In December 2025, Government launched an independent review into mental health conditions, ADHD and autism in England. As the membership body bringing together over 140 charities working alongside disabled people of all ages, families and carers, VODG and our members welcomed the review.
The stated purpose of the independent review by the Department of Health and Social Care (DHSC) is to examine trends in prevalence, the impact of clinical practice, risks and benefits of medicalisation, related social and cultural factors relating to people with people’s own and direct living experience, ways to promote prevention of mental ill health and ways to improve early intervention. It will look at different models of support across and beyond the NHS so that people receive the right support, in the right place at the right time.
The review comes at an important moment with a notable increase in the diagnosis of people with mental health conditions, ADHD and autism in England over the last decade. Also, it comes at a time of increasing pressure on resources, capacity and provision of support as the gap between public sector funding and the costs of delivery services increase.
There is much that can be learned from this review, if designed and delivered with people with living experience and full comprehension of the backdrop against which support is being delivered. Only by understanding the complexities of the market, funding structures and workforce pressures, will the recommendations meaningfully deliver on Government’s intended shifts from hospital to community, analogue to digital and sickness to prevention.
Review scope
This review is set to focus on mental health conditions, ADHD and autism – whether experienced singularly or concurrently. The review will look at the similarities and differences regarding prevalence, treatment, drivers and interventions, inequalities and inequity of access and experience, challenges facing services and the role and effectiveness of different interventions. This review will consider the needs of children and young people separately to those of adults, which is a welcome distinction.
Purpose
The purpose of the review is to provide advice and recommendations to Government on trends, inequalities and experience – what works in terms of diagnosis, treatment and support, barriers that exist and the role of prevention and early interventions.
The review will also consider changes over the last 10 years – to pathways, assessment, diagnosis, clinical support and medicalisation. The domestic experience will sit alongside international comparisons, social and cultural influences.
Outputs
The relatively swift review will report back to DHSC Ministers within six months, setting out conclusions and recommendations for change within Government and the wider health and care system.
It is hard to ignore the recent politicisation of autism, disability and mental health conditions, but the independent review has been designed to cut through that noise and instead focus on people’s experience. To do anything less does a huge injustice to the millions of people seeking support across the country.
A recent NHS England survey found that one in five people have a common mental health condition while the National Institute for Health and Care Excellence (NICE) estimated that three to five percent of the global population are affected by ADHD. NHS England also estimates that around 1% of the adult population in England may be autistic.
While welcome progress has been made in raising awareness and understanding around mental health conditions, ADHD and autism, the review signifies an acknowledgement by Government that the current systems of support in place are in need of transformative change. With the passing of the Mental Health Act, legislative reform is progressing but will only be meaningful with a shift in funding, commissioning and prioritisation of community-based provision.
That is why VODG supports the ambitions set out by DHSC to better understand the diverse needs of those diagnosed with or on the pathway to a diagnosis of mental health and neurodiverse conditions. We also welcome the commitment made by Professor Peter Fonagy, the Chair of the review, to work with people, families and carers directly, along with charities and frontline staff, to ensure the reality of people’s living experience informs the final recommendations.
Data and evidenced-based insights
VODG brings together more than 140 disability charities and not-for-profit organisations across England. Our values-based members are key pillars of their communities and play a vital role in supporting more than one million disabled people to live full and independent lives.
The breadth of insight and experiences gained from our unique network has shown that for too long individuals with mental health conditions, ADHD, autism and their support networks have had to navigate an inconsistent and unequal system.
We believe the independent review provides a solid opportunity to make a step-change in provision to improve the experience of the millions of people in need of support. In doing so we can also highlight the vital role of voluntary sector organisations in our health and care system. A person-centred approach combined with a focus on data and evidence-based insights will help to dispel myths that persist around these conditions, such as unhelpful narratives about alleged over diagnosis of ADHD and autism.
VODG recognises that stigma associated with mental health conditions also differs across communities and cultures. Our members have a unique reach and vital role to play in delivering services while also strengthening partnerships with individuals, families, councils, schools and the NHS to ensure local solutions reach those who need them most.
The independent review must take a whole society viewpoint in searching out contributions from all parts of our communities and ensure these are well represented in final recommendations.
Building a framework for the future
Our understanding of mental health conditions in terms of medical and service requirements has steadily progressed over the decades. The independent review provides a vital focus on the evolving needs of children, young people and adults. It will also help to identify where tensions in the system inhibit timely support and how best to harness the solutions that we know work.
Analysis of NHS data by the British Medical Association highlights a systemic problem in referrals made by GPs and in waiting times. This is attributed to the pressures on both primary and secondary healthcare services.
NHS Referral to Treatment (RTT) data for England, November 2025, shows the waiting list stood at 7.3 million cases with around 2.75 million patients waiting more than 18 weeks for treatment. We need the review to consider the impact on people waiting extended periods for assessments, diagnosis and support, including the wider impact this has on themselves, their families and communities.
The independent review must identify areas to strengthen accountability in the system. The Centre for Health and Public Interest recently highlighted inconsistencies in healthcare such as the lack of requirements for providers of ADHD assessments to be registered with CQC, and that there are no agreed national qualifications to certify competence of an ADHD assessor.
The independent review also needs to consider the market-based regulations underpinning the NHS, the subsequent costs and the opportunities to streamline spending decisions. The same report highlighted the dependency on private healthcare providers costing the NHS up to £412m for this financial year. The ambition should be to ensure the NHS can guarantee the quality of care that patients deserve and that public money is being properly spent.
VODG’s expectations for the independent review
Like most organisations and practitioners within the health and social care sector, VODG welcomes the intentions behind the independent review. But this cannot be a tick box exercise, and we hope that contributions, first and foremost for people themselves, alongside organisations like VODG working across the breadth of health, care, housing, education, employment and justice, will deliver a blueprint that reflects today’s needs and realities.
For VODG’s part, we will continue to advocate for a future where the rights, dignity and individuality of disabled people and those with mental ill health, and families and carers are at the forefront of policy development. Our commitment is to progressive policy development that recognises and embraces difference and puts people first in the services they are able to draw on.
If meaningful and lasting impact is to be achieved then it is vital that the recommendations from the independent review result in comprehensive, fully funded and integrated implementation across the country. With Government’s Schools White Paper imminent and the forthcoming first phase of the Independent Commission on Adult Social Care, the findings of the independent review will be timely and could – potentially – move us to policy that is much closer to people.
VODG is engaging with the review and is gathering case studies of good practice. If you run initiatives that demonstrate the positive impact of early intervention, where good pathways exist and why, and how assets-based commissioning has led to services being co-produced, contact VODG.
Dr Rhidian Hughes is Chief Executive Officer at VODG. Email: [email protected] X: @VODGmembership