NHS pilot gives adults referred for ADHD a triage decision in under six days

What the pilot is

An NHS pilot in the North East has given adults referred for possible ADHD a triage decision in under six days. It's run by NHS North East and North Cumbria Integrated Care Board (ICB) with the private provider Psychiatry UK, and so far it has triaged 344 adults across 13 primary care networks and 34 GP practices. The early results were presented at the Royal College of GPs conference in Glasgow and reported by Medscape News UK on 2 November.

How it works

Instead of everyone joining one long queue for an assessment, people first fill in a digital screening covering how likely their symptoms are, how much they affect daily life and any clinical risk. A nurse then holds a 15-minute video call, goes through the answers and decides the right route. That could be community support, a specialist ADHD assessment through the NHS Right to Choose pathway, or secondary mental health services for people with more complex needs.

What happened to the 344

About 75% met the threshold for a specialist ADHD assessment, which Psychiatry UK said matched what earlier clinical data predicted. The rest could be pointed to other support based on their symptoms, impairment and risk. The nurse call made a real difference too. After clinical review, 9% of people had their screening scores downgraded and 0.6% were upgraded. As Anna Matty of Psychiatry UK put it, "No online-only methodology is perfect."

Six days to what, exactly

This is the bit that's easy to miss. The six days is the time to decide which route someone goes down, not the time to get a diagnosis. Medscape is clear about that. Psychiatry UK's Anna Matty said: "We do not have a wait list, even at this kind of scale." People with complex conditions alongside ADHD aren't seen virtually and are best supported by a trust, and anyone at immediate risk of suicide is sent to local crisis services.

Why it matters

Adults often wait years for an ADHD assessment and get very little help while they wait. This is one of the first real-world tests of the "needs-led" approach the Fonagy review called for in October. Dr Katharine Petersen, a Northumberland GP and the ICB's medical director, who led the design, said: "What we should be doing is providing needs-led services for everybody, whether or not you get a diagnosis." She also said "the need for diagnosis is very personal".

The GP's view

Dr Petersen described how the old system plays out in a surgery: "I sometimes have four appointments to try and work out what an individual needs, and to chase them up about any screening or discussions we've had about Right to Choose." Her point is that support should sit alongside diagnosis and treatment, not replace them. "If we don't address the needs for years, or however long they're on a waiting list, actually we could have been addressing those needs-led things all along."

The cautions

It's early days. The pilot shows fast decisions, but not yet whether people then get effective support, or what it does to diagnosis waits and long-term outcomes. It isn't a peer-reviewed study and has no comparison group, and the results were presented by the private provider delivering it. Dr Petersen herself said: "We are still thinking about, have we got our thresholds right?" The ICB says it's making adjustments for people who struggle with digital services, including translation and other arrangements.

What happens next

The ICB plans to extend the pathway across North East and North Cumbria by the end of March 2027, possibly with wider adoption later, though Dr Petersen said more evaluation is needed before any national roll-out. Dr Toyosi Adeniji, a Northampton GP not involved in the pilot, said: "We know there is a huge waiting list, really. So, it's thinking about innovative solutions." She added that if others adopt it, "they're onto something".