Private Firms Now Handle Over Half of NHS-Funded ADHD Assessments

The figures come from a BMJ article co-authored by Uta Frith and Naomi Fisher, who argue that private providers are profiting from the expansion of ADHD and autism diagnosis. The scale is striking: NHS commissioners are paying independent companies to deliver assessments that were once handled entirely within NHS services.

The shift reflects years of growing waiting lists for neurodevelopmental assessments — lists so long that many patients have been waiting well over a year for an NHS appointment. Commissioning private providers has been one way NHS bodies have tried to reduce that backlog.

But the BMJ article raises questions about who benefits from that arrangement. Frith and Fisher’s piece points to a system in which private companies have a financial interest in the volume of diagnoses made — a concern that sits uncomfortably alongside the clinical judgement those assessments are supposed to represent.

ADHD (attention deficit hyperactivity disorder) and autism are both neurodevelopmental conditions that affect how people think, focus, and interact with the world. Diagnosis opens the door to support in schools, workplaces, and through NHS services — so the process carries real weight for patients and families.

The NHS has not yet issued a formal response to the BMJ article. The BMJ piece does not suggest that private assessments are inaccurate, but it does flag the structural conflict of interest in a market-driven model.

If you’re waiting for an ADHD or autism assessment and have concerns about your care, contact your GP in the first instance, or call NHS 111 for guidance.