All ADHD and Autism Assessments to Be Regulated After Review
An independent review chaired by Professor Peter Fonagy has found that diagnosis has become “a very narrow pathway to finding support”, with referrals rising sharply while underlying prevalence stays broadly stable. The health secretary Yvette Cooper will make every diagnostic assessment regulated by the Care Quality Commission, whether NHS, private or self-funded.
Fonagy is careful about what he is and is not saying: “Our findings show a system under immense strain, where diagnosis has increasingly become a very narrow pathway to finding support… Diagnosis remains essential and must be protected — what has to change is that it is no longer the only door through which help can be reached.” That distinction matters, because the review has been reported both as a warning about over-diagnosis and as a warning about system failure, and the reconcilable fact underneath is that diagnoses and referrals have risen steeply while the share of the population with these conditions has not. The numbers around it are stark: the proportion of sixteen to sixty-four-year-olds with a common mental disorder rose from 15.5% in 1993 to 22.6% in 2024, and children diagnosed with autism or ADHD before seventeen are around four times more likely to be out of education, employment and training between sixteen and twenty-four. Ms Cooper’s regulatory change is aimed squarely at the private market that has grown in the gap: assessments will be inspected “so people can be confident that assessments are high quality and that the NHS is not being overcharged by independent or private providers”. The review also recommends banning direct-to-public advertising of NHS-funded assessments. A Mental Health Strategy follows, alongside a £4bn package for special educational needs.