Questions have been raised about private clinic assessments for ADHD after an investigation found patients were being diagnosed based on poor-quality online checks.
An undercover reporter working for BBC’s Panorama was diagnosed as having ADHD by three private clinics after assessments over video calls, each costing between £700 and £1,100.
Yet a more detailed face-to-face NHS assessment found he did not have the condition, the programme makers said.
As part of the investigation, Panorama said it had spoken to dozens of patients and whistleblowers about rushed and poor-quality assessments at some private clinics.
The three named by the programme were Harley Psychiatrists, ADHD Direct and ADHD 360 all of whom diagnosed the undercover reporter with the condition. In response to the BBC, they all said they do thorough assessments and follow national guidelines.
In addition to limited mental health assessments, the investigation also found long-term prescribing of ‘powerful drugs’ without advice on serious side effects or proper consideration of patients’ medical history.
And they found evidence that patients posting negative reviews had been threatened with legal action.
Due to lengthy waiting lists, the NHS is paying for thousands of patients to go to private clinics for assessments, Panorama added.
Responding to the findings, consultant psychiatrist Dr Mike Smith, who leads a specialist NHS ADHD service and assessed the undercover reporter in a three-hour appointment, said he was seriously concerned about the number of people who might ‘potentially have received an incorrect diagnosis and been started on medications inappropriately’.
‘The scale is massive,’ he said.
GPs reacting to the story on social media said they were sadly unsurprised by the findings with clinics with vested interest filling demand caused by long NHS waiting lists.
There has been an almost 85% increase in the number of identified patients prescribed drugs for ADHD since 2017, according to new data.
Figures show years of steady increases in prescribing but steeper rises since 2021.
A Pulse investigation at the start of 2022 found private health care was thriving as NHS waiting lists grew and GPs at the time raised particular concerns about ADHD with respect to shared-care arrangements for ongoing prescribing of medications.
Two-thirds of GPs have told Pulse they are having to provide specialist mental health support beyond their competence which includes initiating patients on ADHD medication.
READERS' COMMENTS [13]
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All these requests will be happily bounced back to the prescriber.
Bye for now.
Do not get into shared care agreement with any private providers. For anything.
We have been saying this for years and refusing to cover private providers shared care agreements. Lots of kick back from patients when we do, at least we have some evidence now to not do so.
Hardly a surprise as so many (celebrities) now have a ”label’ for a trait that for many actually gives them an advantage in running a busy life (many GP’s would score positively on an ADHD questionnaire) and is a potential quick route to controlled drugs.
One can only hope the GMC will investigate the doctors concerned though that will be unlikely. They initially failed to take action with a (harley street) dr who was prescribing many very potent drugs to people he had never seen or had contact with but did rather well financially
As others have said pressure to prescribe adhd drugs on the nhs following a private assessment should remain a no no as traditionally was always the case for private medicine
There is over diagnosis even in the NHS. The system is geared towards “illness” for claiming benefits, excuses for not being at work & for lazy parenting. I have never prescribed so many ADHD drugs in the past but now everyone feels they’ve got the condition.
Unless Panorama has taken to employing underage reporters, it is impossible to get an ADHD diagnosis on the NHS, because only Paediatricians can diagnose it , and they don’t usually see patients over 18 years of age !
I rarely recall receiving any letter from our local NHS service which says “Thanks for referring this patient, who does NOT meet criteria for ADHD”.
It may be that my practice is brilliant at selecting the right patients for referral.
Or it may be that a large proportion of the population can in fact meet ADHD diagnostic criteria.
20th Century – stoicism/ modesty / keep it hidden/ don’t show your feelings/ carry on regardless/ mustn’t grumble/ there’s always someone worse off/mental health issues seen as a badge of shame./“ADH what? Never ‘eard of it”
21st Century- perturbation/ narcissism /let it all out/ share all your feelings/ take time out/ complain constantly/ nobody has it worse than me/ shop around for a mental health diagnosis and proudly tell the world / “I’ve definitely got that ADHD, all my mates have it too”
Progress (apparently)
There is a massive industry in diagnosing adults with ADHD now.
There’s a massive industry diagnosing children with ADHD as well. It started in the USA quite a few years ago and spread over here. It seems everyone’s child is on the spectrum somewhere. If one were cynical One would think that a group of psychiatrists with vested interests had re-written the DSM to create more work.
One can see why parents would revise the criteria and tell the paediatrician what they needed to hear. No one needs to hear that they’re terrible at parenting and there’s nothing with their child.
If you want private work flooding through the door then you need to promote your business, Including by word of mouth. Giving the people what they want, really really want. People who don’t get the answer they want on the national health, some will go private for a second opinion to get the opinion they wanted in the first place.
I’ve always declined the ADHD shared care private refs. The letters I’ve had the private company have done 1 zoom call and are not even following up and titrating meds, response and requested GP to do that. With no speciality training? I think not. Or the private service have said they can f/u but patient will have to pay meds and patients in both cases put a lot of pressure on the GP to prescribe. WE should just explain this to patients before we refer; NHS ref or private ref with ongoing management by private team long term which means paying for their meds. I am not taking clinical responsibility for prescribing an amphetamine for which I have no understanding of the condition or medication, etc.
Re parenting; I read that levels of ADHD in french kids is 1/10 that of US; french parenting style being fairly boundaried. Says it all.
I definitely have adhd traits and as someone said above. Very useful for a manic job like GP with 10 min consults and hundreds of clinical contacts/ admin work per day. My sister thinks we have the perfect combination of adhd traits for energy and drive, with ASD to provide hyperfocus.
Hence my work and study is very good and everything else is a disaster.
One burnt saucepan per week; if I don’t stand by the stove, dinner is burnt because when I leave the room it is forgotten.
Peri menopause brain fog isn’t helping.
But yes; I suspect over 50% of us are on the spectrum for one or more of these ‘disorders’.
That Maths kind of intrinsically makes them not a disorder no?
It’s society that needs fixing.
Punitive target based school systems; sats, attendance percentages, parents fined for non attendance.
Punitive working conditions; zero hours contracts, clocking in and out, employee surveillance, no trust, overworked, no clocking off.
Punitive welfare system: fit for work assessments, right wing media rhetoric, bedroom tax.
Tory austerity, wealth divide, tax divide; public service workers; income tax; even partners; we all pay 40% top rate. The wealthy dividends, capital gains tax, corporation tax, trusts, tax ‘benefit’/avoidance schemes.
20% of underpaid and overworked citizens do the essential work for societies function; clue they were the ones working when everyone else was furloughed.
1% of citizens take the profit.
And everyone whinges when public services don’t work but they keep voting Tory.
Orwellian our society.
No wonder everyone needs amphetamine or an ssri or both.
And I’m on an ssri so I am not being prejudiced here.
Is it just me that is really concerned about the longer term cardiac issues with amphetamines in adults? Scares me to see them and just waiting for some young sudden adult deaths. It becomes like pass the parcel with a bomb in the middle and I for one don’t want to be involved in the game in any shape or form.
I notice how the BBC’s “good doctor” spent 3 hours with the patient and refuted the diagnosis of ADHD. Crikey! What kind of productivity is this? No wonder the waiting lists are years. The sooner psychs are replaced by chat GPT, the better!
amphetamines make you feel good – that’s why they have a street value – but it may or may not be a good idea to take them on a regular basis – it’s an incredible cash-cow for Big Pharma so expect this one to run and run
all very reminiscent of Huxley’s Brave New World – for “soma”, read dexamfetamine !