Who can diagnose ADHD in adults in the UK? ADHD Assessor training routes, regulation and how to become an ADHD assessor
Attention deficit hyperactivity disorder (ADHD) has received increased social, political and media attention in recent years. With the positives of increased awareness has come increased funding, availability and access to diagnostic assessments and support. The costs of this are increased uncertainty, confusion and quality concerns over key questions such as: who can diagnose ADHD? How does a professional train to become an ADHD assessor? Which professionals can diagnose ADHD?
In this blog, we look at the UK clinical guidelines on who can assess and diagnose ADHD and look at professional training routes for assessors. It is drawn from our Adult ADHD Assessment and Diagnosis Training, with key references included at the end.
Who can diagnose ADHD in adults in the UK?
In the UK, all clinical practice is guided by guidelines which draw on the best available research evidence. For ADHD assessments, there are two sets of guidelines: the National Institute of Health and Care Excellence guidelines (NICE), and the UK Adult ADHD Network guidelines (UKAAN). Let's see what they say.
NICE Guidelines for ADHD Assessment and Diagnosis
The NICE guidelines (NICE, 2019) for ADHD, at the time of writing, state that a diagnosis of ADHD should only be made by "a specialist psychiatrist, paediatrician or other appropriately qualified healthcare professional with training and expertise in diagnosing ADHD".
They further state that any diagnosis should only be made on the basis of:
a full clinical and psychosocial assessment of the person; this should include discussion about behaviour and symptoms in the different domains and settings of the person's everyday life and
a full developmental and psychiatric history and
observer reports and assessment of the person's mental state.
This means that the "appropriately qualified healthcare professional with training and expertise in diagnosing ADHD" also needs to have core professional training and expertise in conducting full clinical and psychosocial assessments across contexts; in taking detailed developmental and psychiatric histories; and in using multiple sources of evidence including mental state examinations and observer reports.
What do the NICE Guidelines say about who can diagnose ADHD in the UK?
In sum: a highly trained (mental) healthcare professional with core professional training in robust assessments and diagnostic processes, with additional training and expertise in ADHD diagnosis, can assess and diagnose ADHD.
UKAAN Guidelines for Assessing and Diagnosing ADHD
UKAAN - a professional group of experts in the field of adult ADHD - produced a professional consensus statement in 2024 (Adamou et al., 2024). They summarised five themes of what should be included in an ADHD assessment, who can do them, and various quality standards, all based on the best available research evidence, professional concensus, and their expertise.
They state that the following professionals can assess and diagnose ADHD:
consultant psychiatrists
clinical psychologists
nurse practitioners and nurse consultants
In line with the NICE guidelines, they recommend the following professional experience, training and supervision for anyone acting as an ADHD assessor:
core professional training and skills in assessing general mental health needs and problems, development and medical issues
'several years' of experience working with, assessing and diagnosing general mental health conditions
monthly supervision of cases at least, particularly for those with less formal ADHD assessment experience
They add that more junior colleagues, such as NHS band 5 nurses, band 7-8a clinical psychologists, other professionals, and junior doctors can all contribute, if not complete most of, a diagnostic assessment under the guidance of the above.
So, who can diagnose ADHD?
According to the NICE guidelines and the UKAAN professional consensus statements, experienced consultant psychiatrists, clinical psychologists and nurse practitioners/consultants can assess and diagnose ADHD in adults. Other professionals, such as general nurses, junior mental health professionals, social workers, occupational therapists and so on, may be well placed to do most of the work under one of these professional's oversight.
What are the risks of wrongly assessing and diagnosing ADHD?
The risks of assessing and diagnosing ADHD without the right professional background and training are huge. Firstly, the diagnosis may well not be accepted by other professionals, leaving the individual without support. It also risks misdiagnosis and incorrect treatment being given, if the core professional skills are not in place to ascertain differential diagnosis. Secondly, it risks breaching professional and legal regulations in the UK.
How to become an ADHD assessor
There are no formal training routes to become an ADHD assessor. This is because being able to assess and diagnose ADHD in the UK requires the following three things:
The right core profession: psychiatrists, practitioner psychologists and nurses are typically trained and experienced in assessing and working with mental health, development and medical issues, which cannot be gained from a single stand-alone course.
Clinical experience with assessments: alongside working with and understanding neurodivergence, an ADHD assessor needs experience in diagnosing the range of mental health conditions, which again cannot be gained from training alone.
ADHD assessor training: they need a continued professional development course, or courses, in what ADHD is, how it presents, its impact, how to assess and diagnose it, and differential diagnosis considerations.
There is therefore no single course that can qualify someone as an ADHD assessor. Instead, there are continued professional development (CPD) courses for people with the right professional background to upskill.
It is worth exploring options depending on your professional background, as courses to train in the assessment of ADHD might cover:
Specific assessment tools: to gain competence and confidence in the use of interview schedules, observational tools and so on. This is not sufficient to diagnose ADHD on its own
Psychometric measures for ADHD: to gain competence in applying and analysing psychometric measures, which are not diagnostic indicators and have limitations
The full diagnostic process: to gain competence and confidence in the full diagnostic process for ADHD, aligned to the DSM-V and/or ICD-11 criteria
You should consider what any training would give you, or not, given your experience, professional background and goals.
ADHD Assessment Training in the UK
There are various providers of ADHD assessment training. It is worth examining what exactly they teach, who teaches it and who it is for.
Some courses may be more entry-level or for the general population rather than clinically specialist, skills-focused training, for example. Some may focus on competence in a specific assessment tool (such as the DIVA-5 or the ACE) rather than how to do a full diagnostic assessment. Some may cover treatment options for ADHD or not.
If you are to lead the diagnostic process, potentially overseeing multiple sources of information and other professionals, then a full process is advised. If you are to contribute to aspects of the information gathering, then specific tool-based training is advisable. Training in how ADHD is managed, treated and adjusted for is always advisable regardless of your role in assessments, as that is what ultimately makes a difference.
At Unlock Psychology Ltd, we provide a full training for the start-to-finish process of assessing and diagnosing ADHD in adults. This is suitable for professionals who are already suitably qualified who want to upskill and to learn about the diagnostic process, what is involved, and what needs to happen at each stage. We have a live delivered and an on demand, self-paced version available. UKAAN also provide training in both assessment and treatment. If you are seeking a gold-standard ADHD assessment, our team of HCPC-registered practitioner psychologists can provide these, in line with professional and clinical guidelines for best practice.
We hope this blog has been helpful in untangling some of the complexities around who can diagnose ADHD in the UK.
References
Adamou, M., Arif, M., Asherson, P., Cubbin, S., Leaver, L., Sedgwick-Müller, J., Müller-Sedgwick, U., van Rensburg, K., & Kustow, J. (2024). The adult ADHD assessment quality assurance standard. Frontiers in Psychiatry, 15, Article 1380410. https://doi.org/10.3389/fpsyt.2024.1380410
American Psychiatric Association. (n.d.). DSM-5 (& DSM-IV) diagnostic criteria [Table]. National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t3/
National Institute for Health and Care Excellence. (2018). Attention deficit hyperactivity disorder: Diagnosis and management (NICE Guideline No. NG87). https://www.nice.org.uk/guidance/ng87
World Health Organization. (n.d.). ICD-11 for mortality and morbidity statistics. https://icd.who.int/browse/2026-01/mms/en#821852937
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