Response to BBC Panorama “Private ADHD Clinics Exposed”

The BBC Panorama programme Private ADHD Clinics Exposed examines three private clinics offering ADHD assessments and prescribing medication.  

Whilst we welcome responsible and informed television journalism, any reporting that does not engage with patient led groups will inevitably be a cause of concern to us. We question the impartiality of this programme as The ADHD Foundation Neurodiversity Charity and other NGOs have been left out of the conversation and research. 

Our disappointment in BBC Panorama’s journalistic decisions is outlined in more detail below: 

1. We provided ample opportunity for the Panorama team to engage with independent NGO research and expertise.
   
   We contacted the reporting team on May 4^th, 11 days before the programme was to be broadcast, to explain points of concern so they understood the context of why so many people cannot access health care from the NHS and must resort to private providers. It took until the afternoon of May 12^th for them to respond to our concerns, which do not appear to have been considered in the programme. 
   
   It was during this time that we advised the Panorama production team in detail and provided evidence-based research that demonstrated systemic, exclusion and health inequality of access in the NHS for the 1 in 20 children and adults in the UK living with ADHD. This includes the risk of avoidable co-occurring health problems arising out of no diagnosis or support.
   
   https://www.adhdfoundation.org.uk/wp-content/uploads/2022/04/Failure-of-Healthcare-Provision.-Consensus-Statement.pdf

2. The programme fails to capture the historic inequality of access to health services and lack of priority given to patients with ADHD.  
   
   This increases children and adults’ vulnerability to avoidable and expensive comorbid physical and psychological health problems, such as obesity and type 2 diabetes, reduced life expectancy of 11 years, vulnerability to anxiety and depression and how the impact of trauma can also lead to more serious mental health problems and addictions.
   
   We shared evidence that more than half of new adult diagnoses were given by private providers due to wait times and lack of capacity in the NHS. We shared that over 50% of these new adult diagnoses were for women who have experienced greater inequality of access to NHS services. Seventy-five percent of girls and women remain undiagnosed and potentially being treated for avoidable health needs and misdiagnosis, especially women in menopause.

3. The programme does not make effort to fully represent the private sector.  
    
   The Panorama team fails to acknowledge that the majority of private providers are also employed by the NHS but offer this private service in addition to their NHS salaries.
    
   In addition, BBC Panorama producers chose to identify only three providers and during those clinical assessments provided answers that would certainly lead to a diagnosis. This was contrasted against a three-hour assessment with an NHS psychiatrist – something that rarely happens in the NHS. The NHS psychiatrist was given advance notification that this was part of an investigation and would be filmed.
   
   There was no exploration of good quality private provision. There was no comment from the Royal College of Psychiatrists. There was no exploration about why desperate people sought private diagnosis.

4. The programme misrepresents the patient experience.  
    
   The Panorama team were made aware of the challenges of arranging shared care so that people could transition into the NHS after a private diagnosis. We informed the reporting team that some NHS Trusts and NHS Commissioning Groups restrict shared care agreements to manage budgets or to deter people from seeking private diagnosis and treatment. Our concern is that this documentary irresponsibly risks making shared care even more difficult for patients who are tax paying UK citizens.

5. The programme failed to highlight that NHS, like most private providers, offer medication only.  Until recently, there had not been any quality, strength-based patient information resources that enable people to learn how to manage ADHD successfully, understanding that ADHD medication should never be the only resource used to manage ADHD. Medication should be used alongside a wide range of healthy lifestyle choices and self-care strategies.   
    
   The over reliance on a medical model and absence of psycho-educative support ‘disables’ people from learning how to manage ADHD successfully. 
    
   www.canddid.nhs.uk/adhd 
   ADHD in Adults (adhdfoundation.org.uk) 
   https://www.adhdfoundation.org.uk/wp-content/uploads/2022/03/The-neurodiversity-concept-is-it-helpful-for-clinicians-and-scientists.pdf

We are disappointed that BBC Panorama has opted to broadcast a poorly researched, sensationalist piece of television journalism. This programme has focussed on a niche issue whilst completely ignoring the broader context, including why there has been a rapid growth in private providers.  

Some private providers do provide quality service. We believe the unscrupulous behaviour of some people/organisations in the private sector should be challenged, but it must also be contextualised within the wider environment of our health services. Not doing so irresponsibly risks discrediting the entire private sector, jeopardising patients’ access to NHS Shared Care Agreements with their GP. The British public deserve better than this poor quality journalism that will only serve to make things more difficult for those who need quality health care assessments so they can live healthy lives, be employable and economically independent – and for parents, that their children do not struggle needlessly as a result of lack of provision in the NHS.