The NHS recorded substantial increases in the prescribing of a range of mental health drugs in England last year, with a particular hike for ADHD medicine.

And this week NICE has recommended a new digital tool which could speed up ADHD diagnoses and help clinicians rule out more cases.

NHS adult ADHD medicine prescribing up nearly a third

The NHS Business Services Authority (NHSBSA) annual report, released last week, highlighted a large jump in the number of medicines prescribed for ADHD in 2023/24, which included a 28% rise in adults and a 9.9% increase in children.

In addition, an estimated 89 million antidepressant drug items were prescribed last year, an increase of 3.3% since 2022/23.

This was also the largest number of patients in a category to 8.7 million people being given a prescription up by 2.1% on the previous year.

The report also noted that dementia drugs prescribed increased by 5.8% to 4.5 million and the number of patients prescribed dementia medicines increased by 5.6% to 310,000.

Dementia was also the only category where prescribing was higher in the least deprived areas, NHSBSA noted.

Figures also showed that 14 million antipsychotic items were prescribed to 860,000 identified patients with twice the rate of prescribing in the most deprived areas.

Antidepressant, ADHD medicine and dementia drug prescribing has all been following a steadily rising trend since 2015/16 when the annual report on mental health drugs was first compiled.

ADHD medicines have seen the steepest rise particularly since 2020/21, the figures show, with 278,000 patients prescribed them last year up from 80,800 in 2015/16.

In April, NHS England announced it would launch an ADHD taskforce to improve care amidst concerns about rising demand and problems with medicine shortages.

Figures showed ADHD was the second most viewed health condition on the NHS website in 2023, after Covid-19, with 4.3 million page views that year

NICE recommends digital test for ADHD to help speed up diagnosis

Meanwhile, NICE has recommended a new digital tool which could speed up ADHD diagnoses and help clinicians rule out more cases.

In draft guidance published yesterday, NICE approved NHS use of the computer-based QbTest, alongside a standard clinical assessment, for diagnosis of attention deficit hyperactivity disorder (ADHD) in children and young people.

QbTest tracks the movement of participants while measuring the three main symptoms – inattention, impulsivity, and hyperactivity – and the results are then compared to a control group.

A previous clinical trial showed that QbTest led to a larger proportion of patients receiving a diagnostic decision within six months of their first assessment appointment.

NICE has said that use of the test also resulted in ‘clinicians being able to rule out ADHD in more cases’ and that the technology provides a ‘quicker diagnosis’.

ADHD diagnoses are usually made by specialist psychiatrists or paediatricians, and the NHS has seen a large rise in GP referrals for diagnosis in recent years.

A report earlier this year argued that demand for ADHD assessments is increasing at such a rate it has surpassed the ability of the NHS to keep up.

NICE heard from patient experts that long waiting times for ADHD assessment – sometimes lasting ‘many years’ – are a ‘significant issue’, and that many patients are seeking private care instead.

The recommendation for the use of digital technologies is limited to children and young people aged six to 17 for now, while further research is carried out for adults.

NICE’s diagnostics advisory committee emphasised that the QbTest should ‘only be used to supplement professional judgement, and not replace it’.

Director of NICE’s HealthTech programme Mark Chapman said children ‘deserve to receive a diagnosis in a timely manner’ and that there are ‘challenges’ in the current NHS pathway.

He continued: ‘This technology has the potential to generate tangible benefits to the lives of those waiting for an ADHD diagnosis.

‘Evidence presented to our committee showed the QbTest could increase the number of children and young people who get a diagnostic decision within 6 months of starting assessment.’

Dr Jessica Eccles, chair of the Royal College of Psychiatrists’ neurodevelopmental special interest group, said people often have to wait ‘months or even years’ for an ADHD assessment, and that any new ‘evidence-based tools’ should be used to reduce these ‘unacceptable waiting times’.

She added: ‘It’s critical that these tests are administered by a fully trained and qualified professional who can accurately interpret the information they provide. They must not be used in isolation but as part of a broader assessment.

‘The challenges facing ADHD services will not be solved by new technology alone. There is still a clear need for targeted resources to help them meet rising demand and provide vital care.’

A consultation on NICE’s draft guidance, which applies to England and Wales, is now open until 6 August.

ADHD is estimated to affect between 1% and 2% of children and young people in the UK, when using the World Health Organisation’s diagnostic criteria.

This was first reported by Emma Wilkinson and Eliza Parr in our sister publication Pulse