The State of ADHD Access in England 2026
What Freedom of Information responses from England's Integrated Care Boards reveal about NHS spending on private ADHD and autism assessments — and the quiet tightening of Right to Choose.
An independent analysis by NeuroCompare · October 2026 · Updated 4 October 2026
Key findings
- NHS spending with independent providers for ADHD and autism assessment more than doubled in a year — up 2.4× across the 31 ICBs that disclosed both years, from £52.3m (2023/24) to £125.8m (2024/25).
- Total disclosed independent-sector spend reached ~£135m in 2024/25 (35 ICBs); part-year 2025/26 figures already total ~£214m.
- Right to Choose is tightening, not closing: of 37 ICB responses, 19 still accepting, 7 restricting (activity caps, long waits), 11 unclear, 0 fully paused.
- Some areas have minimum waits of up to two years, and several are introducing quality/accreditation frameworks for providers.
- Access is a postcode lottery — reported spend and waits vary enormously by ICB.
The money: a market transformed in twelve months
Demand has outrun NHS capacity. ICBs report paying independent providers to fill part of that gap, with disclosed spending rising sharply. The figures below are reported amounts, not estimates of total national spending.
| ICB | 2023/24 | 2024/25 | 2025/26 (part-year) |
|---|---|---|---|
| Greater Manchester | £5.36m | £13.94m | £22.32m |
| Sussex | £3.36m | £11.25m | £21.42m |
| North East & North Cumbria | £4.94m | £12.67m | £18.84m |
| Norfolk & Waveney | £1.82m | £5.88m | £10.28m |
| South Yorkshire | £2.02m | £5.34m | £6.93m |
| Black Country | £0.05m | £0.64m | £3.04m |
Independent-sector / Right to Choose spend as disclosed by each ICB. 2025/26 figures are part-year (cut-offs vary) — indicative of direction, not full-year totals.
Greater Manchester
Sussex
North East & North Cumbria
Norfolk & Waveney
South Yorkshire
Black Country
Right to Choose: not closed, but narrowing
Of 37 ICB responses, 19 reported that they were accepting Right to Choose referrals, 7 reported restrictions such as activity caps or long waits, 11 were unclear, and 0 reported a full pause. Some ICBs described caps as “indicative activity plans”; some areas reported minimum waits of up to two years. Several also reported emerging quality or accreditation requirements for providers. The right remains on paper, but increasingly comes with queues.
Supporting NHS context
Prescribing and demand are rising fast
NHS prescribing data helps explain the pressure behind the reported spending. The figures below cover England in April–June 2026.
1,309,903
ADHD prescription items dispensed in the quarter
up 12% on the previous quarter
395,000
people identified as receiving ADHD medication
up 11.6%
46%
of patients (whose sex is recorded) are female
up from 41% a year earlier
£17bn
estimated annual cost of undiagnosed, untreated ADHD to the UK (ADHD Taskforce)
The number of ADHD prescription items rose 12% in a single quarter — from 1,168,980 to 1,309,903. A year earlier, the same quarter saw about 965,000 items, so prescribing was up by roughly a third year-on-year. The number of identified patients rose 11.6% to 395,000, up from 284,000 a year before.
The gender picture is changing — but girls are still missed
Among adults aged 20 and over, NHS prescribing data recorded slightly more women than men receiving ADHD medication: 136,508 women and 110,722 men. Among children and young people aged 5–19, it recorded 104,063 boys and 43,094 girls. These figures show who received medication; they do not measure everyone with ADHD or explain the reason for the difference.
The assessment bottleneck
More people receiving treatment does not remove the assessment backlog. The FOI responses and prescribing data describe different parts of the same system: growing recognised demand, limited NHS capacity, and substantial reported spending with independent providers.
What it means for patients
- A postcode lottery: reported spending, waits and restrictions vary substantially between ICBs.
- More pressure towards self-funding: as waits grow, some people may consider paying privately, making transparent comparison of waits, prices and quality more important.
- A new workplace front: government is also procuring neurodiversity assessment through employers via the £175.5m occupational-health lot of framework RM6400.
NeuroCompare's view
This is why NeuroCompare exists: to offer an independent, transparent way to understand NHS Right to Choose and private options, and to compare providers on published waits, prices and quality information. Rankings are never sold.
Methodology and caveats
The FOI analysis is based on responses from about 42 English ICBs, requested through WhatDoTheyKnow in August 2026, and re-derived from the raw responses. Figures are independent-sector / Right to Choose spend as each ICB reported it. Block-contract totals are excluded. Scope varies: some ICBs combine ADHD and autism or include treatment. 2025/26 figures are part-year. Several ICBs withheld information on cost grounds or did not respond. Full per-figure sourcing is available on request.
The prescribing figures come from NHS Business Services Authority data for England, published on 10 September 2026 and covering April–June 2026. Patient counts cover people who received at least one relevant prescription; percentages by sex are of patients whose sex is recorded. These datasets have different scopes and should not be treated as directly comparable.
Sources
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