An independent provider in the Cornwall area

3. Mr N complains the Provider started but quickly abandoned his ADHD assessment in August 2024. This led to a delay of five months in him getting a confirmed diagnosis of ADHD. He says during this time his mental health got worse.

4. He also complains the Provider unreasonably pressured him into agreeing to record the meeting despite his objections and allowed other people to listen to the recording. He found this distressing.

5. He would like the Provider to acknowledge what it got wrong, apologise for the impact on him and give him £3000. He would like to see evidence it has made service improvements so it does not make the same mistakes again.

6. In early August 2024 Mr N attended an appointment with the Provider. The appointment was online with a consultant psychiatrist to assess whether he has attention deficit hyperactivity disorder (ADHD).

7. The appointment did not go well and the psychiatrist ended it within five minutes. Mr N complained about this.

8. In November 2024 the Provider did a new assessment for Mr N. It found he does have ADHD.

August 2024 assessment

12. Mr N says the consultant psychiatrist acted unprofessionally during this appointment. The Provider has acknowledged it got things wrong. It said its consultant did not create any rapport with him and made comments which were inappropriate and unprofessional.

13. The relevant standards for the type of assessment Mr N was having are NICE NG87, RCP’s CR235 and AQAS. These say organisations doing ADHD assessments should make sure they give enough time to make a clear decision. They say this requires detailed and careful clinical interviews and decisions cannot be made after a brief consultation. The GMC’s ‘Good Medical Practice’ also says clinicians should communicate sensitively and considerately with patients, especially when what they are discussing is potentially distressing.

14. Our adviser said the evidence indicates the psychiatrist handled the assessment poorly. They did not ensure Mr N had a detailed and careful clinical interview in line with the guidance. In reality, the psychiatrist did not have chance to do that because their comments meant the assessment broke down and ended very quickly, before they could do anything meaningful. The evidence indicates the psychiatrist did not treat Mr N considerately. We do not think the Provider acted in line with the relevant guidance during this assessment.

15. We next considered the impact on Mr N. The Provider rescheduled his assessment for November 2024. It diagnosed him with ADHD after this. There is no indication anything had changed in Mr N’s presentation between August and November. So it is more likely than not that the Provider would have made the same decision if it had completed its assessment properly in August. So the mistake delayed Mr N’s diagnosis. This was by three months, rather than five months. We believe Mr N has included the time before the August appointment when it was being arranged. the Provider would only ever have been able to make a diagnosis after an assessment.

16. This meant Mr N was not able to access ADHD support as quickly as he should. This was clearly frustrating and upsetting for him, particularly as he had waited over a year for the assessment from when his GP had first referred him to the Provider.

17. Mr N says what the Provider got wrong had wider mental and physical impacts on his health beyond a delayed diagnosis. He says he had to have an operation to remove gallstones in 2025, which was partly caused by the stress the Provider’s actions caused him. We have considered Mr N’s view carefully.

18. Mr N’s medical records show he has other conditions as well as ADHD. They do not indicate Mr N’s mental health worsened after August. There is no evidence he raised any concerns with his GP about stress caused by the delay, or that this was any factor in him needing gallstones removed. Our adviser could not see any link between stress factors and the need for surgery or how bad his abdominal issues were. When we weigh up the evidence, we cannot say the Provider’s actions were the sole or primary cause of any deterioration in either his mental or physical health.

19. The ‘NHS Complaint Standards’, say organisations should investigate complaints, apologise for the impact and put right what they get wrong where they find they have made a mistake and learn from complaints.

20. We can see the Provider investigated Mr N’s complaint and acknowledged what it got wrong. It apologised for the impact of this on him. It organised a new assessment for him. It also confirmed it had met with the consultant from the August assessment to discuss what went wrong and make sure this did not happen again. This is in line with the ‘NHS Complaint Standards’ and what we would expect it to do.

21. So the Provider has already provided two of the outcomes Mr N told us he wants – an acknowledgement of failings and an apology. He also told us he wants a financial remedy of £3000 because he says his mental and physical health got worse as a result of the August 2024 assessment and delay. As we have set out above, we cannot say this was the case, so we do not have grounds to ask the Provider to offer Mr N a financial remedy for this.

22. It is clear the August 2024 appointment and subsequent wait for a further assessment were worrying and distressing for Mr N. We think the Provider has taken the matter seriously and already done enough to put things right.

Recording the assessment

23. Mr N says he did not agree to the Provider recording the August 2024 assessment. He says it then wrongly shared this recording with other people. He says he found both incidents very upsetting.

24. The Provider said the consultant psychiatrist wanted to record the assessment to help write up their notes following the meeting. It said it did not have a formal policy about recording assessments at the time. It said it only shared the recording with the independent investigator who investigated Mr N’s complaint.

25. Our ‘Principles of Good Administration’ say organisations should treat people as individuals, recognising their personal circumstances. They should also investigate complaints thoroughly. The ‘NHS Complaints Standards’ say organisations should make improvements following complaints where they find they have got something wrong.

26. We can see from the records Mr N told the Provider he did not agree to it recording the assessment in August 2024. But it did so anyway. This is not in line with our Principles, as it did not recognise his individual wishes. We can see this upset Mr N.

27. The Provider apologised for recording the appointment when he did not want this. We can also see it has changed its policies and practice around recording meetings following his complaint. We think this shows it took this part of his complaint seriously. It acted in line with what the ‘NHS Complaints Standards’ says organisations should do. We do not think it needs to do anything more to put this right for Mr N.

28. We do not think the Provider did anything wrong when it allowed the complaint investigator to listen to the recording. But we appreciate Mr N was unhappy with this. It needed to thoroughly investigate his complaint about what happened. The recording was the only impartial evidence it had. We can see it used this to uphold his complaint. We think the Provider acted within the spirit of our Principles here.

29. We would like to thank Mr N for bringing this complaint to us. We can see this was a frustrating and worrying time for him. We wish him well for the future.

1. We have carefully considered Mr N’s complaint about the independent provider. We think it got things wrong in how it handled his first ADHD assessment in August 2024. We cannot say this had the impact Mr N says and we think it has done enough to put things right. We think it also got something wrong when it recorded the assessment against his wishes. We can see this caused him upset. Again, we think the Provider has already put things right. We do not think it got something wrong when it allowed the complaint investigator to listen to the recording of the assessment.

2. We can see Mr N found what happened at his assessment in August 2024 upsetting and frustrating both at the time and afterwards. We would like to thank him for raising these issues with us.