ensure quality assessments. Similarly, Thea Stein, chief executive of the Nuffield Trust, noted that the state has been unable to keep pace with the “dramatic growth” in demand for ADHD and autism services. She described the situation as a growing crisis and suggested that unless the government suspends the provision allowing NHS-funded private assessments, controlling spending will remain difficult.

Stein also emphasized the need to assist patients in navigating the uneven quality of private providers, warning that some clinics offer rapid online assessments with less diagnostic rigor. The latest figures come ahead of a government inquiry into the rising rates of ADHD and autism diagnoses. An interim report from March pointed to “institutional incentives” for seeking diagnoses due to potential special adjustments at school and work.

An NHS spokesperson acknowledged the extended waiting times for many families and stated that steps are being taken to improve access to services while ensuring value for money. The challenges surrounding ADHD and autism assessment costs underscore a complex balancing act between meeting rising demand, controlling public expenditure, and maintaining service quality.

This article was reported by synthesizing coverage from multiple independent news outlets to present a balanced, unbiased account. Read about our editorial standards. Spotted an error? Let us know.