Coroner report sparks concern over lack of ADHD services

Replies to a media request from HSJ suggested around one in 10 clinical commissioning groups are not routinely providing diagnosis or assessment for adults with ADHD.

Eleven out of the 113 CCGs which responded said they do not commission a specific assessment and diagnostic service (see box below). Eighty-two CCGs did not reply.

Meanwhile, a number of CCGs which said they had an ADHD diagnosis service also said they did not commission a support or follow-up service. In addition, six CCGs said they did not provide a diagnosis service for adults with suspected autism.

Tony Lloyd, chief executive of the ADHD Foundation, said it was “short-sighted” not to routinely commission diagnostic and support services, bearing in mind the social and economic impact of the conditions.

The findings come following a coroner for Cornwall raising concerns over the lack of available ADHD diagnostic and support services for adults, in response to the suicide of 48-year-old David Sargeant.

According to a prevention of future deaths report from the Cornwall coroner, Mr Sargeant, who suffered from problems with addiction, died from an “intentional overdose” in 2017. However, during periods of sobriety, he became “vulnerable to his ADHD and mental health problems”.

Despite being referred to Cornwall Partnership Foundation Trust for an ADHD assessment in 2016, Mr Sargeant was discharged without a diagnosis or treatment, as the trust was not commissioned to carry out this service.

In response to the report, Kernow CCG, which commissions services for Cornwall Partnership FT, said it was due to launch a service supporting adults with ADHD from this April.

A number of CCGs said, although they did not commission a specific ADHD assessment service, patients could access this through an individual funding request.

A Rotherham CCG spokesman said it was working with partners to develop an all age neurodevelopmental pathway covering diagnostic and post-diagnostic care for ADHD and autism.

An NHS England spokeswoman said: “Local areas are expected to review and arrange the services and care needed by their patients.”

A mother from Essex, who did not wish to be named, told HSJ she had been struggling to get an assessment for both ADHD and autism for her daughter for four years, as she turned 18 before her assessments were complete.

She added: “The impact is that she isn’t seen as disabled, despite her moderate learning disabilities and has been kicked off universal credit, because where she can’t tell the time, she was late to a few appointments and forgot others, so she keeps getting sanctioned, leaving her with no money for food.

“She does these week-long job trials but they never keep her on, because her autism, ADHD, and learning disability, combine to make her a so-called ‘unattractive prospect as an employee’.

“Because of the lack of diagnosis, it means she can’t access personal independence payments or employment support allowance, the disability element of universal credit.”