What the review found
The review looked at how common these conditions are, what is driving demand, and how well services respond. Its main findings for England include:
- Mental distress has risen. The share of adults aged 16 to 64 meeting the criteria for a common mental disorder rose from 15.5% in 1993 to 22.6% in 2024, with the fastest rises among young people. The review did not find the same increase in severe mental illness.
- ADHD demand has soared. Monthly ADHD referrals rose from around 5,000 in 2019 to around 17,000 in 2024, and open referrals passed 560,000 by the end of 2025.
- Autism waits are long. By December 2025, more than 254,000 people had an open autism referral, and over 90% had waited longer than 13 weeks.
- Underlying prevalence looks broadly stable. Referrals and diagnoses have risen sharply, but the review found little evidence of a big change in how common ADHD and autism are in the population. It also notes there is no equivalent adult survey data for autism.
The review's central recommendation is a shift from a "diagnosis-dependent" system to what it calls a "needs-led plus diagnosis" system. Diagnosis stays essential where it is clinically needed, but help should be available before, during and after assessment. On 21 October 2026 the report was amended to say diagnosis has increasingly been seen as a requirement for help, rather than that it had become one.
What the government has committed to
DHSC's response, published the same day, includes:
- CQC regulation of diagnostic assessments. Working with NHS England and CQC to regulate ADHD and autism diagnostic assessments for NHS-funded, non-NHS-funded and self-funding patients. Integrated care boards must also improve oversight of the assessment services they commission.
- Advertising. The Health and Social Care Secretary will write to the Advertising Standards Authority about adverts for ADHD and autism services.
- A national tariff. NHS England will consult on a national set of prices for NHS-funded ADHD and autism services, covering assessment, post-diagnostic support and follow-ups, with new payment arrangements intended from April 2027.
- Clinical guidance. NICE will be asked to urgently consider what the report means for its ADHD and autism guidance.
- A mental health strategy. A cross-government strategy is due "later this year", focused on prevention and earlier support.
What changes at CQC, and what doesn't yet
CQC said on 9 October that DHSC has asked it to regulate all services providing ADHD and autism diagnostic assessments, once new regulations are in place. At present it regulates services that offer both diagnosis and treatment, but the law does not let it regulate services that only diagnose. No date has been given for the new regulations, so nothing changes for those services today.
Why it matters for care providers
Most of the review is about NHS, school and community services, but parts of it touch adult social care directly:
- Needs-led support. The review's message is that people should not be left without help while they wait for an assessment. For providers supporting someone on a long waiting list, that means planning around the person's needs now.
- Specialist and high-needs care. Recommendation 4 calls for stronger investment in specialist community, crisis and inpatient services, more consistent medication reviews and safe deprescribing, and a focus on quality of life for people with the highest support needs.
- Workforce. Recommendation 6 says all staff should have a core competence in mental health and neurodevelopmental needs, backed by a nationally agreed competency framework. Neighbourhood teams should include social care.
These are recommendations. The government has not yet said how, or whether, each one will be put into practice.
What this means for your service
- Don't wait for a diagnosis to adjust support. If someone you support is on an ADHD or autism waiting list, base their care plan on their needs and record the reasonable adjustments you make.
- Keep medication under review. The review backs regular medication reviews and safe deprescribing. Make sure every psychotropic medicine has a clear reason, and that reviews with the GP or prescriber happen on time.
- Check where assessments come from. If you or the people you support use a private ADHD or autism assessment service, ask whether it is CQC-registered. Diagnosis-only services aren't regulated yet, but they are expected to be.
- Look at staff training. The review's call for core competence fits with the Oliver McGowan training duty that already applies to CQC-registered providers.
- Watch for the mental health strategy. It should set out which recommendations go ahead and when. We will report on it when it is published.
Sources
- DHSC, Government pledges earlier support to tackle mental health crises (press release, 9 Oct 2026): https://www.gov.uk/government/news/government-pledges-earlier-support-to-tackle-mental-health-crises (checked 27 Oct 2026)
- DHSC, Independent review into mental health conditions, ADHD and autism: final report (published 9 Oct 2026, updated 21 Oct 2026): https://www.gov.uk/government/publications/independent-review-into-mental-health-conditions-adhd-and-autism-final-report (checked 27 Oct 2026)
- DHSC, 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 (checked 27 Oct 2026)
- Care Quality Commission, CQC to regulate autism and ADHD diagnostic assessments (9 Oct 2026): https://www.cqc.org.uk/news/cqc-regulate-autism-and-adhd-diagnostic-assessments (checked 27 Oct 2026)
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