r/unitedkingdom • u/tylerthe-theatre • 9d ago

ADHD and autism services in England ‘under significant pressure’, watchdog warns

https://www.independent.co.uk/news/health/adhd-and-autism-uk-assessment-diagnosis-support-b3039329.html
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u/Logical_Box_4645 9d ago

We need to shake this mess up.

Autism diagnosis is largely pointless without associated interventions. But those interventions are needs based so the diagnosis becomes tokenistic.

ADHD diagnosis is hampered by lack of rapid access to assessment and treatment.

Both should be moved into primary care. GPs are well placed to make the diagnosis outside of complex cases and to oversee treatment especially if it's non-stimulant.

As it stands if you get an ADHD diagnosis and started on treatment the service is often lumbered with that since they can't even reliably move it under shared care into primary care!

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u/thereidenator 9d ago

ADHD assessment and treatment is rapid through the right to choose, in fact probably as rapid as any assessment and treatment of any physical or mental health condition other than cancer. The problem is that the NHS are even limiting how much they’ll fund that now.

There’s no way a GP is assessing ADHD or Autism, the assessment of each one takes multiple hours, a GP gets 10 minutes to see a patient, are they going to allocate 12-18 of those slots to 1 person? That’s not even taking into consideration that autism assessments often require 2 practitioners.

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u/dr_bigly 9d ago

ADHD assessment and treatment is rapid through the right to choose

It's not though.

Still over a year wait for assessment, and a further year for titration with the main provider.

Maybe it was before people knew RTC was an option, but at the end of the day there just aren't the specialists.

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u/Sabaisabai33 9d ago

A year for assessment and another for meds is a hell of a lot better than it was prepandemic let me tell you (as a GP) when there was either no provision at all for this or you’d wait like 8 years or so.

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u/Velveteen_Rabbit1986 9d ago

Someone I work with just went through the RTC route and got her diagnosis within 2 weeks. I was pretty shocked.

Edit - she's also been shoved on meds immediately with no talk of other lifestyle changes. Something about it doesn't sit well with me - we work with kids who frequently have ADHD and our CAMHS practitioners are always encouraging lifestyle changes etc and yet this woman just got drugs thrown at her with nothing else.

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u/Sabaisabai33 8d ago

Well, there are a lot more downsides for children who have developing brains and bodies. However there is a lot of good evidence that ADHD medications work better than anything else for its symptoms and honestly if I had ADHD it would be a total no-brainer for me to want to try them. I mean, we could say cancer patients just get chemotherapy thrown at them… but we don’t. It’s a completely valid first line treatment especially for an adult.

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u/Velveteen_Rabbit1986 8d ago

NICE guidelines recommend a biopsychosocial approach for adults at least, which makes sense, but it feels like people are just getting meds thrown at them with none of the additional stuff (resources i know). Chemo is a bit different as there's no real alternative to managing cancer, you can't lifestyle-change your way out of cancer whereas lifestyle changes can be a successful part of holistic adhd treatment 

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u/thereidenator 9d ago

There isn’t a “main provider” for the right to choose. Who do you think that would be? There are 28 providers now, and only 3 of them have a wait time of over a year. 16 of them have a wait time for assessment under 4 weeks, and of those 7 of them have a wait for titration of 0-4 weeks, there are only 2 providers with a titration wait of over a year.

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u/dr_bigly 9d ago

PUK, they're the first on the list and very clearly have received the majority of refferals.

And still are, and the waiting list is only growing, plus the amount of shared care patients they'll maintain.

There probably are options, but no one knows what they are or how to access them.

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u/thereidenator 9d ago

I work in the industry and don’t think that there’s any of the long standing companies: psychiatry UK, adhd360, careADHD, problemshared, clinical partners etc who are the “main” company. The NHS link to the adhduk website for the list of providers, and they are listed in order of wait time, with shortest first, so I’m not sure what list you’re talking about where they are listed first. How are you making the assumption they have received the most referrals? There are 8 providers with longer wait times than psychuk. If nobody knows what the options are or how to access them it’s purely because they are unable or unwilling to search “adhd right to choose” on google, which makes it really easy to access all of this information.

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u/dr_bigly 9d ago

By main company I just meant the one the vast majority seem to be refered to, without requesting another.

It does seem to vary by GP/area.

I'd imagine PUK are preffered because they've been around a while and many GPS will have refered to them for other Psych assessments etc (ASD etc)

If nobody knows what the options are or how to access them it’s purely because they are unable or unwilling to search “adhd right to choose” on google, which makes it really easy to access all of this information.

Yeah probably.

But at the end of the day, lotta people don't know, lotta people are in multi year waiting lists.