Add us as a preferred source
Rhian Bulmer, chief customer officer at Radar Healthcare, explains how private ADHD clinics can prove quality and strengthen regulatory compliance.
Independent ADHD provision has grown quickly, and for good reason. NHS waiting times for adult assessment now stretch into years in many parts of the country, and private clinics have absorbed patients the public system simply couldn’t see quickly enough. That growth has been good for patients. But growth on this scale tends to outpace a sector’s ability to prove its own standards, and that gap is exactly where scrutiny lands.
Complaints about ADHD and autism services in England have more than tripled in five years. I don’t take that as evidence that care has got worse. I take it as evidence that demand moved faster than the systems built to support it, and that commissioners, regulators and patients are now asking independent providers a more pointed question. Not simply “do you provide good care,” but “can you show me.”
That question will only grow louder. The clinics that build a considered answer to it now, rather than assembling one under pressure later, will be the ones commissioners continue to trust as scrutiny of this sector increases.
The pain points we hear about most
Speak to enough clinical directors and the same concerns surface again and again.
Consistency is chief among them. When assessment quality depends on which clinician happens to be on duty, rather than a pathway every clinician follows in the same way, outcomes vary in ways that are difficult to explain and harder still to defend. Incomplete histories, missed physical health checks, a contraindication overlooked because nobody was prompted to check for it, these are not failures of clinical judgement. They are what happens when a consistent pathway isn’t built into daily practice.
Consent is another recurring concern. Clinics understand the need for informed consent around diagnosis, medication and monitoring, but “informed” carries real weight in that phrase. Knowing what was explained to a patient, and what they genuinely understood and agreed to, is quite different from a signature on a form. When a decision is questioned months later, that distinction is often where clinics find themselves exposed.
Then there is the record itself. When assessments, decisions, consent, prescribing checks and incidents sit across different systems and different clinicians’ notes, assembling a complete and honest account of what happened can take days, sometimes weeks, precisely when speed matters most.
None of this reflects a shortfall in clinical skill. It reflects a gap in the systems that should be supporting that skill, and it is a solvable one.
Consistent clinical pathway
We work with a growing number of independent ADHD providers, and we are applying the same model we have already proven under genuine regulatory pressure elsewhere.
The starting point is making the clinical pathway itself consistent, so every patient receives the same standard of assessment, physical health check and documented decision-making, regardless of who is on shift, and so a risk such as an incomplete history or a missed check is flagged and escalated before it becomes a complaint rather than after.
Alongside this, we are building the same discipline into consent, giving clinics a digital way to record what information was actually provided about diagnosis, medication and monitoring, and what the patient understood and agreed to, so that record exists from the moment it is created rather than being reconstructed from memory later.
We are also bringing incidents, risks, audits, complaints and follow-up actions into a single view, so that when a clinic needs to demonstrate to a commissioner, CQC or other regulatory body, what happened and what was learned, that record already exists rather than needing to be built under pressure.
We are encouraging clinics to look beyond diagnosis rate and patient volume, too. Those figures are easy to measure but say little on their own. Whether patients genuinely felt listened to and properly assessed, and whether their symptoms and day-to-day functioning improved following treatment, offers a far more honest answer to the question that matters: is this working?
Succeeds under pressure
That confidence comes from having watched this model succeed under real pressure. The National Autistic Society emerged from a Care Quality Commission (CQC) inspection with an inadequate domain rating and warning notices, a situation Kate Nixon, its head of assurance and compliance, has described as one that some members of her team had never encountered in their entire careers.
What changed things was not simply more effort, but a stricter model of oversight: no action could be marked complete until it had been independently verified. By the time the CQC returned, NAS had submitted 180 pieces of evidence across four separate regulators and emerged with zero outstanding warning notices. As Nixon put it: “The inspector was satisfied that we can demonstrate learning from the first inspection and that this learning is being applied through actions across other local services.”
That is not an ADHD clinic. But it is the same underlying principle: oversight that once felt like a burden becoming something a team could use to demonstrate, with confidence, that care was safe.
A fair challenge
There is a fair challenge to raise here. More process can sound like more administrative burden for clinicians who are already stretched, and one could argue that the real answer to patient trust is greater capacity, not greater governance. That view isn’t wrong, but it is incomplete. Capacity helps more patients get seen. It does not answer the question a regulator asks once something has gone wrong, which is simply: can you show me what happened, and why? Clinics that treat governance as something to address later tend to discover that gap at the worst possible moment, mid-complaint, when the record they need does not exist in a usable form.
Scrutiny of this sector is not going away, and I don’t believe it should. I would rather see clinics get ahead of it than be caught out by it. The providers that build their evidence before they’re asked for it are the ones commissioners will continue to choose, and more importantly, the ones patients can trust without having to take it on faith.
