(UK) Kent: Local NHS service to spend $62M on ADHD/ASD this year

Oct 25,  2026,  Kent Online: Why has Kent's NHS bill for ADHD and autism soared from £640k to £29m?

NHS spending on autism and ADHD services in Kent has increased an astonishing 45-fold in just two years – and is set to rise even further.

But while some question whether growing awareness is encouraging unnecessary diagnoses, others argue people who have struggled for years are finally getting the help they desperately need. We look at what's driving the extraordinary increase and the debate surrounding it…

Kent GP Dr John Ribchester says growing awareness of autism and ADHD has led to a dramatic rise in patients seeking assessments

Kent's NHS spending on autism and ADHD services has rocketed from just £640,000 [$857K] to almost £29 million [$39m] in two years - and the bill could climb as high as £46 million [$62m] this year.

The extraordinary increase has raised serious questions about how the cash-strapped health service can afford to meet soaring demand for assessments and treatment.

But others warn that a growing “moral panic” around the conditions risks stigmatising those affected and discouraging people from seeking help.

Dr John Ribchester, of Whitstable Medical Practice, says the number of patients seeking assessments has risen dramatically, particularly as awareness of how autism and ADHD affect women and girls has grown.. . .

 “It is a very hot topic nationally at the moment,” he said.

“There’s a massive expansion of diagnoses and cost as well.” . . .

What's behind the increase in demand?

Dr Julian Spinks, a Medway-based GP, has also experienced a noticeable rise in people seeking assessments for autism and ADHD (attention deficit hyperactivity disorder).

He says patients who might once have struggled without medical support are increasingly recognising that their difficulties could warrant professional help.

“There’s been a steady increase for some time and that reflects two things - greater awareness and people coming forward for themselves or their children, and there's been a degree of readjustment of diagnostic criteria and thresholds before you get the diagnosis.” . . .

Dr Spinks says greater awareness has helped people with less obvious difficulties come forward, but deciding when those difficulties amount to a diagnosable condition is not always straightforward.

“It’s a continuum from absolutely normal to very severely affected. The question of at what point you put a formal diagnosis on it is a hard one,” he said.

A government-commissioned review published earlier this month found that while recorded diagnoses and referrals for autism and ADHD have risen dramatically, the best available evidence suggests the underlying prevalence of the conditions has remained relatively stable.

It revealed that monthly referrals for ADHD assessments in England had more than tripled, from about 5,000 in 2019 to 17,000 in 2024.

The review also warned of an increased risk of misdiagnosis and overdiagnosis, but found insufficient evidence to conclude this was happening on a large scale. . . .

The ICB is responsible for planning and funding most NHS services across Kent and Medway, deciding how the area's healthcare budget is spent.

Despite spending almost £29 million [$39m] last year, it allocated just £20.02 million for the current financial year.

Its board papers acknowledge that the original budget was based on affordability rather than the full cost of meeting existing commitments and growing demand.

The most likely forecast for 2026/27 is now £32.1 million [$43m]– more than £12 million over budget – while a worst-case scenario could see spending reach approximately £46 million [$62M].

The ICB warns that without action to control costs spending will continue growing at a rate that is “not financially sustainable”.

But the colossal increase in spending does not necessarily mean there has been a corresponding rise in diagnoses.

The ICB admits it does not have complete information about assessments, diagnoses and treatment from some providers. It also warns that some patients may be on more than one waiting list, making it harder to judge the true level of demand. . . .

Almost 50 providers delivering services

One factor behind the increasing bill is NHS Right to Choose, which allows eligible patients to be referred to other NHS-funded services, including those run by private healthcare companies, for autism and ADHD assessments.

For families facing years on NHS waiting lists, it can offer a quicker route to diagnosis and treatment. But the NHS still has to foot the bill, even when the care is provided by a private company.

There are currently 46 providers delivering autism and ADHD services in Kent and Medway, only 19 of which hold contracts directly with the local ICB.

The number has grown significantly since 2023/24, with more providers continuing to enter the market.

An ICB spokesperson said: “The increase in spend in recent years has been driven by a significant and sustained rise in demand for autism and ADHD assessment services, across both statutory NHS pathways and NHS Right to Choose provision. . . .

'Gaming the system'

The increase in people seeking diagnoses comes amid a wider political debate about disability benefits.

Faversham and Mid Kent MP Helen Whately, the shadow work and pensions secretary, believes some people are exploiting the welfare system, particularly Personal Independence Payment (PIP). .

PIP is designed to help people with the additional costs of living with a long-term health condition or disability. People with autism or ADHD can qualify, although a diagnosis alone does not entitle someone to payments. . . .

Ms Nesling rejects the suggestion that awareness campaigns are encouraging people to mistake everyday difficulties for ADHD.

The Kent and Medway ICB board papers warn that without action to control costs its spending on autism and ADHD services is 'not financially stable'

“Everyone loses their keys sometimes: ADHD isn't that,” she said. . . .

Dr Julian Spinks, a Medway-based GP, has also experienced a noticeable rise in people seeking assessments for autism and ADHD (attention deficit hyperactivity disorder).

He says patients who might once have struggled without medical support are increasingly recognising that their difficulties could warrant professional help.

“There’s been a steady increase for some time and that reflects two things - greater awareness and people coming forward for themselves or their children, and there's been a degree of readjustment of diagnostic criteria and thresholds before you get the diagnosis.”

For years, autism and ADHD were commonly associated with boys displaying obvious behavioural difficulties at school.

But growing recognition of how the conditions can present differently, particularly in women and girls, has led to more people seeking help.

Dr Ribchester said: “Go back a decade and most people diagnosed with ADHD or autism were the difficult-to-handle boy at school - that was the classic description.

“But the criteria has expanded to include adults. For girls especially, difficulty in staying attentive, anxiety, etc, have been included in the diagnostic criteria.”

Autism and ADHD are neurodevelopmental conditions rather than mental illnesses, although they can exist alongside mental health problems.

ADHD can affect attention, impulse control and activity levels, while autism can influence communication, social interaction, sensory processing and behaviour.

Both vary considerably between individuals, and some characteristics can overlap with experiences common among the wider population.

Dr Spinks says greater awareness has helped people with less obvious difficulties come forward, but deciding when those difficulties amount to a diagnosable condition is not always straightforward.

“It’s a continuum from absolutely normal to very severely affected. The question of at what point you put a formal diagnosis on it is a hard one,” he said.

A government-commissioned review published earlier this month found that while recorded diagnoses and referrals for autism and ADHD have risen dramatically, the best available evidence suggests the underlying prevalence of the conditions has remained relatively stable.

It revealed that monthly referrals for ADHD assessments in England had more than tripled, from about 5,000 in 2019 to 17,000 in 2024.

The review also warned of an increased risk of misdiagnosis and overdiagnosis, but found insufficient evidence to conclude this was happening on a large scale. . . .

Doctors caught in the middle

For GPs, the increase in demand has brought difficult decisions about who should be referred for an assessment and what support they might need.

Dr Spinks says there will always be people who fall into a grey area, where a diagnosis may be appropriate but extensive treatment is not necessarily needed. . . .