ADHD treatment: your NHS 18-week waiting-time right

The 18-week right

Waiting months for ADHD care? You may have more rights than you realise.

You might still be waiting for an assessment, or have a diagnosis and be facing another queue before treatment begins. Either way, knowing what you can ask for matters.

In England, there is a right to start qualifying non-urgent, consultant-led treatment within 18 weeks, subject to exceptions. Some ADHD care can fall within this right, but it depends on your service and treatment pathway.

What the NHS says

The NHS waiting-time guidance explains the 18-week maximum waiting time for non-urgent consultant-led treatment. It includes qualifying physical and mental health services, but excludes mental health services that are not consultant-led.

Consultant-led does not necessarily mean every appointment is with a consultant. Your care may be delivered by another member of a team under a consultant’s responsibility.

These rules apply to England. They should not be presented as a single rule covering ADHD services across the whole UK.

Does ADHD count?

ADHD care can be covered. In a parliamentary answer about ADHD waiting times, published on 24 November 2022, the Department of Health and Social Care confirmed that consultant-led mental health services are included in the NHS 18-week maximum waiting time.

The same answer explained that NICE’s ADHD guideline did not recommend a separate maximum waiting time from referral to assessment or from assessment to diagnosis.

The question is whether your particular ADHD pathway falls within the consultant-led waiting-time rules. Having an ADHD referral does not automatically establish that every service you use is covered.

When counting begins

The waiting-time clock normally starts when the service receives your referral, or when your appointment is booked through the NHS e-Referral Service.

It does not normally start from your diagnosis date. The guidance does not establish a blanket right to ADHD medication within 18 weeks after diagnosis.

The NHS explains that the clock can end when treatment begins or certain clinical decisions are made, including that treatment is unnecessary or monitoring is appropriate.

If you have been diagnosed and are waiting to start medication, ask whether your clock is still running. If it has stopped, ask for the date and the clinical reason. Your diagnosis date alone does not answer that question.

Asking for another provider

The NHS Choice Framework explains that you can ask to change provider if you have waited, or expect to wait, more than 18 weeks for qualifying non-urgent consultant-led care.

You can contact your current service or the integrated care board, usually called the ICB, responsible for arranging your care. You do not have to wait until 18 weeks has passed before raising it.

There are exceptions, including where no suitable alternative service can start treatment sooner. Asking to move therefore does not guarantee an earlier appointment.

What to ask

Ask your service to explain your position in writing. Useful questions include:

• Is my ADHD pathway covered by the 18-week consultant-led waiting-time rules?
• What date did my waiting-time clock start?
• Has it stopped? If so, when and why?
• If the right applies, could another suitable provider start my care sooner?
• Who at my ICB can help me explore this?

Keep the response alongside your referral and appointment letters. Having the dates and explanation together can make following up easier.

A message to send

“Please confirm whether my ADHD referral is covered by the 18-week consultant-led referral-to-treatment rules, when my waiting-time clock started, and whether it has stopped.

“If it has stopped, please explain when and why. If the right applies and my wait will exceed 18 weeks, please explain what suitable alternative providers could start my care sooner and how I can request this.”

Getting help with answers

If you cannot get a clear response, the Patient Advice and Liaison Service, known as PALS, can provide information and support. It can also explain the NHS complaints procedure and how to get independent help with a complaint.

The NHS Choice Framework also explains that ICBs must provide advice or assistance to people who have waited, or will wait, beyond the maximum waiting time for qualifying care.

Knowing where you stand

The 18-week right gives you something concrete to ask about. It does not mean every ADHD wait breaches the rules or guarantee medication by a particular date.

You can ask for a clear explanation of what you are waiting for, how your wait is being counted and whether an earlier option is available. You should not have to piece together your treatment rights from social media.