ADHD assessment waits in England have become a major access-to-care issue, with some people facing delays of 2 years or more before receiving a clinical assessment.
For many people living with symptoms of attention deficit hyperactivity disorder (ADHD), seeking an NHS assessment can be the start of a long and uncertain process.
In some parts of England, people are now being told that they may have to wait 2 years or more simply to be assessed for ADHD. In some areas, reported waits are considerably longer.
ADHD is not an administrative problem, difficulties with concentration, organisation, impulsivity, emotional regulation, education, employment or relationships, a prolonged wait for assessment can mean years without an explanation and access to appropriate treatment and support.
There has been a substantial increase in demand for ADHD assessments in recent years.
NHS England’s ADHD data reported up to 803,658 open referrals that may have been for an ADHD assessment in March 2026. Up to 32,375 new referrals that may have been for an ADHD assessment were received during that month alone, representing an increase of almost 30% compared with March 2025.
At the same time, ADHD remains undiagnosed in people, who have not sought a diagnosis yet. The independent NHS England ADHD Taskforce estimated that ADHD affects approximately 3–5% of children and 2–3% of adults, while considerably fewer people have received a diagnosis.
The increasing demand therefore reflects a complicated combination of factors: greater awareness of ADHD, improved recognition of presentations that may previously have been missed, increased referrals from schools and primary care, and people seeking explanations for longstanding difficulties.
The NHS has not expanded assessment capacity sufficiently to meet this demand in many areas.
In February 2026, more than 63,000 people aged 17 and under and more than 46,000 people aged 18–24 were recorded as potentially waiting for an ADHD assessment through mental health services for more than two years. A further 31,000 people on community paediatrics waiting lists who could have been waiting for an ADHD assessment had been waiting more than 104 weeks.
Importantly, waiting times are not the same everywhere. Some people may be assessed within months, while others face waits measured in years. NHS England itself has acknowledged that some people wait more than 2 years and that waits of 10–15 years have been reported in some areas.
The result is a postcode lottery in access to assessment.
An ADHD assessment is not about obtaining a diagnostic label. The assessment provides an explanation for difficulties that have been present since childhood. Someone may have spent years being described as disorganised, lazy, unreliable, careless or lacking motivation when the underlying difficulties have been related to ADHD.
Adults may have developed elaborate strategies to compensate for their difficulties. They may be struggling at work, missing deadlines, experiencing relationship difficulties, finding household organisation overwhelming or feeling unable to manage competing demands.
For children and young people, untreated difficulties can affect education, friendships, family relationships and self-esteem.
Individuals may benefit from practical support based on their current difficulties rather than a confirmed diagnosis, however, often these adjustments are only available to those with a diagnosis. This might include discussing workplace adjustments, asking schools or universities about available support, using written reminders and structured routines, and speaking with a GP if symptoms are affecting safety, mental health or daily functioning.
Diagnosis matters because it can open the door to treatment, adjustments and a clearer understanding. Diagnosis alone is not enough if services cannot also provide appropriate follow-up care.
A proper assessment should consider the person’s developmental history, current difficulties and functioning across different areas of life. It should also consider other possible explanations and co-existing conditions.
Where ADHD is diagnosed, treatment may include medication, psychological approaches, psychoeducation, environmental adaptations and practical strategies. The appropriate approach depends on the individual.
This adds pressure to services because diagnosis can increase the need for ongoing treatment, medication monitoring and practical follow-up support.
The NHS England ADHD Taskforce reported that only around 25% of children and 15% of adults with ADHD were receiving pharmacological treatment, with substantial regional variation. Therefore, simply increasing the number of assessments without developing sufficient treatment capacity will not solve the underlying problem.
It is important that not every difficulty with concentration, organisation or attention is attributed to ADHD, stress, anxiety, depression, sleep problems, trauma, substance use, physical illness and environmental pressures can all affect concentration and executive functioning. A high-quality assessment is therefore important.
The answer to increasing demand cannot simply be to make it progressively harder for people to access an assessment. People need appropriate clinical assessment to determine what is happening and what support may be helpful. At the same time, children and adults should not necessarily have to wait for a formal diagnosis before receiving reasonable support.
Schools, universities, employers, families and primary care services can sometimes make practical adjustments while an individual is waiting for assessment, depending on their circumstances and needs.
Long waiting lists lead to inequality. Some people may be able to seek a private assessment if they have the financial resources to do so, while others may have no realistic alternative but to remain on an NHS waiting list. This creates the potential for a two-tier system in which the ability to pay determines how quickly someone can access specialist assessment.
The access is important as it has consequences for employment and education. For someone whose difficulties are affecting their ability to remain in work or complete their education, waiting several years may have significant practical consequences. The NHS England ADHD Taskforce highlighted the wider consequences associated with untreated or unsupported ADHD, including effects on education, employment, mental health, substance misuse and contact with the criminal justice system.
There are some signs that different models of care can reduce waiting lists, but they need careful design so that speed does not come at the expense of assessment quality or follow-up treatment.
For example, an NHS England-supported pathway in Surrey and Sussex has reported clearing almost a third of ADHD referrals and reducing the assessment waiting list by 21% following the introduction of a new pathway involving trained GPs working with consultant psychiatrists (2). Before the pilot, some patients had reportedly faced waits of up to 17 years.
The NHS also continues to make use of the Right to Choose arrangements in England, under which some patients may be able to choose an alternative provider for an NHS assessment where the relevant criteria are met. NHS information specifically notes that children may be able to access a provider with a shorter waiting list through Right to Choose.
These approaches demonstrate that long waits are not necessarily inevitable.
The NHS needs sufficient capacity to provide timely, high-quality assessments and appropriate support before and after diagnosis.
The NHS England ADHD Taskforce has already identified long waits, under-recognition and insufficient treatment as significant problems within the current system. (1)
The debate around ADHD needs to move beyond arguments about whether there are “too many diagnoses” or whether awareness has simply increased.
The more important question is whether people who may have ADHD can access an appropriate clinical assessment within a reasonable period.
A two-year wait can be a very long time in anyone’s life. For a child, it represents a substantial proportion of their school years. For a young adult, it can encompass important years of education, employment and personal development. For an adult, it may mean continuing to struggle at work or in relationships without understanding why.
The challenge for the NHS is therefore not simply to reduce waiting lists. It is to create a system in which people can receive timely, high-quality assessment followed by appropriate, accessible care.
The current system leaves many patients waiting for clarity that should be easier to access. Until national reforms reduce delays, people may need to combine persistence, clear documentation and proactive self-advocacy while seeking support from their GP, school, university, employer or relevant NHS service.
You can read more here.
https://thenhsalliance.org/resources/transforming-adult-adhd-support-in-sussex