NHS England: Report of the independent ADHD Taskforce: Part 1 (20 June 2025)

Summary

The independent ADHD Taskforce was commissioned by NHS England in 2024. This was due to serious concerns about access to timely support, the impacts, risks (e.g. suicide, crime) and avoidable costs of unsupported ADHD (e.g. welfare, benefits, long-term unemployment. It was tasked with considering how services and support across health, education, justice and the whole of society need to be transformed to ensure those with ADHD are able to access timely, appropriate, effective and high-quality support beyond health alone, and live to their full potential, as well as making recommendations on a whole system approach to managing ADHD. Societal changes in attitude and the provision of appropriate support can enable people with ADHD to engage successfully in education and work and participate fully in society.

Given the urgency for action, and the need for recommendations to be considered in the 2025 Spending Review, this is Part 1 of the report. This report provides initial evidence-informed recommendations to be addressed now and in the longer term. These align with the government’s three key health priorities (from hospital to community, prevention and digitalisation) and wider missions.

See also: Report of the independent ADHD Taskforce. Part 2

Content

Recommendations

Cross-agency and government department working

1. Data capture: government and its relevant departments (specifically DHSC, MoJ, DfE and DWP) need to work together to improve data capture digitally and join up of datasets. This is to understand where people with ADHD or neurodivergence are in public services, the disproportionalities that exist, and to capture impacts and outcomes.
2. The Office for National Statistics should routinely collect and analyse data relating to ADHD in health, education, the workforce and the justice system.
3. Spending review plans: government and its relevant departments (specifically DHSC, DfE, DWP and MoJ) need to work together on radical and holistic spending review plans. These plans should consider the work of the Taskforce, the DWP academic panel on neurodivergence and the DfE Task and Finish group on neurodivergence. We recommend an invest to save model that includes ADHD and neurodivergence training and awareness building across all different sectors as well as evidence-based, holistic models of care (that will be described in the final report).

Prevention

1. Needs-led support that is uncoupled from diagnosis: DHSC/NHS England, DfE and MoJ must work together to prioritise early years support that is based on needs not diagnosis to break the school to prison, school to adult unemployment and school to ill-health pipelines. Examples of very early, structured support that have worked include evidence-based parenting interventions and early years support, embedded in Sure Start areas. For school age children, another step is to ensure that rollout of outreach mental health support teams in schools (MHSTs; Mental Health Support Teams) is completed and enhanced by the inclusion of staff with neurodivergence expertise in every school. These teams need to be linked up with integrated neurodevelopmental and Children and Adolescent Mental Health Services (CAMHS) teams.
2. Urgently address escalating NHS ADHD waiting times: DHSC and HMT must act quickly to address the growing backlogs across both children’s and adult services to avoid wasted expenditure on the adverse outcomes of untreated ADHD (e.g. repeated A&E use, chronic mental and physical health problems, prison, unemployment) and identify those at highest risk. The government should ensure that local systems bring down ADHD waiting times for children’s and adult services in line with its commitments on reducing waiting for diagnosis and treatment for physical health conditions. This can be achieved in cost-effective ways that meet quality standards, are accessible and build for the future (e.g. by nurse-led triage, by task-shifting so that senior medical time is primarily utilised for consultation, supervision and the most complex cases).
3. Improve support to those on waiting lists: health care providers/integrated care boards (ICBs) must ensure support for those waiting and provide clear signposting to local organisations that can provide information and support. Health care providers/ICBs to consider screening of wait lists to identify the most severe ADHD, co-morbidities and risks (e.g. suicidal) for prioritisation using evidence-based clinical screening tools (different to profiling tools) but not on their own, as such tools can over and under-identify ADHD.

From hospital to community

1. A generalist model: NICE should reconsider its stance and interpretation that ADHD always requires a highly specialised, secondary care workforce (ADHD super-specialists) for diagnosis, treatment initiation, follow-up and other types of support. It should clearly define the meaning of specialist to enable greater involvement of primary care (with training and remuneration), with secondary care support as well as generalist secondary care. This approach would align ADHD management with the way other common conditions, such as diabetes, are managed. A clear definition of ADHD specialist and monitoring of NICE adherence is also important to regulate non-NHS providers and allay concerns raised by some about the quality of diagnosis or over-diagnosis by some providers.
2. A single, accessible front door: Integrated care systems (ICSs)/Neighbourhood Health Services need to work with other local services to modernise ADHD pathways to join up professional expertise across different types of neurodivergence/neurodevelopmental disorders. Furthermore, there needs to be an explicit link up with mental health services. Such pathways need to operate across all age groups and involve different settings of care and intensity of support (inclusive of primary and secondary care, local authority, VCSE (voluntary, community and social enterprise) and, where needed, private providers). One potential model that has been adopted in Canada and some other countries is the community-based Integrated Youth Service (IYS) for youth aged 12 to 25 years. These provide an evidence-based ‘one-stop shop’ that include support for neurodivergence, mental health and substance use, physical health, peer support, education, employment and social services. The emphasis is on needs, goals and strengths rather than diagnostic siloes and, in Canada, these have led to more rapid access to support and cost savings (to be described in Part 2 of our report).
3. Stepped care: Integrated care systems (ICSs)/Neighbourhood Health Services should adopt ‘test and learn approaches’ to a stepped care model that involves providing support of different intensities for ‘possible ADHD’ and high-quality ‘clinical diagnosis of ADHD’. This should involve primary and secondary care, local authority, VCSE and private providers. The NIHR should fund formal evaluation of these models.

Digitalisation

1. Introduce NHS digitalisation into ADHD services now: the DHSC through its 10-year plan should prioritise the digitalisation of ADHD services. Digitalisation can speed up routine administrative tasks (e.g. questionnaire measures, height, weight, blood pressure centiles, generating reports), help screen waiting lists and, where evidence based, improve efficiencies (e.g. Quantitative Behaviour test (26). These do not substitute for clinical care and clinical measures should be evidence based.
2. Improve evidence base: NICE should scope an early value assessment (EVA) of digital products delivering improved outcomes and efficiencies for ADHD management and treatment across the pathway and settings of care.
3. Improve data quality: NHS England/DHSC must prioritise its data improvement work. Currently, data on ADHD waiting lists, referrals, outcomes, local and regional ADHD diagnosis and treatment rates and on clinical standards of all providers are of poor quality.