Complaints about autism and attention deficit hyperactivity disorder services in England have more than tripled in five years, official figures show, with the NHS ombudsman warning of years-long waits and patients paying thousands of pounds for private care.
One woman was removed from an ADHD medication waiting list without warning after almost four years, leaving her without the support she needed for about six months. Another patient was given an autism assessment lasting just 50 minutes that failed to follow guidance from the National Institute for Health and Care Excellence, while a man referred to an ADHD service that was not yet operational ended up paying almost £4,000 for private treatment.
Complaints rose from 410 in 2021-22 to 1,257 in 2025-26, an increase of more than 200%, as referrals and the number of people waiting for assessment, treatment and support also increased.
Demand for ADHD and autism assessment and support services has surged dramatically across England, with open NHS referrals reaching roughly 562,000. More than 60% of adults and children face waiting lists exceeding a year, while prescribing data shows historic multi-year increases.
The parliamentary and health service ombudsman, Paula Sussex, said ADHD and autism services were “under significant pressure, with demand outstripping capacity”, adding: “While commissioning cannot solve these supply constraints, the way services are designed, commissioned and delivered can compound the pressure people experience and make it harder to make the best use of available resources.”
She said: “Right now, the system is too complex and inconsistent, leaving too many patients falling through the gaps.”
A report, called Improving ADHD and Autism Services: Commissioning With Confidence, shares the ombudsman’s findings based on 3,000 complaints. It found recurring issues, including uncertainty around patients’ right to choose a provider. Under right to choose, patients in England can choose from eligible NHS-funded providers for certain services, including some independent providers. However, the ombudsman found uncertainty around how this right applied, with patients sometimes being told wrongly that they could not exercise it.
Other problems included inconsistent recognition of diagnoses across NHS and independent providers, and lengthy waits for assessment and treatment.
In one case, Rich, 48, asked to be referred to Psychiatry UK for his ADHD treatment. NHS South East London integrated care board denied Rich’s request and wrongly insisted he be referred to a local ADHD service, which was still being developed and had no opening date. The ombudsman found his NHS treatment was delayed by five months. Rich felt he had no choice but to pay for private care, amounting to almost £4,000.
In another investigation, South London and Maudsley NHS foundation trust removed a woman from the ADHD medication titration (the process of adjusting medication to find the right balance) waiting list without warning or valid reason, leaving her without specialist monitoring support for about six months. This delay may have affected her symptoms and her ability to carry out everyday activities, causing frustration and distress.
Sussex said: “People should not have to fight their way through a confusing system to get ADHD and autism care.”
The ombudsman’s office itself has a six-month waiting time because of the rise in complaints it is receiving.
A government spokesperson said: “Last December, we asked clinical psychologist Professor Peter Fonagy to lead an independent review, examining the prevalence of – and support for – ADHD, autism, and mental health conditions. Professor Fonagy’s final report will be published later this summer, and will inform our new national approach in this area.”
