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Failure of healthcare provision for Attention-Deficit/Hyperactivity Disorder in the United Kingdom: a Consensus Statement

Failure of healthcare provision for Attention-Deficit/Hyperactivity Disorder in the United Kingdom: a Consensus Statement
Failure of healthcare provision for Attention-Deficit/Hyperactivity Disorder in the United Kingdom: a Consensus Statement
Background: despite evidence-based national guidelines for ADHD in the United Kingdom (UK), ADHD is under-identified, under-diagnosed, and under-treated. Many seeking help for ADHD face prejudice, long waiting lists, and patchy or unavailable services, and are turning to service-user support groups and/or private healthcare for help.

Methods: a group of UK experts representing clinical and healthcare providers from public and private healthcare, academia, ADHD patient groups, educational, and occupational specialists, met to discuss shortfalls in ADHD service provision in the UK. Discussions explored causes of under-diagnosis, examined biases operating across referral, diagnosis and treatment, together with recommendations for resolving these matters.

Results: cultural and structural barriers operate at all levels of the healthcare system, resulting in a de-prioritization of ADHD. Services for ADHD are insufficient in many regions, and problems with service provision have intensified as a result of the response to the COVID-19 pandemic. Research has established a range of adverse outcomes of untreated ADHD, and associated long-term personal, social, health and economic costs are high. The consensus group called for training of professionals who come into contact with people with ADHD, increased funding, commissioning and monitoring to improve service provision, and streamlined communication between health services to support better outcomes for people with ADHD.

Conclusions: evidence-based national clinical guidelines for ADHD are not being met. People with ADHD should have access to healthcare free from discrimination, and in line with their legal rights. UK Governments and clinical and regulatory bodies must act urgently on this important public health issue.
ADHD, assessment, healthcare commissioning, service provision, treatment
1664-0640
Young, Susan
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Asherson, Philip
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lloyd, Tony
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Absoud, Michael
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Colley, William Andrew
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Cortese, Samuele
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Cubbin, Sally
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Doyle, nancy
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Dunn Morua, Susan
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Ferreira-Lay, Philip
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Gudjonsson, Gisli
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Ivens, Valerie
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Jarvis, Christine
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Lewis, Alexandra
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Mason, Peter
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Newlove-Delgado, Tamsin
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Pitts, Mark
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Read, Helen
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van Rensburg, Kobus
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Zoritch, Bozhena
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Skirrow, Caroline
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Young, Susan
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Asherson, Philip
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lloyd, Tony
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Absoud, Michael
acd51a51-9b31-4984-8f80-49028a27e30e
Colley, William Andrew
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Cortese, Samuele
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Cubbin, Sally
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Doyle, nancy
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Dunn Morua, Susan
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Ferreira-Lay, Philip
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Gudjonsson, Gisli
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Ivens, Valerie
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Jarvis, Christine
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Lewis, Alexandra
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Mason, Peter
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Newlove-Delgado, Tamsin
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Pitts, Mark
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Read, Helen
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van Rensburg, Kobus
e4f77ef1-e121-488a-84fb-16aa9889184c
Zoritch, Bozhena
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Skirrow, Caroline
b3140900-fbff-4ac7-9131-971f4ed16d66

Young, Susan, Asherson, Philip, lloyd, Tony, Absoud, Michael, Colley, William Andrew, Cortese, Samuele, Cubbin, Sally, Doyle, nancy, Dunn Morua, Susan, Ferreira-Lay, Philip, Gudjonsson, Gisli, Ivens, Valerie, Jarvis, Christine, Lewis, Alexandra, Mason, Peter, Newlove-Delgado, Tamsin, Pitts, Mark, Read, Helen, van Rensburg, Kobus, Zoritch, Bozhena and Skirrow, Caroline (2021) Failure of healthcare provision for Attention-Deficit/Hyperactivity Disorder in the United Kingdom: a Consensus Statement. Frontiers in Psychiatry, 12, [649399]. (doi:10.3389/fpsyt.2021.649399).

Record type: Article

Abstract

Background: despite evidence-based national guidelines for ADHD in the United Kingdom (UK), ADHD is under-identified, under-diagnosed, and under-treated. Many seeking help for ADHD face prejudice, long waiting lists, and patchy or unavailable services, and are turning to service-user support groups and/or private healthcare for help.

