Update on adult ADHD assessments in Lancashire and South Cumbria
Lancashire and South Cumbria ICB have recently asked all providers of adult ADHD services, commissioned both locally and nationally; to reduce the number of new adult ADHD assessments they offer from April onwards for patients who have waited less than 52 weeks.
We are committed to ensure that residents can continue to access ADHD assessment pathways in respect of Choice legislation and continue to have a choice of provider.
This however needs to be done in fair way, ensuring those people who have waited the longest time are prioritised for care. We will therefore be doing everything we can to prioritise care for patients who have in some cases waited more than two years for support.
Why are these changes needed?
Over the past five years, requests for assessment and treatment of adult ADHD have risen significantly across Lancashire and South Cumbria, reflecting a national picture.
This has placed immense strain on commissioned services, leading to long waits for assessment, and an increase in referrals to services commissioned outside of the local area, under patient choice (right to choose) legislation.
These challenges have been worsened by the extremely high levels of additional support required due to medication shortages over the past 18 months, placing even greater strain on overwhelmed services.
No additional funding has been made available to support this work, and despite a five-fold increase in investment by the ICB over the past 12 months, we still cannot meet the demand for care in relation to people experiencing symptoms of ADHD.
It has therefore become crucial to explore ways of helping people that are both affordable yet still offering high quality services for those who need them.
What is changing?
From April onwards, we are developing activity plans for providers of adult ADHD services that will reduce the number of clinical assessments for patients who have waited less than 52 weeks. This is to focus on those who have waited longer, and to invest in much-needed non-clinical support, widely requested by our population.
No decision has yet been made in relation to services for children and young people, or for autism services, and further communication about services for children and young people will be provided in the near future.
These measures will likely contribute to increased waiting times in the short-term for adult patients registered to providers with the shortest waits. This is likely to impact all providers delivering services under patient choice (right to choose) legislation, given they generally have the shorter waiting times than local providers.
We recognise that this will be of concern to anyone affected. This however is a necessary short-term measure to enable us to address a system that our population informs us is clearly not working for everyone.
We want to improve this and ensure everyone asking for help is offered this help in an effective and timely manner. Services will be made available to support people affected by these changes, with information shared in due course.
What are we doing to improve services for our population?
In the future, services will be allocated based on need, with the development of new care pathways to support people sooner, alongside traditional clinical services. This work is being done in collaboration with the public, including dedicated public engagement sessions, to ensure effective and sustainable services for the future.
This includes the development of an entirely new service to help people cope better with symptoms of ADHD, including education, peer support, and interactive sessions to discuss experiences of living with ADHD. We will communicate the availability of this offer soon and hope to have this in place by June 2026.
What should you do in response to these changes?
These changes are being directly managed between the ICB, who commission ADHD services, and providers of ADHD services. Patients are advised that they should not contact their GP practice, as GP practices will not be able influence how patient care is managed once a referral has been made.
Patients will be contacted in due course by the ADHD service supporting their care with any relevant information. We do not wish for them to be inundated with an unmanageable number of queries and requests, so would encourage you to keep checking ICB publications for updated guidance.
Patients who have waited more than 12 months for an assessment are now more likely to be prioritised, but there will still be some delay due to the many people requiring a service. We ask for your patience as we work through outstanding referrals.
What should do if you have not yet been referred to an ADHD service?
Adults who suspect they may be experiencing ADHD symptoms but have not yet been referred to an ADHD service, should consider how urgently they require a formal diagnostic assessment at this time. Referrals will however continue to be made by GPs in line with NICE guidance*, where symptoms are consistent with ADHD and associated functional impairment.
*NICE Guidance for ADHD offers national guidelines to recommend the most appropriate care for people with ADHD symptoms and can be viewed here: https://www.nice.org.uk/guidance/ng87.
What other help is available?
We understand that the changes made will have an impact on clinical pathways for some people, but this does not mean you should go without help. Please refer to the following page for more information and a range of helpful resources, which will include details of any future services once they become available:
https://www.lancashireandsouthcumbria.icb.nhs.uk/adult-adhd.
We know that many people seeking support for ADHD also have other associated difficulties relating to their experiences of living with ADHD, such as depression, anxiety, or low self-esteem. If this is the case, people can self-refer directly to NHS Talking Therapies in Lancashire and South Cumbria to discuss their options. More information and contact details can be found here:
If you have any immediate concerns in relation to your mental health, as a consequence of these changes, please call 111 and select option 2, or call the Initial Response Service on 0800 953 0110.
What should you do if you are unhappy about this decision?
We recognise that these changes will be of concern to some people, but we ask for your patience and understanding while we work to improve the services we offer for our population. We want to ensure that nobody goes without support when they ask for help. The current system does not allow for this, and we need to make these changes to enable better services for the future.
Any complaints can be directed to the ICB using the following email address: