The NHS Alliance, which represents health managers, says the current system represents a bad deal for patients and taxpayers alike. The group points to big variations in what the NHS is being charged for assessments and care - in one case, a local health board was paying £300 to £3,000 for similar services.

The NHS Alliance says there has been a rapid expansion in new providers – both private firms and charities are involved – and NHS managers are struggling to ensure the quality and safety of care being provided. The group found that a number of integrated care boards were reporting sharp rises in spending, describing it as out of control.

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Expansion of Private Providers

Unlike for routine operations, like hip and knee replacements, where there is a set tariff for different treatments regardless of whether the NHS or private sector carry them out, for autism and ADHD there are only guide prices that do not have to be kept to. Local health bosses have also reported a rapid increase in providers.

Providers who carry out assessments only do not have to be filed with the Care Quality Commission, the regulatory body for health and care. This is causing problems with the ability of boards to check the quality and safety of the care and support being provided.

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Rebecca Gray of the NHS Alliance stated managers were caught between a rock and a hard place. They understand the anguish and frustration caused The situation is a bad deal for patients and taxpayers, and there is a risk the whole system will fall into chaos.

Variation in Charging

The government stated an independent review into services would be published soon and it would act on the findings of that, promising a new national approach for autism, ADHD, and mental health. Mel Merritt, of the National Autistic Society, stated it was clear the system was in crisis.

Spending is rising on short-term solutions due to years of a lack of long-term investment in improving services. And despite the sums being spent, people are still facing unacceptable delays.

Autism and ADHD care is at risk of descending into chaos, NHS bosses are warning, as costs spiral out of control and unregulated private providers capitalise on the huge demand for help.