Private providers costing ICB ‘three times more’ than NHS equivalent

NHS-funded access to private autism and ADHD services is “unsustainable” and “up to three times more expensive than our local provision”, according to an integrated care board’s review.

Northamptonshire ICB found the use of independent providers under “right to choose” rules for diagnosis and treatment of autism and ADHD was expected to cost it £3m in 2024-25, according to the document obtained by HSJ.

This represents an additional 66% on top of its £4.5m budget for its commissioned autism and ADHD services.

Extremely long waits, rocketing demand, and a growing market nationally have seen a big rise in people exercising choice rules, which require commissioners to pay for treatment if a provider has a contract with at least one other ICB.

In its review of community paediatric services, the ICB said its spending growth on the independent sector is “unsustainable” as “costs are up to three times more expensive than our local provision”. 

NHS funding of the same services is effectively capped as they are on “block” contracts. The review was completed in December and recently released after a Freedom of Information request.

Government has deprioritised tackling long waits for these services, but NHS England last year launched a national taskforce on the issue. The ICB’s review warned any “national solution will almost certainly involve greater use of the independent provider market”, which it said was less cost-effective than its commissioned services. 

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Source: HSJ, 6 May 2025