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On 1 December 2025, Berkshire Healthcare NHS Foundation Trust announced it would temporarily stop accepting new referrals to its adult ADHD service. The decision, described as difficult but necessary, was made in consultation with local Integrated Care Boards to protect the safety and sustainability of care for existing patients.
For the thousands of adults in Berkshire who were planning to seek assessment, the news was devastating. For the wider ADHD community across England, it was a stark and highly visible example of a crisis that has been building for years.
Berkshire is not an isolated case. NHS ADHD services across England are under unprecedented pressure. Waiting lists have grown to lengths that would have been unthinkable a decade ago. Right to Choose pathways, which offered an alternative route to faster assessment, are being capped or paused in multiple areas. And through all of this, people with undiagnosed or inadequately managed ADHD continue to struggle in ways that affect every area of their lives.
This article explains exactly what happened in Berkshire, why it happened, what the broader national picture looks like, and most importantly, what your options are right now if you are affected.
From 1 December 2025, Berkshire Healthcare NHS Foundation Trust temporarily stopped accepting new referrals to its adult ADHD service. The trust confirmed the decision was made in discussion with local Integrated Care Boards and was intended to allow the service to focus on patients already under its care while redesigning its model to be more sustainable going forward.
The scale of the crisis within the service is significant. Over 4,000 people are currently on the waiting list. More than 1,100 patients who are already prescribed ADHD medication are waiting for their annual reviews, with some delayed by up to three years. National shortages of some ADHD medications are adding extra pressure to clinicians and patients. West Berkshire
The service now receives more referrals in a single month than it was originally commissioned to assess in a whole year. Berkshire Healthcare That single statistic perhaps more than any other illustrates the scale of the mismatch between demand and capacity that has led to this point.
Importantly, the pause applies only to new referrals to the adult service. People who have already been referred for an ADHD assessment or have received a diagnosis and are waiting to start medication will stay on the waiting list and do not need to do anything. If someone is on ADHD medication and being reviewed by the adult ADHD team, their care will continue as normal. People transitioning from children's ADHD services to adult services will also continue as planned. HW Wokingham
There is currently no fixed end date for the pause. The service will reopen for new referrals once it is safe, stable, and sustainable to do so. Berkshire Healthcare
The decision was driven by a combination of factors that have accumulated over several years.
Unprecedented demand growth is the primary issue. Awareness of ADHD has grown significantly among the public, GPs, employers, and educators. As a result, referral rates have risen sharply, far beyond the projections on which the service was originally commissioned and funded. The service was never designed to handle the volume it is now receiving, and funding has not kept pace with demand.
National ADHD medication shortages have added a further layer of pressure. Patients already on medication who require annual reviews have experienced delays of up to three years in some cases. Managing this backlog alongside an ever-growing assessment waiting list while medication supplies are unreliable has stretched clinical capacity beyond what is safely manageable.
Staffing and specialist capacity constraints mean that even with goodwill and effort, the number of qualified clinicians available to carry out assessments and reviews is limited. Training and deploying new ADHD specialists takes significant time.
Systemic underfunding of neurodevelopmental services has meant that despite the growth in demand, the resources allocated to ADHD services in many areas have not expanded proportionally. This is not a problem unique to Berkshire but reflects a national pattern of insufficient investment in services that are needed by a growing number of people.
If you are in Berkshire and were planning to seek an ADHD referral, the trust's advice is clear: please still speak to your GP. They can offer advice, support, and information about managing symptoms and accessing other sources of help while referrals are temporarily closed. Berkshire Healthcare
Your GP remains your first point of contact and can help you understand your options, access interim support, and ensure you are on the list for when the service reopens.
If you are already on the waiting list, you do not need to take any action. Your place on the list is retained.
If you are currently receiving medication through the service, your care continues as normal. The trust has prioritised medication reviews during the pause to ensure patient safety.
If you are transitioning from children's to adult services, this process also continues as planned and is not affected by the pause.
Berkshire has received significant attention because of the clarity and transparency of its public announcement. But the pressures it describes are not unique.
NHS adult ADHD services across England are facing similar challenges to varying degrees. Some trusts have introduced stricter referral criteria. Others have extended waiting times to lengths that represent years of delay for patients. In some areas, services have quietly reduced capacity without formal public announcements.
The average waiting time for an adult ADHD assessment on the NHS is now measured in years rather than months in many parts of the country. Some areas report waits of five years or more from initial GP referral to formal assessment. In that time, individuals are navigating daily life without diagnosis, without treatment, and often without understanding why certain things feel so much harder for them than for others.
The situation in Berkshire is a highly visible version of a problem that is affecting patients across England. The transparency of the trust's announcement, while distressing for those affected, at least provides clarity. Many people in other areas are experiencing similar delays without ever receiving an explanation.
