Autism and ADHD care complaints in England more than triple in five years

The Parliamentary and Health Service Ombudsman reported a sharp rise in complaints about NHS autism and ADHD services, with figures showing a threefold increase over the past five years. The ombudsman highlighted cases that illustrate the scale of the problem: one woman was removed from an ADHD medication waiting list without warning after nearly four years, leaving her without support for about six months; another patient received an autism assessment lasting just 50 minutes, which failed to follow National Institute for Health and Care Excellence (NICE) guidelines; and a man referred to an ADHD service that was not yet operational ended up paying almost £4,000 for private treatment.

These cases, the ombudsman said, represent a systemic failure in the NHS to meet the needs of patients with neurodevelopmental conditions. The surge in complaints reflects both a growing awareness of autism and ADHD and a genuine increase in diagnoses, but health services have not kept pace. Patients are often left waiting for years for assessments and, once diagnosed, face further delays for treatment and medication reviews.

The ombudsman's report calls on NHS leaders to urgently address the crisis, noting that the current system is “not fit for purpose” and that patients are being “let down at every stage.” The report recommends better coordination between primary care, mental health trusts, and specialist services, as well as more investment in assessment and treatment capacity. The Department of Health and Social Care has acknowledged the challenges, pointing to a new national autism and ADHD action plan that aims to reduce waiting times, improve training for clinicians, and expand access to digital therapies.

Why This Matters

Thousands of patients face prolonged waits for essential diagnoses and treatment, affecting their mental health, employment, and quality of life.
The crisis forces many to seek expensive private care, widening health inequalities and putting financial strain on families.
The NHS ombudsman's findings put pressure on the government to commit more resources and reform how neurodevelopmental conditions are handled.

Background

Autism and ADHD diagnoses have risen sharply in England over the past decade, driven by greater public awareness, better screening, and a broader understanding of how these conditions present in adults and girls. However, NHS services have struggled to keep up. Long waiting times for assessments have been a persistent issue, with some patients waiting more than three years. The COVID-19 pandemic exacerbated the problem, as many services were paused or reduced. Previous reports from the ombudsman and charities, such as the National Autistic Society, have repeatedly flagged similar concerns. The latest figures show that complaints escalated from around 1,000 in 2019-20 to over 3,500 in 2024-25, indicating that earlier warnings have not been acted upon effectively.

Key Perspectives

[Patients and their families]: They experience distress, loss of employment, and deteriorating mental health while waiting for support. Many feel abandoned by the NHS and are forced to take on significant debt for private assessments and medication.

[NHS England and the Department of Health and Social Care]: They acknowledge the problem and point to the new autism and ADHD action plan, which includes funding for more assessment teams, training for GPs, and digital tools. They argue that the rise in complaints partly reflects increased awareness and that change takes time.

[Health professionals and charities]: They warn that the action plan, while welcome, lacks sufficient funding and binding targets. They argue that the NHS needs a fundamental shift in how it approaches neurodiversity, moving from a crisis-driven model to one of proactive, community-based support.

What to Watch

Waiting times for first autism and ADHD diagnostic assessments, which are currently not published regularly for all areas.
The publication of the government's full response to the ombudsman's report, expected within 60 days, and whether it includes specific funding commitments.
The rollout of the new national action plan later this year, particularly its impact on private sector referrals and the number of patients who still have to pay out of pocket.

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