NHS bodies in England are imposing minimum waits of up to two years for people seeking ADHD and autism assessments, as local commissioners struggle to meet rising demand within their budgets.

The Guardian reported that four integrated care boards covering large regions had adopted the approach, while 15 ICBs covering 19 million people had introduced some form of rationing or clinical prioritisation. Patient groups described the delays as dangerous and damaging to education, work and mental health.

The regional rules are not identical. West Yorkshire’s official guidance says patients using independent providers for NHS-funded autism or ADHD assessments currently face a minimum wait of two years from referral, with urgent cases considered for faster assessment where there is a clear and immediate risk.

North East and North Cumbria’s official guidance says providers funded by the ICB are working to an approximately 78-week minimum wait for an initial assessment during 2026/27. It says referrals remain open and that the arrangement is intended to equalise waits rather than cancel them.

The scale of the pressure is visible in the figures reported by the Guardian: 960,000 people in England waiting for an ADHD assessment and another 295,000 awaiting an autism assessment. Those numbers describe a system problem, not a single local failure.

The central policy question is whether financial control can be reconciled with timely assessment and support. A waiting-time rule may ration activity, but it cannot by itself answer what happens to people who need adjustments, medication or safeguarding before their turn arrives.