To ask the Minister of Health to detail (i) the number of adults estimated to have ADHD; and (ii) how his Department is planning to meet their needs in the absence of specialist services.

There is currently no commissioned service for Attention Deficit Hyperactivity Disorder (ADHD) in Northern Ireland. ADHD provision has evolved across Trusts in response to population demand and expertise within HSC teams. There is some provision available across the Health and Social Care system, but there are inconsistencies and lengthy waiting lists across Trusts.

Although there is no commissioned Adult ADHD service, Belfast; Northern and Southern Eastern Health and Social Care Trusts provide a level of provision.

Belfast Health and Social Care Trust reconfigured a small resource (0.5 Consultant Psychiatry) from within adult teams to process these referrals. Current waiting is in excess of 3500, waiting times for an ADHD assessment based on current provision is 8 years from the point of referral.

Northern Health and Social Care Trust (NHSCT) in response to demand for Adult ADHD services; decided to progress with a small, unfunded pilot for service users who had been referred to the Trust. This pilot captured need by placing people on a waiting list and then offering an appointment with the Trust. Part of the process detailed pre-screening to ensure assessments are offered; where there is a high likelihood of Adult ADHD. All patients on any waiting lists remain under the care of their GP. This pilot approach has taken time to establish given the preparatory work required. Communication with individuals on the register commenced in December 2023, in chronological order of date of original referral.

South Eastern Health and Social Care Trust (SEHSCT) in response to demand, has progressed a small unfunded service for those patients who have transferred with an existing diagnosis and who are prescribed medication and require monitoring as per NICE Guidelines. For patients awaiting a diagnostic assessment, the demand for ADHD assessment far outweighs capacity, which is resulting in long waiting times of several years.

SEHSCT receives referrals for Adult Mental Health Services via Mental Health Assessment Centres located in Newtownards, Lisburn and Downpatrick. Individuals, including those with a potential/confirmed co-morbid ADHD diagnosis are offered a mental health assessment and are managed via the adult mental health core care pathway, where appropriate.

There is no adult ADHD diagnostic service in the Southern Health and Social Care Trust, therefore there is no waiting list for ADHD diagnostic assessment. If a person is diagnosed with ADHD in children’s services and required ongoing medication management by a Consultant Psychiatrist, they will continue to receive regular reviews by a Consultant Psychiatrist in adult mental health services.

The Western Health and Social Care Trust is not commissioned to deliver ADHD assessment. The pathway for ADHD into WHSCT adult services is through transition from CAMHS to Adult Recovery Services where Trust diagnosis has been delivered within CAMHS and concordance with medication is evident.

The National Institute for Health and Care Excellence (NICE) estimates that 3-4% of the adults in the UK have ADHD.

The Department commissioned a needs assessment on ADHD in early February 2025, the findings of which will help inform options for a commissioned ADHD service across Trusts, subject to future budget availability.

The needs assessment, which covers both adults and children, will aim to determine the level of demand for a commissioned service, as well as recommendations for what such a service might look like, including potential implementation and staffing costs.

While the initial estimated completion date was end June 2025, due to the extensive stakeholder engagement, information gathering and analysis required, it is likely that the work will now be completed by November 2025. Given the importance of this work in informing future ADHD service provision, it is important that sufficient time is given to ensure a robust evidence base and proposals.

In line with the usual process for commissioning of services, any decision to commission adult ADHD services in the future will be based on an assessment of the level of demand for services, and in the context of future budget availability.