Major Review Examines NHS Waiting Times and Over-Diagnosis Risks for Autism and ADHD
A comprehensive review spanning over 600 pages has examined NHS waiting times, support systems, and diagnostic trends for autism, ADHD, and mental health conditions across the UK. Commissioned 10 months ago following concerns from then-health secretary Wes Streeting, the review highlights an increasing risk of over-diagnosis for ADHD and autism among younger age groups, while firmly rejecting the idea of over-diagnosis in mental health. The report also details severe backlogs, noting that a third of young people referred to mental health services wait over a year, and calls for coordinated action across healthcare, education, and employment support over the next 12 to 24 months.
Key points
- A 600-plus-page review has been published examining NHS waiting times and diagnostic trends for autism, ADHD, and mental health.
- Experts report an increasing risk of over-diagnosis for ADHD and autism in younger age groups, though data limitations prevent a definitive conclusion of over-diagnosis at scale.
- Review chair Prof Peter Fonagy stated that former health secretary Wes Streeting was completely wrong to suggest over-diagnosis is occurring in mental health.
- Severe backlogs persist, with a third of young people waiting over a year for mental health services and 90% of 900,000 waiting for ADHD or autism checks waiting over three months.
What happened
A major review spanning over 600 pages has been published, evaluating NHS waiting times, support structures, and diagnostic practices for autism, ADHD, and mental health conditions. The review was commissioned 10 months ago by then-health secretary Wes Streeting amid concerns regarding rising diagnoses and systemic strain.
According to BBC Health, the report evaluates whether young people are being over-diagnosed and assesses the overarching impact of diagnostic labels on education, employment, and wider social opportunities.
Context
On autism and ADHD, the report states there is an increasing risk of over-diagnosis in certain younger age groups. For instance, more than 4% of children aged six to 17 have been diagnosed with autism, exceeding the 1-2% suggested by baseline studies. However, experts noted that data weaknesses—such as surveys not being updated for nine years—mean the review team had to estimate recent trends, preventing a definitive conclusion that over-diagnosis is happening at scale.
In contrast, the review team rejected the concept of over-diagnosis for mental health. Review chair Prof Peter Fonagy stated that claims of over-diagnosis in mental health were completely wrong. While severe illnesses like schizophrenia and bipolar disorder have remained stable, rising distress is driven by conditions such as anxiety, depression, self-harm, and eating disorders, with one in four 16 to 24-year-olds affected.
The report also highlights acute service strains. A third of young people referred to mental health services wait more than a year, and 90% of the 900,000 people awaiting ADHD or autism assessments have waited over three months.
What's next
The review recommends that all individuals on waiting lists be reassessed to prioritize those most in need rather than following a first-come, first-served approach. It also calls for better pre-assessment screening, stronger regulation of private and non-NHS providers, a ban on direct-to-public advertising of assessments, and a more joined-up approach across care, education, and employment.
