800,000 people are waiting. A review may change who gets an ADHD diagnosis
What happened
A government review of mental health conditions, autism and ADHD is due to report next week, and early details have caused a row. The review is expected to say that people with ADHD symptoms should not automatically be given a formal diagnosis. Instead, they would be "triaged". That means being assessed and offered help based on what they actually struggle with, rather than on a label. Under this "needs-based" system, NHS ADHD clinics would focus on the people affected most severely. That includes people at risk of self-harm and people unable to work. Only patients who would clearly benefit from a formal diagnosis, such as those who need medication, would be referred on to a clinic. Everyone else would still be offered support. The review suggests this could include one-to-one help for children in lessons, quiet rooms in schools, classes to help parents, and employers offering flexible hours. The review was commissioned in December by the then health secretary, Wes Streeting. It is led by Professor Peter Fonagy, a clinical psychologist and psychoanalyst at University College London. Details were first reported by the Times, and the Guardian reported the reaction on 17 September 2026. That reaction was sharp. Henry Shelford, chief executive of the charity ADHD UK, called the plan "rationing".
Why this matters
The numbers behind this are large. Around 800,000 people in England are on NHS waiting lists to be assessed for ADHD or autism. Many wait years. Complaints about autism and ADHD services in England have more than tripled in five years. That tells you how much pressure the system is under. There is a money side too. Growing numbers of adults and young people with ADHD are not in education, training or work. About 100,000 of them are on health-related benefits because of their condition. The ADHD taskforce calculated that the cost of undiagnosed, untreated ADHD was £17 billion. So the question is not whether the current system is struggling. Almost everyone agrees it is. The question is whether this is the right fix. If you or someone in your family is on a waiting list, this could change what happens next. It could mean help arrives sooner. It could also mean a diagnosis you were expecting never comes.
What the evidence actually says
It is worth being careful here, because the full report is not out yet. What we have is a briefing about what it is expected to say. That is not the same as the final recommendations. The interim review did reach one clear conclusion: the current system forces children and adults to get a formal diagnosis in order to get any support at all. That is a real problem. A label should not be the only key that unlocks a quiet room or extra time. Critics make an equally serious point. Henry Shelford of ADHD UK said: "There is no 'mild' ADHD. Diagnosis requires evidence of a debilitating impact on your life. We already have a clinically drawn line of need." He added: "Without a formal diagnosis, it appears we will be left to self-diagnose via social media. Schools and businesses shouldn't be forced to rely on TikTok to know when to put in adjustments and support." Shelford also pointed to figures showing that, on average, a woman with ADHD dies nine years younger than her peers, and a man seven years younger. Mel Merritt, head of policy and influencing at the National Autistic Society, said: "Denying people a diagnosis will only worsen inequalities experienced by people who are autistic and autistic people with ADHD." Andy Bell, chief executive of the Centre for Mental Health, said people seeking mental health support need speedy access to effective help, and that a diagnosis can help people understand their distress and get the right treatment. So the honest summary is this: there is broad agreement that waiting years is unacceptable. There is real disagreement about whether reducing formal diagnoses is help or rationing. Both sides are arguing from genuine concern, and the evidence does not settle it yet.
Practical advice
If this affects you or your family, here are some steady steps. Stay on the waiting list. Nothing has changed yet. The review has not been published, and no new system is in place. Coming off a list now would be premature. Ask for support without waiting for a label. This is the part many people do not realise. Schools already have a duty to support pupils with additional needs, and employers already have duties under the Equality Act 2010 to make reasonable adjustments. You can ask now. You do not have to wait for a diagnosis to start that conversation. Write things down. Keep a simple record of what your child or you find hard, and when. Specific examples carry more weight than general statements in any assessment or school meeting. If you take ADHD medication, keep taking it as prescribed. None of this changes your current prescription. If you are worried about supply or about a review of your treatment, speak to your GP or pharmacist rather than stopping on your own. Be careful with social media. Short videos can be a helpful starting point for recognising yourself in something. They are not an assessment. If a video prompts a worry, take that worry to a professional rather than acting on it alone. Respond to the consultation if there is one. Reviews like this usually invite views. Your experience of waiting is exactly the evidence such a process needs.
What to know
A government review, led by Professor Peter Fonagy of University College London, is expected next week. It is likely to recommend that fewer people receive a formal ADHD diagnosis, and that support instead be based on assessed need. Around 800,000 people are on NHS waiting lists for ADHD or autism assessment. Charities including ADHD UK and the National Autistic Society have criticised the plan as rationing. Supporters argue the current system wrongly makes a diagnosis the only route to help. Nothing has changed yet. If you are waiting, stay on the list, and remember you can ask your school or employer for adjustments now. Sources: The Guardian, "Plan to limit NHS diagnoses of ADHD attacked as 'rationing' healthcare", 17 September 2026, https://www.theguardian.com/society/2026/sep/17/plan-limit-number-nhs-patients-diagnosed-adhd-rationing-healthcare ; GOV.UK, "Independent review into mental health conditions, ADHD and autism", https://www.gov.uk/government/collections/independent-review-into-mental-health-conditions-adhd-and-autism ; GOV.UK, "Independent review into mental health conditions, ADHD and autism: terms of reference", https://www.gov.uk/government/publications/independent-review-into-mental-health-conditions-adhd-and-autism-terms-of-reference This article is for general information and does not replace advice from a doctor, pharmacist or other qualified healthcare professional. If you are taking prescribed medication for ADHD, do not stop or change it without speaking to the professional who prescribed it.
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