There has been a 200% surge in complaints related to attention deficit/hyperactivity disorder (ADHD) and autism services in the past four years, says a new report.
The parliamentary and health service ombudsman, Paula Sussex, said the demand was outstripping capacity, and delays in diagnosis and treatment were driving dissatisfaction.
She added that far too many people now feel forced to pay for private treatment, and this has created a post code lottery.
The cost of private treatment is close to £4,000.
The report, "Improving ADHD and Autism Services: Commissioning With Confidence", shares the ombudsman’s findings based on 3,000 complaints.
It found recurring issues, including uncertainty around patients’ right to choose a provider.
Under right to choose, patients in England can choose from eligible NHS-funded providers for certain services, including some independent providers.
However, the ombudsman found uncertainty around how this right applied, with patients sometimes being told wrongly that they could not exercise it.
The complaints rose from 410 in 2021-22 to 1,257 in 2025-26, an increase of more than 200%, as referrals and the number of people waiting for assessment, treatment and support also increased.
Demand for ADHD and autism assessment and support services has surged dramatically across England, with open NHS referrals reaching roughly 562,000.
More than 60% of adults and children face waiting lists exceeding a year, while prescribing data shows historic multi-year increases.
Sussex said the system is too complex and inconsistent, "leaving too many patients falling through the gaps.”
“People should not have to fight their way through a confusing system to get ADHD and autism care.
Henry Shelford, chief executive of ADHD UK, told The Independent: “The Ombudsman has diagnosed the system correctly and we urge government to follow the Ombudsman’s recommendations.”
