NHS bosses are warning that autism and ADHD care is at risk of descending into chaos due to spiraling costs and unregulated private providers taking advantage of high demand. The NHS Alliance reports that some local health boards are paying £300 to £3,000 for similar services, with one board seeing costs rise 10-fold in a year to £1.5m a month. A sharp increase in new providers, both private firms and charities, is making it difficult for NHS managers to ensure the quality and safety of care being provided. An independent review into the rising demand for autism and ADHD services is expected to be published soon by the government.
Written by the local model on 2026-08-28,
using this article's own text rather than the other coverage of the
same event (that is the story summary below).
Story summary
NHS bosses in England are warning of potential chaos in the care of children with autism and ADHD**, as costs spiral out of control. They claim that unregulated private providers are taking advantage of a huge demand for help, charging vastly different prices for similar services. For example, one local health board was paying between £300 and £3,000 for the same assessments and care. This has led to concerns about the quality and safety of care being provided, with NHS managers struggling to keep up. The government has promised a "new national approach" for autism, ADHD, and mental health, but is first conducting an independent review into the rising demand for services, including whether there is over-diagnosis of these conditions.
Written for “NHS Mental Health Crisis” on 2026-08-31,
grounded in this article and the 0 other(s) covering the same event.
- Published
Autism and ADHD care is at risk of descending into chaos, NHS bosses are warning, as costs spiral out of control and unregulated private providers capitalise on the huge demand for help.
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providers → publish → help
The NHS Alliance, which represents health managers, says the current system in England represents a "bad deal" for patients and taxpayers alike.
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system → represent → patients
It points to big variations in what the NHS is being charged for assessments and care - in one case, a local health board was paying £300 to £3,000 for similar services.
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board → point → services
The group says there has been a rapid expansion in new providers – both private firms and charities are involved - and NHS managers are struggling to ensure the quality and safety of care being provided.
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managers → say → care
The government said an independent review into services and what is behind the rising demand, including whether there is over-diagnosis of these conditions, would be published soon.
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what → say → conditions
It said it would act on the findings of that, promising a “new national approach” for autism, ADHD and mental health.
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it → say → autism
Ahead of that, the NHS Alliance has been gathering information from integrated care boards, which hold the budgets for local services, about the current state of care.
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which → gather → care
Under the right to choose policy, patients can decide to opt for care from both NHS and non-NHS autism and ADHD services.
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patients → choose → services
The initiative is aimed at helping patients bypass the long waiting lists that have developed in recent years.
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that → aim → years
The NHS Alliance said the policy has led to an influx of new providers, helping to reduce some of the longest waits for adults and children, but at a cost.
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policy → say → cost
It found a number of boards were reporting sharp rises in spending, describing it as "out of control".
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number → find → control
One board saw costs rising 10-fold in a year, to £1.5m a month.
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costs → see → m
Another saw annual spend jump from £4m a year to £30m over the course of two years, while in Cheshire and Merseyside spending on adult ADHD has gone from £11m in 2023-24 to a projected £51 million this year.
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spending → see → million
It said a particular problem was the huge variation in what was being charged by non-NHS providers.
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what → say → providers
Unlike for routine operations, like hip and knee replacements, where there is a set tariff for different treatments regardless of whether the NHS or private sector carry them out, for autism and ADHD there are only guide prices that do not have to be kept to.
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that → be → autism
Local health bosses have also reported a rapid increase in providers.
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bosses → report → providers
One board reported working with 48 providers – four times more than in two years previously.
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board → report → years
This expansion was causing problems with the ability of boards to check the quality and safety of the care and support being provided.
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expansion → cause → care
Providers who carry out assessments only do not have to be registered with the Care Quality Commission, the regulatory body for health and care.
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who → carry → health
Rebecca Gray of the NHS Alliance said managers were "caught between a rock and a hard place".
"
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managers → say → rock
They understand the anguish and frustration caused by long delays in the system as people wait for assessments, treatment and support.
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people → understand → assessments
"But in working to meeting demand they face soaring costs that are running out of control."
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that → work → control
She said the situation was a "bad deal for patients and taxpayers" and there was a risk the whole system would fall into "chaos".
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system → say → chaos
But a spokeswoman for the Independent Healthcare Providers Network said private providers were helping the NHS meet the growing demand by bringing "significant capacity and innovation".
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NHS → say → capacity
However, she agreed there needed to be better co-ordination, including a national tariff to ensure consistent prices were paid by the NHS.
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prices → agree → NHS
Mel Merritt, of the National Autistic Society, said it was clear the system was in crisis.
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system → say → crisis
"Spending is rising on short-term solutions due to years of a lack of long-term investment in improving services."
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Spending → rise → services
And she added despite the sums being spent people were still facing "unacceptable" delays.
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people → add → delays
