Another week, another headline about the soaring cost of ADHD and autism assessments to patients and the taxpayer. The numbers are striking. Cheshire and Merseyside’s Integrated Care Board says its adult ADHD services bill could reach £51 million in 2026/27, up from £11 million in 2023/24.
Private clinics provide another route to assessment for people facing long NHS waiting lists. For those paying privately, however, access depends on being able to afford the assessment.
HR needs a clearer picture
The independent ADHD Taskforce, commissioned by NHS England, puts those headlines into context. It estimates that around 5% of children and 2 to 3% of adults have ADHD, with many remaining undiagnosed and unsupported. Assessment waits exceed 10 years in some parts of the country. Some NHS bodies in England have also introduced minimum waits of up to two years for ADHD and autism assessments.
Concerns about costs, assessment quality and regulation deserve scrutiny. But diagnosis has become a gateway to support, and long waits leave people trying to manage difficulties without the understanding or help they need.
For employers, this creates an immediate question: what happens to people’s working lives while they wait? HR can already examine the demands of a role, remove unnecessary barriers and agree practical support. Those conversations should not be postponed until someone has a diagnosis.
The power of visibility
Growing awareness and more open conversation are helping people recognise needs that may previously have gone unexplained. Public figures such as Christine McGuinness, Sara Davies and Robbie Williams speaking candidly about their ADHD have contributed to that understanding.
People already in your workforce may be discovering why certain aspects of work have been harder for them than for their colleagues. Diagnosis can provide clarity, but its value at work depends on whether that understanding leads to changes in how people are supported and how their contribution is assessed.
Recognising capability at work
Some people with ADHD bring particular strengths to urgent or demanding work: clarity in a crisis, rapid idea generation and a considerable capacity for work that engages their interest. Others contribute through horizon scanning, questioning assumptions or identifying risks across complex projects.
These strengths matter when a leadership team needs to challenge a plan, identify an emerging risk or make decisions under pressure. Someone who questions assumptions may expose a weakness before it becomes expensive. Someone who connects information across different parts of a business may see an opportunity that would otherwise be missed. The value grows when people with different ways of thinking can test and develop one another’s ideas.
HR needs to understand where an individual’s strengths lie and what enables them to use them effectively. A person can be highly capable and still need support.
High output can conceal considerable effort. Employers need to understand what makes strong performance sustainable, rather than assuming that someone who consistently delivers needs no support. For neurodivergent women whose needs have been recognised later in life, professional success may have obscured those needs for years.
What HR can do now
Line managers need practical guidance on supporting neurodivergent colleagues. That means understanding how work is organised, how expectations are communicated and which adjustments help an individual perform well.
Agree priorities clearly, put important instructions in writing and protect time for concentrated work. Ask individuals which working conditions help them perform, and review whether the arrangements are effective. Organisations need to equip managers to have those conversations and act on them.
Recruitment deserves the same attention. Share interview questions in advance. Offer alternative formats for assessment tasks. Drop the assumption that eye contact and quick verbal answers equal competence.
These changes allow candidates to demonstrate their capability without being excluded by an assessment process that gives too much weight to presentation and too little to how they think or approach the work.
Review promotion and succession decisions as carefully as recruitment. Who is being recognised for judgement and contribution, and who is being overlooked because their communication or working style is less familiar? HR and senior leaders need to examine the criteria they use to identify potential, as well as the opportunities people receive to demonstrate it.
That includes being deliberate about supporting neurodivergent women into senior roles. Recruiting a broader range of people achieves little if the routes to leadership continue to favour familiar ways of working and presenting.
Assessment costs deserve scrutiny. So do recruitment and promotion decisions that overlook capable people because they do not fit familiar expectations. HR has considerable influence over whose ability is recognised and who gets the opportunity to progress. That responsibility extends beyond helping people enter the organisation to ensuring they can contribute, develop and lead.
With almost three decades of experience in recruitment and talent advisory, including over twenty-five years in leadership, Michelle Carson has dedicated her career to building diverse and high-performing leadership teams.
As a passionate advocate for neurodivergent inclusion in the workplace, she draws from her own experiences of living with autism and ADHD to drive meaningful change in business and leadership.
- Michelle Carson
