‘Urgent need’ for GPs to be better trained to recognise ADHD, report says

There is an “urgent need” for all GPs in England to be better trained to recognise signs of ADHD in a bid to help tackle long waits for care, according to a new report.

The ADHD Taskforce said family doctors have “taken on a central role” in the diagnosis and management of other chronic conditions, such as diabetes and depression, but they do not play a major role in ADHD care.

However, the Royal College of General Practitioners (RCGP) said that the current system “does not consistently provide the integrated approach needed to deliver this safely”, and any changes would need to be supported with dedicated funding and training.

It comes as a BBC investigation found specialist ADHD services for adults are stopping taking on patients amid high demand.

The final report by the taskforce, which was launched by the Government and health service last year to address rising demand, said GPs need to be able to recognise ADHD and should ensure any referrals they make for an assessment are “clinically appropriate”.

Family doctors should “be equipped with the skills and knowledge to perform an initial screening consultation, as they would for any other health condition”, it added.

The report stressed that “there is an urgent need for all GPs” to “develop and use core competencies in recognising and supporting ADHD” and other neurodevelopmental conditions.

It also recommends that family doctors who take on aspects of ADHD care, such as prescribing, should get additional funding and have access to specialist advice.

The taskforce suggests that interested GPs should be able to train as specialist ADHD practitioners.

Earlier this year, NHS England estimated that almost 2.5 million people in England are likely to have ADHD.

Of this number, around 741,000 are children and young people aged five to 24.

It comes after data from freedom of information requests submitted by the BBC found 15 local areas in England have closed waiting lists, while another 31 have implemented tighter criteria.

Taskforce chair Professor Anita Thapar told the PA news agency: “In England, ADHD is under-recognised, under-diagnosed and under-treated, so there’s a lot of catch-up for services.”

She added: “GPs need training; it needs to be part of their curriculum and continuing professional development.

“They need to be able to recognise ADHD and know where somebody can get support. And also, if someone comes to them, once they’ve got the diagnosis, they need to know what to do.

“We need the Department of Health and Social Care to incentivise GPs to take on aspects of ADHD.

“So that includes a new GP contract to include funding for training, and also enable the primary care workforce to undertake a lot of the routine, generalist work, particularly for less complex ADHD.”

Prof Thapar said the neighbourhood health hubs proposed in the Government’s 10 year health plan would be “an ideal place for primary care to take on more of a leadership role around ADHD”.

Professor Kamila Hawthorne, chair of the RCGP, said: “GPs already play a key role in caring for patients with ADHD by working with specialist colleagues under shared care agreements, and by providing ongoing monitoring and support for patients on waiting lists – some have taken on extended roles in neurodiversity.

“However, as GPs, we recognise that many patients require more support than is currently available – and if we are expected to fill this gap, there must be time to develop the appropriate expertise necessary, and this must be supported by dedicated funding, protected learning time and timely access to specialist services, such as mental health support and other relevant wraparound services.

“At present, the system does not consistently provide the integrated approach needed to deliver this safely – the move to neighbourhood health services could support this change, but would need to be adequately resourced.

“Implemented well, and with appropriate recognition of workload pressures and funding constraints in general practice, these reforms could help ensure that people with ADHD receive the safe and timely care they need, and that the clinicians who care for them are able to do so safely and sustainably.”

The RCGP is planning to develop resources for GPs focused on caring for people with ADHD, Prof Hawthorne added.

Elsewhere, the taskforce called for more support for those on waiting lists, and claims “youth wellness hubs” could provide a “front door” to care for teenagers and young adults.

It also recommends the expansion of school-based programmes that provide early needs-based – rather than diagnosis-based – support for ADHD and neurodivergence as well as mental health.

This should “include a whole school approach and integrate with neurodevelopmental and child and adolescent mental health services”, the report said.

Prof Thapar told PA: “Unsupported ADHD is a really potent route into long-term mental and physical ill health, suicide, substance misuse, early entry into the criminal justice system, educational challenges and chronic unemployment, not being in education, employment and training.

“But we actually have the research – there are effective support and interventions. Given in a timely way, people with ADHD can and do thrive.

“It’s a bit like high blood pressure. You want to intervene before you get to having a stroke, which is much more complicated and, of course, costly.”

She added that “inaction isn’t an option, not just for ethical reasons, but for economic reasons”.