A BBC investigation into the private clinics that offer an attention deficit hyperactive disorder (ADHD) screening has raised concerns. An undercover reporter at Panorama was diagnosed with ADHD by three private clinics.
The consultations were all held virtually through short video calls. When the reporter was seen at an NHS clinic, which was held in person, he was told he did not have ADHD.
The Panorama investigators spoke to multiple people who had accessed clinics like these, and even spoke to some former members of staff who worked at the clinics. A senior nurse practitioner, Andrew Jay, who worked at ADHD 360 in Lincoln, which also assesses NHS patients, told reporter Rory that he would see a different patient each hour, which he didn't feel comfortable with.
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Reporter Rory Carson underwent an NHS consultation with Dr Mike Smith, who works at Leeds and York Adult ADHD Service. Rory described the NHS consultation "like a full mental health MOT", which lasted more than three hours, and covered "almost every aspect of my life."
Dr Mike Smith explained: "You have outlined that you have occasional problems where you might forget something, occasional problems where you might feel a bit fidgety, but in order to meet the threshold for a condition, these need to be things that happen frequently and cause a problem for you in your life. There is no evidence that that is the case."
The Panorama episode then saw Rory be assessed at three private clinics online. The cost of the assessments varied from £600 to £1,100. All lasted between less than one to two hours.
Rory arranged a consultation with a private clinic, Harley Psychiatrists, but is seen by a psychologist, not a psychiatrist. He was asked if he was a disorganised child, with a messy bedroom, he replies yes. He was also asked if he finds waiting difficult, he said maybe sometimes, if the queue was long. Rory said he answered all the questions honestly. He is told that he "fits the criteria for ADHD very well." He is told that this diagnosis has no expiration date, and he is "diagnosed for life."
These are the six things we learned from the Panorama documentary on ADHD:
1. ADHD is a big talking point on social media
Reporter Rory Carson detailed how ADHD has become a big talking point on social media. People are sharing videos to TikTok detailing "traits" and symptoms of ADHD. This is leading to people taking online surveys that ask questions like "Do you find it hard to sit still?" Reporter Rory answered yes to this question when filling out the questionnaire. At the end of the survey he is told his results are "highly consistent with ADHD".
2. ADHD has long been undiagnosed but there has been a stark rise in people querying a diagnosis
Dr Jackie Applebee, a GP that appeared on the programme said there are "at least 20 times more people coming now than there were five or six years ago." She described the increase as "from almost 0 to 100mph in a couple of years."
3. Some people are waiting up to five years for an assessment for ADHD on the NHS
Rory met with an NHS consultant who specialises in adult ADHD. Dr Mike Smith told him that some of his patients are waiting up to five years to be seen for an assessment on the NHS.
4. Short private assessments are being done online
In the episode of Panorama, Rory sees a psychologist who diagnoses him with ADHD after less than an hour consultation. He said it "seemed like a TikTok exercise." Unlike the NHS consultation, Rory said he was not asked any other mental health questions.. He then sees a psychiatrist at a later meeting, virtually, and said after three minutes he is offered drugs to combat ADHD. He is recommended a common ADHD treatment which is safe and effective when properly prescribed. Once again, Rory said he is not asked about existing mental health problems.
5. Being prescribed ADHD medication when you don't have the condition, can make other symptoms worse
Dr Mike Smith told Rory that being prescribed medication for ADHD when you don't have the condition can make other conditions worse - for example, psychotic illnesses and bipolar disorder. This is why it is important that assessments for ADHD take into account a person's full medical history and mental health background, which he discovered was not always the case at private clinics.
6. The NHS is paying for thousands of people to be assessed in private clinics
Rory explained that as part of the Government's drive to cut waiting lists, the NHS is paying for thousands of people to be assessed in private clinics. Rory explained: "In England, the NHS is under a legal obligation, if the patient decides that a waiting list is too long, they can request that the NHS pays for them to go private."
The response
Lawyers for one of the firm's mentioned in the investigation told the BBC: "The suggestion there is a high risk our client is misdiagnosing adults with ADHD is untrue and unsubstantiated - as is the suggestion that adequate checks are not conducted." They did however accept that Rory should not have been able to obtain a prescription.
Lawyers representing a second clinic said there would have been more checks before Rory was able to obtain drugs for ADHD once he was diagnosed with it, but the clinic stood by their diagnosis. The lawyers added that the clinic had "no incentive to over diagnose."
One clinic, which is used by the NHS to assess NHS patients, said it is a regulated NHS provider and delivers "high standard assessment, diagnosis, treatment and care" for thousands of patients It admitted on this occasions, prescription policy was regrettably not followed and their procedures have now been reviewed.
You can watch the Panorama investigation on the BBC iPlayer now.
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