---
title: "ADHD and Autism Review: What It Means for Leaders"
description: "What England’s ADHD and autism review means for leaders: ten findings, ten recommendations and practical ways to support your people while they wait."
---

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# ADHD and Autism Review: What It Means for Leaders.  So, are we being listened to?

My take on the recent Department of Health and Social Care’s **Independent Review into Mental Heal Heath conditions, ADHD and Autism**.

What do **YOU** think? 

 Written by Nick Silverstone  Published October 26, 2026

*26 October 2026 · Nick Silverstone*

England’s review of mental health conditions, ADHD and autism makes an uncomfortable point: diagnosis has become the front door to help, and that door is overwhelmed. In my work at [Fractional MD](https://www.fractional-md.com/), I see supporting people as part of leading a business well.

One finding matters particularly: the sharp rise in recorded ADHD diagnoses does not establish a matching rise in underlying prevalence. The review says ADHD prevalence appears broadly stable or has increased only modestly. That distinction matters when you interpret the headlines.

The evidence is dated and uncertain, so I would not claim that prevalence has not risen at all. What the review makes clear is that recorded diagnoses, demand for assessment and underlying prevalence are different measures.

I have read the executive summary and pulled out what matters for founders, senior leaders and the people who work with them. The report spans 20 chapters. Treat this as a leadership briefing on the summary, rather than a review of every chapter.

The figures below are those cited in the executive summary. They cover different periods and populations; they are not live October 2026 waiting-list totals.

## 10 findings every leader should understand

The review describes rising demand, unmet need and a system that relies too heavily on diagnosis as the route to support.

1. **ADHD open referrals exceeded 560,000 by the end of 2025.** That was more than 17 times the 2019 figure. Monthly referrals rose from around 5,000 in 2019 to around 17,000 in 2024. Behind those numbers are people trying to manage daily life while waiting for answers.
2. **Autism assessment queues are also substantial.** By December 2025, more than 254,000 people had an open referral, and over 90% had waited longer than 13 weeks.
3. **Recorded diagnoses have risen much faster than estimated underlying prevalence.** Among 12 to 17 year olds, recorded ADHD increased from 0.26% in 2000 to 3.88% in 2025; autism rose from 0.10% to 4.06%. Population evidence suggests broadly stable prevalence, or modest increases for ADHD, but remains uncertain. Estimates of 3% for ADHD in 5 to 15 year olds and 1.2% for autism in young people come from 2017. The review’s ADHD projection of around 3.8% is explicitly rough. It notes the lack of equivalent adult population survey data.
4. **The rise in common mental health conditions is real.** Among adults aged 16 to 64, the proportion meeting criteria for a common mental disorder rose from 15.5% in 1993 to 22.6% in 2024. Among 16 to 24 year olds, it increased from around one in six to one in four. The review says awareness alone cannot explain this, while population rates of severe illnesses such as schizophrenia and bipolar disorder have remained broadly stable.
5. **Mental ill health carries a substantial economic and social cost.** The review cites a 2024 estimate of around £300 billion annually in England. This is a society-wide estimate, not a measure of employers’ costs alone.
6. **Young people face serious barriers to participation.** The review reports around one million 16 to 24 year olds not in education, employment or training (NEET). Among young people who were NEET, the proportion reporting a work-limiting health condition increased from 26% in 2015 to 44% in 2025. Childhood ADHD diagnosis is associated with around four times the likelihood of being NEET in early adulthood. That association does not establish causation.
7. **Longer waits are associated with worsening difficulties.** The review cites national evidence, referenced to the CQC’s 2024–2025 report, that around one in four people waiting less than two weeks experienced deterioration, compared with more than seven in ten waiting over six months. This is broader evidence about waiting for care, not an ADHD-only finding.
8. **Overdiagnosis at scale is not established.** The review cannot conclude that it is happening at scale, but warns of increasing risks of misdiagnosis and overdiagnosis. It also finds no evidence that people presenting now are less impaired than those presenting previously. Their difficulties are real.
9. **Independent assessment provision has grown faster than consistent oversight.** The review reports independent providers delivering more than half of NHS-funded ADHD assessments and over a third of autism assessments. It cites 2026 research reporting a roughly 252% increase in independent-sector ADHD spending over three years and a projected £164 million overspend across the areas analysed. That is not a national overspend total.
10. **Overlapping difficulties deserve attention.** In 2024, among 16 to 24 year olds with a common mental disorder, 57% also screened positive for ADHD and 61% for autistic traits. Screening is not diagnosis. These findings reinforce the need to consider the whole person.

## The review’s 10 recommendations in plain English

These are recommendations to government and local systems. Their inclusion in the report does not mean they have been implemented.

