An independent provider in the Hillingdon area

5. Ms Y complains Harrow Health CIC mismanaged an assessment for attention deficit hyperactivity disorder (ADHD) in February 2025. Specifically, Ms Y says Harrow Health CIC recorded incorrect information about her condition and history when assessing her.

6. As a result of the mismanagement, Ms Y claims the outcome of the assessment was incorrect. Ms Y says she now must wait one year before reapplying for an assessment. This has resulted in her life having been put on hold as she does not have a diagnosis or the appropriate treatment she feels she needs to manage her symptoms.

7. As an outcome to her complaint, Ms Y seeks service improvements and an apology.

8. Ms Y was assessed by Harrow CIC for ADHD in February 2025. ADHD is a group of behavioural symptoms that include difficulty concentrating and paying attention, hyperactivity and impulsiveness.

9. Ms Y received the assessment results the same month. The outcome of the assessment was Ms Y did not have ADHD. Upon reviewing the assessment notes, Ms Y claims there were inaccuracies in the information and history recorded.

10. Subsequently, Ms Y complained to the organisation, claiming the ADHD assessment was inaccurate and therefore the clinical conclusion of the assessment was invalid.

Assessment

14. Before we decide if we should conduct a detailed investigation of a complaint, we look at whether there are signs the organisation has got something wrong. We do this by comparing what should have happened with what did happen. We have done this and have not found any indications that something has gone wrong.

15. We know Ms Y raises concerns about the way the assessor recorded information.

16. We reviewed Ms Y’s records and asked our clinical adviser whether the assessor should have recorded the information provided by Ms Y at the assessment in a different way. We note the assessor recorded information in writing. Ms Y complains the Practice mishandled her ADHD assessment by failing to record her answers in full and recording information and history incorrectly. As a result, Ms Y claims that the conclusion of the assessment is invalid.

17. Our clinician advised the information was recorded in an appropriate manner during the assessment. They told us some clinicians now use AI tools or recording devices, although this is at the discretion of the clinician and would require the patients consent. Our clinician confirmed the manner in which the assessment was documented would have not affected the assessment conclusion.

18. In its response, the Practice explained the ADHD assessment was conducted correctly, and it conducted an extended review of Ms Y’s problems. The Practice confirmed that no assumptions were made during the assessment and informant reports were considered alongside the assessment. Informant reports provided detailed information about Ms Y’s behaviours from those known to her which supported the ADHD assessment. The Practice did note that changes requested by Ms Y regarding aspects of the assessment that she believed were recorded incorrectly. These changes were amended to Ms Y’s records by the Practice. However, the Practice confirmed that these changes would not have affected the conclusion of the ADHD assessment.

19. We considered if the ADHD assessment was in line with the relevant guidance. We refer to NICE clinical guideline 87. Section 1.3.1 states:

• ADHD should only be diagnosed by a specialist psychiatrist, paediatrician or other appropriately qualified healthcare professional with training and expertise in diagnosing ADHD, 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.

20. It also outlines the following:

‘For an ADHD diagnosis, symptoms of hyperactivity, impulsivity or inattention should:

• meet the diagnostic criteria for hyperkinetic disorder in DSM-5 or ICD-11 (but exclusion based on a pervasive developmental disorder or an uncertain time of onset is not recommended) and symptoms present before 12 years age • cause at least moderate psychological, social, or educational or occupational impairment based on interview or direct observation in multiple settings and • be happening often, occurring in 2 or more important settings including social, familial, educational or occupational settings.’

21. We can see a detailed clinical and psychological assessment was conducted by the Practice, and this was compared appropriately and accurately to the ADHD diagnostic criteria. The ADHD diagnostic criteria set out the standard for clinicians to compare patients’ symptoms against to provide accurate and consistent diagnosis.

22. The clinician who conducted Ms Y’s assessment reviewed Ms Y’s symptoms against these criteria accurately but ultimately concluded that too few symptoms of either inattentiveness or hyperactivity were present against criteria’s A and B. Further, under criteria E, the clinician stated that the symptoms could be better explained by another mental health condition: Anxiety. The clinician undertaking the assessment took a full psychological assessment of Ms Y, including a comprehensive history.

23. Based on the information available, we consider the Practice conducted the assessment in accordance with NICE guidelines for ADHD assessments. Our clinician has reviewed Ms Y’s assessment and confirms our view.

24. We understand it must have been frustrating for Ms Y when she saw the medical records did not reflect her recollection of the assessment. We were pleased to see the Practice made an amendment to the medical records to reflect Ms Y’s concerns following her initial complaint. In conclusion, we do not consider there are any indications of a service failure in relation to Ms Y’s complaint.

1. We were sorry to hear how Ms Y has been affected by the attention deficit hyperactivity disorder (ADHD) assessment conducted by Harrow Health CIC in February 2025.

2. We have carefully considered Ms Y’s complaint about Harrow Health CIC. We have seen no indication that anything went seriously wrong.

3. We recognise the frustration Ms Y has felt because of the assessment conducted by harrow Health CIC. She had told us this has impacted her mental health, and we are very sorry to hear this. We have taken Ms Y’s concerns seriously and carefully considered them. Having done so, we do not consider there to be any indications of service failings in Ms Y’s care and treatment.

4. We acknowledge our decision will be disappointing for Ms Y. We are sorry for any further distress our decision may cause, and we hope our explanation set out below shows clearly how we have considered her complaint.