Methods: a group of UK experts representing clinical and healthcare providers from public and private healthcare, academia, ADHD patient groups, educational, and occupational specialists, met to discuss shortfalls in ADHD service provision in the UK. Discussions explored causes of under-diagnosis, examined biases operating across referral, diagnosis and treatment, together with recommendations for resolving these matters.

Results: cultural and structural barriers operate at all levels of the healthcare system, resulting in a de-prioritization of ADHD. Services for ADHD are insufficient in many regions, and problems with service provision have intensified as a result of the response to the COVID-19 pandemic. Research has established a range of adverse outcomes of untreated ADHD, and associated long-term personal, social, health and economic costs are high. The consensus group called for training of professionals who come into contact with people with ADHD, increased funding, commissioning and monitoring to improve service provision, and streamlined communication between health services to support better outcomes for people with ADHD.

Conclusions: evidence-based national clinical guidelines for ADHD are not being met. People with ADHD should have access to healthcare free from discrimination, and in line with their legal rights. UK Governments and clinical and regulatory bodies must act urgently on this important public health issue.

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Accepted/In Press date: 24 February 2021
e-pub ahead of print date: 19 March 2021
Published date: 19 March 2021
Additional Information: Funding Information: We thank Takeda for sharing their Freedom of Information (FOI) data with us. We are grateful to the assistance of Lucy Warr, Catherine Coales, and Vicki Williams, who attended the consensus meeting and made notes during the breakout sessions. We are grateful to an informal external review and feedback on the first draft by a Consultant Psychiatrist working in CAMHS, who wished to remain anonymous. Funding. The meeting was jointly funded by the ADHD Foundation, the UK Adult ADHD Network (UKAAN), and the UK ADHD Partnership (UKAP). Other than reimbursement of travel expenses to attend the meeting, none of the authors received any financial compensation for attending the meeting or writing the manuscript, aside from CS who was remunerated for her time. PA was supported by NIHR Biomedical Research Center for Mental Health, NIHR/MRC (14/23/17) and NIHR senior investigator award (NF-SI-0616-10040). TN-D was funded by an NIHR Advanced Fellowship (NIHR300056). The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health and Social Care. Funding Information: The meeting was jointly funded by the ADHD Foundation, the UK Adult ADHD Network (UKAAN), and the UK ADHD Partnership (UKAP). Other than reimbursement of travel expenses to attend the meeting, none of the authors received any financial compensation for attending the meeting or writing the manuscript, aside from CS who was remunerated for her time. PA was supported by NIHR Biomedical Research Center for Mental Health, NIHR/MRC (14/23/17) and NIHR senior investigator award (NF-SI-0616-10040). TN-D was funded by an NIHR Advanced Fellowship (NIHR300056). The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health and Social Care. Publisher Copyright: © Copyright © 2021 Young, Asherson, Lloyd, Absoud, Arif, Colley, Cortese, Cubbin, Doyle, Morua, Ferreira-Lay, Gudjonsson, Ivens, Jarvis, Lewis, Mason, Newlove-Delgado, Pitts, Read, van Rensburg, Zoritch and Skirrow. Copyright © 2021 Young, Asherson, Lloyd, Absoud, Arif, Colley, Cortese, Cubbin, Doyle, Morua, Ferreira-Lay, Gudjonsson, Ivens, Jarvis, Lewis, Mason, Newlove-Delgado, Pitts, Read, van Rensburg, Zoritch and Skirrow.
Keywords: ADHD, assessment, healthcare commissioning, service provision, treatment

Identifiers

Local EPrints ID: 449382
URI: http://eprints.soton.ac.uk/id/eprint/449382
ISSN: 1664-0640
PURE UUID: f8245362-859f-45d1-84f5-c2c373873f0e
ORCID for Samuele Cortese: ORCID iD orcid.org/0000-0001-5877-8075

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Date deposited: 26 May 2021 16:32
Last modified: 17 Mar 2024 03:37

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Contributors

Author: Susan Young
Author: Philip Asherson
Author: Tony lloyd
Author: Michael Absoud
Author: William Andrew Colley
Author: Samuele Cortese ORCID iD
Author: Sally Cubbin
Author: nancy Doyle
Author: Susan Dunn Morua
Author: Philip Ferreira-Lay
Author: Gisli Gudjonsson
Author: Valerie Ivens
Author: Christine Jarvis
Author: Alexandra Lewis
Author: Peter Mason
Author: Tamsin Newlove-Delgado
Author: Mark Pitts
Author: Helen Read
Author: Kobus van Rensburg
Author: Bozhena Zoritch
Author: Caroline Skirrow

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