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ADHD 'Right to choose' diagnosis leaves patients fighting for NHS care

The Guardian

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January 24, 2026

Sameer Modha knows the ADHD system all too well.

- Sarah Marsh

He has been diagnosed himself, as have his two children, giving him a clear view of how the system works - and where it breaks down.While his own diagnosis was relatively straightforward, the experience with his daughter was very different. The diagnosis he obtained for his eldest child, after an assessment carried out privately by a “very senior ex-Camhs [child and adolescent mental health services] director, someone who knows the system and has seen a huge amount of this”, was rejected by the NHS. He was told it was not compliant with guidelines from the National Institute for Health and Care Excellence (Nice), which sets healthcare standards nationally.

The NHS is increasingly referring patients to private providers, which the health service pays for, only for those assessments to be rejected. The result is an inefficient system that wastes money and leaves patients without care and mental health trusts struggling to cope.

One NHS trust has said this process is clogging its ability to treat patients as people cycle back into services after private assessments stall. The NHS is overspending an estimated £164m a year on ADHD services.

Modha had to have the diagnosis reconfirmed through the NHSsomething that only happened after “constant hassling”, and he has struggled to get different parts of the system to work together. He describes being “caught between the private and state systems”, with GPs reluctant to engage.

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