英国政府即将发布的独立审查报告提议改革ADHD诊断制度，采取"需求为基础"的分诊模式1。根据该方案，仅有严重患者将被转诊至NHS诊所进行正式诊断，而轻度患者虽可获得支持但将不被赋予正式诊断1。这一审查由时任卫生大臣Wes Streeting于12月委托，由伦敦大学学院临床心理学家Peter Fonagy领导1。
改革方案引发医疗专家和权益组织的强烈反对。ADHD UK首席执行官Henry Shelford批评称"没有'温和的'ADHD"1，指出诊断需要有证据显示对生活造成衰弱性影响。医学界人士认为这实质上构成对医疗服务的"配给"1，担心此举将导致患者转向社交媒体自诊。
改革的背景是NHS面临的巨大诊疗压力。目前NHS等待名单上有80万名患者1，英格兰对自闭症和ADHD服务的投诉在五年内增加了三倍1。权益倡导者强调未诊断、未治疗ADHD的社会代价，ADHD工作组估计相关成本达170亿英镑1。此外，据ADHD UK数据，确诊患者寿命显著缩短，女性患者比同龄人早死9年，男性早死7年1。约10万名患者因ADHD状况领取与健康相关的福利1。
An independent review commissioned by the government is set to propose sweeping changes to how the NHS diagnoses and manages attention deficit hyperactivity disorder, drawing sharp criticism from medical experts and patient advocacy groups.1 The review, led by Peter Fonagy, a clinical psychologist at University College London, was commissioned by then-Health Secretary Wes Streeting in December and recommends adopting a "need-based" triage system that would reserve formal diagnoses and NHS clinic referrals for severe cases, while milder cases would receive support without official diagnosis.1
The proposal has provoked fierce opposition, with critics arguing it amounts to rationing healthcare.1 Henry Shelford, chief executive of ADHD UK, warned that there is no such thing as "mild ADHD," noting that diagnosis requires evidence of disabling impact on daily life.1 He further highlighted that women with ADHD die nine years earlier than their peers, while men die seven years earlier.1
The backlash reflects concerns about the scale of unmet demand: approximately 800,000 patients currently wait on NHS lists, while an estimated 100,000 are already claiming health-related benefits due to ADHD.1 The cost of undiagnosed and untreated ADHD is estimated at £17 billion, according to an ADHD taskforce calculation.1 Complaints about autism and ADHD services in England have tripled over the past five years.1 Advocates fear the triage approach will push patients toward self-diagnosis through social media rather than proper clinical assessment.1
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