ADHD and autism services 'running out of control', NHS leaders warn amid tenfold cost rises

The NHS Alliance, which represents health managers across England, said the surge in demand since the COVID-19 pandemic has made the current model of care unsustainable. In some regions, spending on ADHD and autism services increased tenfold over the course of a year, the group reported.

The rising costs have forced some local health services to close waiting lists and consider cutting back on other services they provide, the Alliance warned. The organisation described the situation as “running out of control” and said the current trajectory cannot be maintained without significant changes to funding or service delivery.

The warning comes amid a broader national debate about access to neurodevelopmental assessments and support. NHS leaders have previously cited long waits for assessments and a lack of specialist capacity as drivers of the rising demand, alongside increased awareness and diagnostic rates following lockdowns.

The Alliance did not provide a breakdown of total national costs but highlighted that the pressure is being felt acutely at the local level, where clinical commissioning groups and NHS trusts are grappling with budgets that were not designed for the current level of need.

There was no immediate response from the Department of Health and Social Care. The government is expected to set out its plan for NHS reform later this year, with neurodevelopment services likely to feature in the discussion.

Why This Matters

Patients seeking ADHD or autism assessments already face years-long waits in many areas; further cuts to services could worsen access and outcomes.
The financial strain on local NHS budgets may force trade-offs with other mental health or community services, affecting broader patient populations.
The warning adds pressure on the government to deliver a sustainable funding and workforce plan for neurodevelopmental care ahead of the forthcoming NHS reform package.

Background

The NHS in England has seen a sharp post-pandemic increase in referrals for ADHD and autism assessments, driven by greater public awareness, reduced stigma, and a backlog from lockdowns. Specialist services have struggled to keep pace, leading to long waiting times and calls for more investment. The NHS Alliance represents managers who run clinical commissioning groups and trust services, making its assessment a frontline view of operational pressures.

Key Perspectives

NHS Alliance (health managers): Warns that current demand and cost trajectories are unsustainable. Some areas are already closing waiting lists or scaling back other services to cope with ADHD and autism pressures. Patients and advocacy groups: While not quoted here, patient organisations have long argued that underfunding and workforce shortages are the root cause, not demand itself. They want more investment, not service cuts. Government: Has not yet responded to this specific warning. The Department of Health and Social Care faces the challenge of balancing rising demand across all NHS services against fiscal constraints.

What to Watch

Whether the government signals additional funding for neurodevelopmental services in its upcoming NHS reform plan.
How many NHS trusts are forced to close or cap waiting lists in the coming months — a potential trigger for political action.
Updated national data on ADHD and autism assessment waiting times, expected later this year from NHS England.

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