For many people facing long NHS waiting lists, the Right to Choose pathway has historically offered an important alternative. Under this scheme, patients in England can ask their GP to refer them to an alternative NHS-commissioned provider for assessment, often with significantly shorter waiting times than their local service.
However, Right to Choose for ADHD and autism assessments is itself under significant pressure. In late 2025, multiple independent providers announced that their ADHD Right to Choose services were paused for NHS patients in certain areas, following changes to how Integrated Care Boards manage activity plans and spending caps.
At least nine NHS areas told providers to stop booking assessments. Special Needs Jungle This development has removed one of the most significant alternative routes to timely assessment for many people, at precisely the moment when direct NHS services are also under severe strain.
For the most current and detailed information about Right to Choose and how recent changes may affect your access to assessment, see our dedicated article on Right to Choose and ADHD assessments.
It is easy to discuss waiting times in administrative terms, as a backlog management challenge or a commissioning problem. It is harder but more important to understand what those waits mean for the people living through them.
One patient described in reporting around Berkshire's announcement had received her diagnosis at age 48. Before diagnosis and treatment, she experienced overwhelming thoughts, poor concentration, and severely disrupted sleep. After starting medication, she described the experience as transformative, as though her brain had been reorganised, giving her clarity, improved focus, better sleep, and significantly greater productivity both at work and at home.
Her experience is not unusual. For adults who reach diagnosis later in life, the diagnosis itself is often the moment things finally make sense, a framework for understanding decades of difficulty that had previously been attributed to personal failing or character deficiency.
The cost of not reaching that point sooner is real and measurable. Undiagnosed ADHD is associated with significantly higher rates of anxiety, depression, and low self-esteem. It affects relationships, employment, financial management, and physical health. Every year of delay is a year in which those impacts accumulate without intervention.
For a broader understanding of what delays in ADHD diagnosis mean and how to navigate the current system, see our article on how long an ADHD diagnosis takes in the UK.
If you are in Berkshire or another area where NHS ADHD assessment capacity is severely limited, there are steps you can take.
Speak to your GP regardless. Even where referrals are paused, your GP can provide support, discuss symptoms, and may be able to address co-occurring conditions such as anxiety or sleep difficulties that are making things harder while you wait. They can also keep a record of your situation and ensure you are referred as soon as the pathway reopens.
Ask about Right to Choose. Despite the pauses in some areas, Right to Choose may still be available in your specific location. Ask your GP whether you can be referred to an alternative NHS-commissioned ADHD provider, and check whether any providers are currently accepting referrals in your area.
Consider private assessment if financially feasible. Private ADHD assessment typically takes two to six weeks from initial contact to formal diagnosis and report. Costs range from approximately £500 to £1,500 depending on the provider and complexity. Following a private diagnosis, many GPs will accept the report and manage ongoing care under a shared care arrangement, though this varies by practice.
Access interim support. While waiting for formal assessment, resources such as ADHD UK, ADDitude, and local ADHD support groups can provide practical strategies, peer support, and guidance. These do not replace clinical assessment but can meaningfully improve day-to-day functioning in the interim.
Document your symptoms. Keeping a detailed record of how ADHD symptoms affect your daily life across work, home, and relationships provides useful evidence for when you do access assessment and can support requests for interim reasonable adjustments from employers or educational institutions.
For a full guide to medication access following diagnosis, see our article on how to get ADHD medication after diagnosis.
The situation in Berkshire and the broader national picture point clearly to the need for systemic change rather than local service redesign alone.
Funding for neurodevelopmental services needs to reflect the actual and growing demand for ADHD assessment and treatment, not the much lower demand levels that existed when services were originally commissioned. The gap between what services were designed to handle and what they are being asked to handle is the fundamental driver of the current crisis.
GP training in ADHD needs to improve significantly. Better training would enable GPs to provide more meaningful interim support while patients wait for specialist assessment, and would improve the quality and appropriateness of referrals reaching specialist services.
National coordination of ADHD assessment capacity, including better use of independent providers and more consistent application of Right to Choose, would help reduce the extreme regional variation in waiting times that currently exists.
ADHD medication supply chains need to be secured at a national level. The medication shortages that have added pressure to already strained services are not inevitable and reflect supply chain and procurement failures that should be addressable.
For healthcare professionals who want to be part of the solution by developing their clinical capacity in ADHD assessment and management, our ADHD training for professionals provides CPD-certified training built around current evidence and practical clinical skills.
