Academic researchers and clinicians say that, unless new approaches are taken to ADHD service provision, NHS services will continue to be overstretched
“Recognition of and treatments for ADHD have expanded over the past two decades, increasing clinical demand. This issue has been exacerbated by the COVID-19 pandemic. Despite an increase in specialist services, resource allocation has not kept pace, leading to extended waiting times.” Authors of paper published in BJPsych Bulletin
A new approach to providing services to people with ADHD is needed, according to researchers who say that current provision is in crisis.
The researchers, who include academics from the University of Cambridge and the University of Huddersfield as well as clinicians from different health trusts, have published an editorial in the BJPsych Bulletin outlining potential new models for service provision.
“The UK’s services for adult attention-deficit hyperactivity disorder (ADHD) are in crisis, with demand outstripping capacity and waiting times reaching unprecedented lengths,” the authors write. “Recognition of and treatments for ADHD have expanded over the past two decades, increasing clinical demand. This issue has been exacerbated by the COVID-19 pandemic. Despite an increase in specialist services, resource allocation has not kept pace, leading to extended waiting times.”
They note that delays to treatment “carry a human and financial cost, imposing a burden on health, social care and the criminal justice system” and add that a rethink of service procurement and delivery is needed.
The authors look at five possible options for dealing with the crisis:
The authors conclude by saying that adult ADHD services in the UK are “at a critical juncture” and that a combination of increasing demand and insufficient resources means the current system is “struggling to provide adequate care for patients.” While some of the options they have suggested relating to efficiency and alternative service models might provide results, they argue that significant strides “will be made only with additional funding and a shift in how we approach ADHD treatment.”
They suggest that the introduction of a national target for starting diagnostic assessments within three months of referral could stimulate positive change. “Such a target could be integrated into the NICE guidelines, helping to keep ADHD treatment at the forefront of health policy,” they write.
The researchers are right to draw attention to the growing pressure on adult ADHD services. The current situation, in which patients have to wait many months for diagnosis, is unsustainable. The authors argue that the potential alternatives to the current model (such as greater use of AI technology to improve efficiency and a redistribution of the workload to primary and secondary care) would in themselves require funding and effort, and would not be enough on their own to alleviate the burden. We agree that there are many challenges. In particular, it is hard for commissioners to create new solutions when they lack the resource to do so. NHS services require a more flexible funding model that will enable them to investigate and pilot more innovative models, including greater use of technology.