1. **Prevent distress earlier.** Strengthen public mental health governance and invest in youth, community and voluntary services, working with people with lived experience.
2. **Put needs alongside diagnosis.** Develop a shared, digitally and AI-enabled needs assessment, prioritising impairment and risk. Clinically review waiting lists, provide support while people wait, and actively arrange appropriate help before anyone is removed from a list.
3. **Join services up.** Provide local, age-appropriate assessment and support that considers mental health and neurodevelopmental needs together, including transitions into adulthood.
4. **Protect specialist care.** Close treatment gaps while strengthening services for people with the most severe, enduring and complex needs.
5. **Improve regulation and commissioning.** Make all ADHD and autism diagnostic assessments CQC-regulated activity and ban direct-to-public advertising of NHS-funded assessments. These are proposals in the review.
6. **Build the workforce.** Invest in multidisciplinary teams, training and supervision, with core competence in mental health and neurodevelopmental needs.
7. **Use technology while preserving human care.** Scale safe digital and AI-enabled tools, improve information-sharing and retain in-person care rather than replacing it.
8. **Measure properly.** Commission regular population prevalence surveys, strengthen data on inequalities and update NICE guidelines.
9. **Improve public understanding.** Co-produce a national information campaign and trusted digital support that people can use without a diagnosis.
10. **Commit to implementation.** Publish a cross-government mental health strategy in 2026, setting out immediate actions over 12 to 24 months and a ten-year reform plan.

## What else deserves leaders’ attention?

The review highlights recognition gaps, unequal access and missing support after diagnosis. Those issues deserve care when you interpret the headline numbers.

- **Diagnosis can become a perceived gatekeeper.** The review describes it being seen as a requirement for EHCPs, Access to Work and parts of welfare. This is not a statement of those schemes’ legal eligibility rules.
- **Neurodiversity is not a clinical diagnosis.** The review warns that services offering “neurodiversity assessments” risk blurring a social concept with diagnostic practice.
- **Self-identification and diagnosis are different.** In the OxWell 2025 secondary-school survey, around one in five pupils described themselves as neurodivergent.
- **Girls and women have been under-recognised.** The review says at least part of the historical sex difference reflected recognition gaps rather than true prevalence differences.
- **Autism diagnosis can be followed by little support.** In a clinician survey cited in the review’s autism section and referenced to a 2025 source, 40% reported no ongoing post-diagnostic support.
- **Inequality matters.** The review describes deprivation, discrimination and disadvantage interacting with access to care. It stresses that neurodevelopmental difference should not be treated as something to eliminate.

## My take as a Fractional MD and Senior Leaders ADHD | AuDHD Coach

My conclusion is that leaders can improve everyday support while people wait. These are my own conclusions, not the review’s instructions to employers. I am not a clinician, and nothing here replaces assessment or treatment.

### Waiting belongs on your leadership agenda

The queue does not stay outside your company. Your people carry uncertainty into meetings, deadlines and performance reviews. I would treat support as part of your [business foundations](https://www.fractional-md.com/insights/how-robust-is-your-business), with an owner, an agreed approach and regular review.

### Ask what helps before asking for a label

If someone needs written instructions, fewer interruptions or a quieter place to work, discuss what would help and agree a practical trial. Review it together. I would not turn that conversation into an attempt to diagnose the person or assume everyone with the same diagnosis needs the same support.

### Make an interim support plan

Agree [clear priorities](https://www.fractional-md.com/insights/setting-clear-business-goals-for-2025-why-less-is-more), realistic workloads, useful check-ins and flexibility where the role allows. Give each change an owner and a review date, rather than leaving support as an informal promise.

Through my [coaching work](https://www.fractional-md.com/), I help people build practical approaches to planning and follow-through. Coaching can complement workplace and clinical support; it does not replace assessment or treatment.

### Look at the person and the working environment

I would ask about the task, the surroundings and the demands on the person before guessing at a single cause. Different [leadership styles](https://www.fractional-md.com/insights/3-type-of-business-leaders) can shape how those conversations happen. Listen first, agree changes together and avoid assumptions about someone’s capabilities.

### Measure participation and sustainable performance

Can your people contribute, stay and develop? I would review those outcomes alongside the person’s experience of support. Removing unnecessary [growth barriers](https://www.fractional-md.com/insights/top-5-growth-challenges-for-smes-and-how-to-solve-them-0) starts with understanding where daily work becomes harder than it needs to be.

## What leaders can do now

Start with one practical support conversation and follow it through. You do not need to redesign your entire organisation before making a useful change.

Ask what is getting in the way, agree one adjustment, write down who will do what and set a review date. Build that people-first approach into your wider [continuity planning](https://www.fractional-md.com/insights/when-the-lights-go-out), so support does not disappear when a manager is absent or priorities change.

Build your team’s understanding, too. My [ADHD | AuDHD awareness webinars, workshops and training](https://www.fractional-md.com/adhd-awareness) help leaders and managers understand how ADHD can show up at work and explore practical ways to support their people.

My view remains that neuroinclusion is a growth strategy. I want leaders to build workplaces where people can contribute and develop, with support that reflects their needs.

Want to know where your organisation stands? The ADHD | AuDHD F.I.T Audit is a workplace neurodiversity health check and a practical place to start. Or [book an introductory conversation](https://www.fractional-md.com/) with me about supporting your people.

## Source and scope

This briefing summarises the Department of Health and Social Care’s [Independent review into mental health conditions, ADHD and autism: executive summary](https://www.gov.uk/government/publications/independent-review-into-mental-health-conditions-adhd-and-autism-final-report/independent-review-into-mental-health-conditions-adhd-and-autism-executive-summary), accessed on 26 October 2026. Statistics are attributed to the summary and its cited evidence, rather than independently reanalysed here. Workplace conclusions are my interpretation.

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