Charity Challenges Two-Year NHS Assessment Wait

Published: 01 October 2026. The English Chronicle Desk. The English Chronicle Online

A major charity supporting people with attention deficit hyperactivity disorder and related neurodevelopmental conditions has threatened legal action against an NHS organisation over a policy requiring many patients in West Yorkshire to wait at least two years for ADHD and autism assessments.

ADHD UK has formally warned the West Yorkshire NHS Integrated Care Board that it could seek a judicial review unless the policy is withdrawn or reconsidered. The charity argues that the decision was made unlawfully and says it has serious concerns about the way the policy was introduced, including the impact on patients who had expected to exercise their legal right to choose an NHS-funded assessment provider.

The dispute centres on a minimum two-year waiting period introduced by West Yorkshire ICB for people seeking ADHD and autism assessments through independent providers funded by the NHS. The policy affects patients across Leeds, Bradford, Kirklees, Calderdale and Wakefield, leaving thousands of people facing substantially longer waits for assessments that can influence access to treatment, education support, workplace adjustments and other forms of assistance.

ADHD UK has sent what is known as a “letter before claim” to the ICB, the formal step that can precede judicial review proceedings. The charity alleges that the board failed to follow the appropriate decision-making processes and raises questions about equality duties, patient involvement and the legal framework governing patient choice within NHS-funded services.

The organisation also argues that patients may have been denied their legal right to choose an alternative provider when waiting times are long. Under the NHS patient-choice system in England, eligible patients can in certain circumstances choose an NHS-funded provider for an assessment when their local waiting time is excessive. ADHD UK believes the West Yorkshire policy undermines that principle by requiring patients referred to independent providers to face a minimum wait of two years.

Henry Shelford, chief executive of ADHD UK, said the charity was prepared to take the matter to court if the rule was not removed. He argued that restricting access to alternative NHS-funded providers could conflict with patients’ rights and questioned whether the procedures used to introduce the policy were appropriate.

The charity’s legal challenge also identifies a series of documents and assessments it says should have been produced as part of the decision-making process. These include a published decision record, an equality impact assessment, evidence of public involvement, an analysis of demand and available capacity, a clinical safety assessment and a clear statement explaining the reasons for introducing the two-year minimum.

ADHD UK has asked West Yorkshire ICB to withdraw or suspend the policy and reconsider the decision through what it considers to be a lawful process. It has also requested information and documents that could help resolve the dispute without court proceedings.

The controversy comes as NHS services across England face growing pressure from rising demand for ADHD and autism assessments. Greater public awareness of neurodevelopmental conditions, changing attitudes towards diagnosis and increased recognition of symptoms among groups that may previously have gone undiagnosed have contributed to a significant increase in referrals.

For health services, the increase has created a difficult balance between meeting demand, maintaining clinical standards and managing limited budgets. West Yorkshire ICB has previously acknowledged that spending on neurodiversity assessment and medication services has increased sharply. The board has said that the growth in expenditure cannot continue at the same rate and has introduced measures intended to manage the number of assessments being commissioned.

According to the board’s published information, the two-year minimum applies to patients using independent providers under the West Yorkshire NHS arrangement. The board says the intention is to make waiting times more consistent between patients and providers rather than allow some people to receive assessments considerably earlier than others.

The ICB has also indicated that patients facing significant risks related to safety, physical health, mental health or education may be considered for an urgent assessment where an expedited assessment would have a clear and immediate impact. However, for many patients without an urgent prioritisation decision, the two-year minimum represents a major delay.

The dispute is particularly significant because an assessment can be an important gateway to further support. For some people, obtaining a formal diagnosis can help explain long-standing difficulties with concentration, organisation, communication, sensory processing or social interaction. It may also assist families and professionals in determining what forms of support are appropriate.

For children and young people, delays can have consequences beyond healthcare. Families may seek formal assessments because they believe a diagnosis could help schools understand a child’s needs and support applications for additional educational assistance. Adults may similarly seek assessments after years of difficulties in education, employment, relationships or everyday life.

Charities supporting patients in West Yorkshire have expressed concern about the effect of prolonged waits. Corinne Hunter, chief executive of Stripes, an organisation supporting children and adults with ADHD in the region, said patients were deeply affected by the policy and criticised the lack of advance communication with her organisation.

Hunter said some people wait years before deciding to seek an assessment, often doing so only when their difficulties have become increasingly difficult to manage. She argued that receiving a referral can create a sense of hope for patients and families, only for that expectation to be replaced by another lengthy period of uncertainty.

The dispute also highlights the growing divide between NHS-funded services and private healthcare. Patients who have the financial means may be able to explore private assessments, while those unable to afford private fees may have fewer alternatives when NHS waiting times become extremely long. Charities have warned that such differences could contribute to wider inequalities in access to diagnosis and support.

At the same time, policymakers are examining whether the current model of diagnosis is sustainable. A government-commissioned review led by Professor Peter Fonagy is expected to consider how mental health, ADHD and autism services should respond to increasing demand. One of the ideas under consideration is a more needs-based approach, in which people experiencing ADHD-related difficulties could receive appropriate support without always requiring a formal diagnosis first.

Such a system could potentially change the relationship between diagnosis and access to support, although questions remain about how eligibility would be determined and how services would be funded. The review is also expected to consider greater regulation of private psychiatry services amid concerns about the rapid expansion of private assessment and treatment.

For families currently waiting for assessments, however, those longer-term policy discussions offer little immediate relief. The legal dispute in West Yorkshire places renewed attention on whether patients should be required to wait for years when alternative NHS-funded assessment routes may exist.

West Yorkshire ICB has not accepted the allegations made by ADHD UK. A spokesperson for the organisation said it had received correspondence from the charity but declined to comment further because the matter could become subject to legal proceedings.

The next stage will depend on how the ICB responds to the legal warning. If the charity remains dissatisfied, it could seek permission for a judicial review, allowing a court to examine whether the decision-making process complied with relevant legal requirements. A judicial review would not simply determine whether the waiting policy was desirable; it would focus on whether the public body acted within the law and followed the appropriate procedures.

The case therefore has implications beyond West Yorkshire. As NHS organisations across England attempt to manage rapidly increasing demand for neurodevelopmental assessments, questions over patient choice, equality, public consultation and access to care are likely to remain prominent.

For people waiting for an ADHD or autism assessment, the central issue is more immediate: how long they will have to wait before their concerns are formally assessed and what support, if any, will be available while they remain on the waiting list. The threatened legal action has brought that uncertainty into sharper focus and could ultimately test how far NHS bodies can go in controlling access to increasingly pressured assessment services.