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In Northern Ireland, private clinics issued nearly 4,000 prescriptions for ADHD medication last year, a sharp increase from just six prescriptions recorded in 2019. According to data obtained from the HSC Business Services Organisation (BSO) by BBC News NI, almost half of these prescriptions in 2024 were provided by clinics located elsewhere in the UK. Although the NHS continues to prescribe a significantly larger volume of ADHD medication, the rate of private prescribing is growing more rapidly. The surge in private prescriptions is largely attributed to people seeking options outside the NHS to avoid the long waiting times, a situation the Department of Health (DoH) has deemed unacceptable.
Keith Lawrence, a network engineer living in Lisburn, discovered his own symptoms of ADHD while his son was being assessed for the condition. In Northern Ireland, children can face waits lasting several years for an ADHD diagnosis, and adult services are currently not commissioned. Mr. Lawrence initially encountered a five-year NHS waiting list for assessment, which worsened to an estimated seven to ten years by the time he followed up two years later. “I always knew there was the option of going private for this kind of diagnosis and treatment, but I kind of always had the hope that the NHS would be able to provide something for me, and I wouldn’t have to do that,” he shared.
Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental condition characterized by impulsivity and inattention. While it has traditionally been associated with children, increasing numbers of adults across the UK are now being diagnosed. Research indicates that the prevalence of ADHD has not increased, but greater awareness encourages more individuals to seek diagnosis and assistance. Long NHS waiting times and the absence of adult ADHD services in Northern Ireland likely contribute to the rise in private prescriptions. Unable to access local services, Mr. Lawrence turned to an online private clinic in England, where he received a diagnosis of inattentive ADHD in September, following detailed questionnaires, a comprehensive video assessment, and input from his mother about his childhood. He was prescribed methylphenidate, the most commonly used medication for treating ADHD. The cost of private prescriptions can vary widely, ranging from £15 to £130 per month depending on the drug.
Data from the BSO, revealed through a freedom of information request, shows that private prescriptions for methylphenidate, lisdexamfetamine, and dexamfetamine increased dramatically from six in 2019 to 3,978 in 2024. Initially, clinics in Great Britain supplied most private prescriptions, but in 2024, clinics in Northern Ireland accounted for 53% of these. Despite the rapid rise in private prescribing, NHS prescriptions still dominate, with 89,128 issued last year. This means private prescriptions made up around 5% of all ADHD medication prescriptions in Northern Ireland in 2024. Mr. Lawrence spends about £100 monthly on medication and prescribing fees and an additional £200 every six months for review appointments. He described the medication’s effect as transformative: “It has been life changing. The medication has so many benefits… I finally feel that I’m actually living my life.”
When Mr. Lawrence asked his GP to take over prescribing under a shared care agreement, the request was denied. Shared care involves a specialist initiating treatment and a GP managing ongoing prescriptions. Dr. Frances O’Hagan, chair of the BMA NI GP committee, explains that Department of Health guidance makes it clear patients who receive private diagnosis or treatment should not expect the NHS to take over their care. She added, “Even if it is on the NHS, GPs have the right, if they feel it’s outside their area of expertise, to say: ‘No, I don’t wish to prescribe that as shared care’.” The DoH noted concerns among GPs about the thoroughness of assessments conducted by private providers. Dr. O’Hagan emphasized that NHS ADHD assessments are typically thorough and face-to-face, a standard she believes should be mirrored in private services. She also highlighted that shared care is not recommended by the BMA in cases involving private healthcare, especially given the lack of NHS adult ADHD specialist clinicians in Northern Ireland.
Katie Graden-Tyson, a social work assistant from Belfast, is currently waiting for a private ADHD assessment. She sees medication as a last resort but is struggling without adequate support. “I’ve heard so many good reports about medication, that it just helps to quieten your brain a little bit so you can focus and manage a bit better,” she explained. Told that NHS waiting times could reach up to ten years, Ms. Graden-Tyson acknowledged she might need to make significant sacrifices to afford private care. A Department of Health spokesperson acknowledged the growing waiting times for ADHD diagnosis among children, young people, and adults in Northern Ireland, calling the situation “unacceptable” and confirming that measures are underway to improve it. A report is expected to be published next year to assess the demand for a formally commissioned ADHD service in the region
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