Clinicians working within ADHD services have been raising concerns about capacity for several years. The situation in Berkshire represents the point at which a service has reached the limit of what it can safely absorb without structural change. That this point has been reached publicly and transparently is, in some ways, a positive development: it forces a conversation that has been needed for some time.
What clinicians consistently emphasise is that the harm caused by delayed diagnosis is not abstract. It shows up in the patients who arrive at assessment having spent decades blaming themselves for difficulties that were neurological in origin. It shows up in the mental health comorbidities that develop during years of unmanaged ADHD. And it shows up in the relationships, careers, and opportunities that are affected in ways that early diagnosis and appropriate support could have prevented.
The services that exist to help people with ADHD need the resources to actually do that. Until funding and capacity match demand, patients will continue to bear the cost of a systemic gap that is not of their making.
If you are in Berkshire and were about to seek a referral, contact your GP to discuss your situation. Ask specifically about what support is available while the pause is in place, whether Right to Choose remains an option in your area, and how to ensure you are prioritised when the service reopens.
If you are in a different area of England, do not assume your local service is unaffected. Contact your GP and ask directly about current waiting times and referral pathways in your area. Ask whether Right to Choose is available and whether any providers in your area are currently accepting referrals.
If you are supporting a child with ADHD, it is important to note that Berkshire's pause applies only to the adult service. Children's services are not affected by this particular pause, though they face their own pressures. Contact your child's school SENCO to ensure appropriate support is in place while waiting for any assessment.
If you are an employer or educational institution with an employee or student waiting for ADHD assessment, be aware that under the Equality Act 2010, reasonable adjustments may be appropriate even before a formal diagnosis is received. A waiting list letter from a GP or specialist service can support a request for adjustments.
Has Berkshire Healthcare given a date for when referrals will reopen?
No. The trust has stated that the service will reopen for new referrals once it is safe, stable, and sustainable to do so, but has not provided a specific date. The pause will be reviewed as the service redesign progresses. It is worth monitoring the Berkshire Healthcare website and speaking to your GP for updates.
I submitted a referral before 1 December 2025. Am I still on the list?
Yes. All referrals submitted before 1 December 2025 will be processed. You remain on the waiting list and do not need to take any action.
I am already on ADHD medication. Will my care be affected?
If you are currently on ADHD medication and under the care of the Berkshire adult ADHD team, your care continues as normal. The trust has prioritised medication reviews during the pause to ensure patient safety.
Is Right to Choose still available for ADHD assessment in Berkshire?
The availability of Right to Choose varies and has been subject to changes across multiple areas of England. Speak to your GP about whether Right to Choose is currently available as an option in your area, and ask them to check which providers are currently accepting NHS referrals.
Can I get support from my GP while waiting?
Yes. Your GP can offer advice, discuss your symptoms, address co-occurring conditions, and provide information about community and online resources that may help while you wait. They cannot carry out a formal ADHD assessment or prescribe ADHD-specific medication without specialist input, but they can provide meaningful interim support.
Why are ADHD medication shortages making the situation worse?
National shortages of certain ADHD medications mean that patients already on medication require more intensive clinical management to ensure their treatment remains safe and appropriate. This diverts clinical time and capacity away from new assessments, adding to the backlog and compounding the pressure on already stretched services.
Are other NHS trusts in England facing similar problems?
Yes. Berkshire has been particularly transparent, but the pressures it describes are not unique. Many NHS adult ADHD services across England are experiencing significant strain, with long waiting lists, capacity constraints, and in some cases restrictions on Right to Choose referrals. The scale and visibility of the problem varies by area, but the underlying drivers are national.
The pause in adult ADHD referrals at Berkshire Healthcare NHS Foundation Trust is a significant and concerning development. But it is also a window into a national problem that has been building for years and affects patients far beyond the borders of Berkshire.
For individuals affected by this pause, the most important message is this: do not disengage. Keep speaking to your GP. Explore every available option, including Right to Choose where it remains accessible and private assessment where it is financially possible. Access interim support and document your symptoms carefully.
For policymakers and commissioners, the message is equally clear. What has happened in Berkshire is not an anomaly. It is the visible tip of a much larger problem in ADHD service provision across England. Addressing it will require meaningful investment in specialist capacity, improvements in GP training, secure medication supply chains, and a commissioning framework that reflects the actual scale of ADHD in the population.
The people on these waiting lists are not statistics. They are adults whose daily lives are being significantly affected by a condition that responds well to timely diagnosis and appropriate support. They deserve better than the system is currently able to offer them.
Medical Disclaimer
This article is for educational and informational purposes only. It does not constitute medical advice. NHS policies, waiting times, and referral pathways are subject to change. If you have concerns about ADHD symptoms, please speak with your GP. Information in this article was accurate as of the date of publication but may have changed since.
