What CQC inspectors find at ADHD and autism clinics

The Department of Health and Social Care has asked CQC to regulate every ADHD and autism diagnostic assessment, including services that only diagnose, once new regulations are in place (CQC, 9 October 2026). No date has been set (our explainer on the change). Clinics that only diagnose will then be inspected for the first time, and clinics already registered can wait years for their first inspection. Either way, it helps to know what inspectors write down.

So we read every CQC inspection report and assessment we could find for independent clinics in England: 1,520 of them, published from 2017 to 2026. We recorded each finding, checked every quote against the report, and compared 66 ADHD and autism clinics with 1,025 similar independent clinics, such as private doctors, online prescribing services and independent mental health services.

What this means for you

• Most clinics wait one to three years for a first inspection. Start building the evidence the day you register, because inspectors will ask for all of it.
• ADHD and autism clinics lose their ratings on Safe and Well-led: risk assessments, incident logs, audits, prescribing and training records. Good patient feedback does not protect a rating.
• Most of the problems below also appear in reports for clinics rated Good. Inspectors list them as things to fix, and they turn into breaches when they pile up.

You can check your own clinic against every finding in this article with our free CQC inspection readiness check. It takes about ten minutes and needs no account.

Most ADHD and autism clinics have not been inspected yet#

In October 2026, 214 of 268 registered locations run by ADHD and autism providers (80%) had never had a CQC inspection report. 40 of them had been registered for more than three years. Clinics that had been inspected waited a median of 1.9 years from registration to their first report, and 44% waited more than two years. One clinic, for example, registered in February 2024 and had its first assessment in May 2026.

When inspectors do come, they ask for evidence from the whole period: audits, incident logs, supervision notes and training records. A clinic that started keeping them the month before has little to show.

80% of registered ADHD and autism clinic locations have never been inspectedRegistered locations run by ADHD and autism providers, and how long inspected clinics waited for their first inspectionNever inspected214 of 26840 of them registered more than 3 years agoWait for first inspection1.9 yearsmedian, across 54 clinics registered since 2015Waited over 2 years44%of clinics that have had a first inspectionNever inspected: 214Inspected: 54Source and notes

ADHD and autism clinics are rated below Good about twice as often#

In their newest report, 16% of rated ADHD and autism clinics (10 of 64) were rated Requires improvement or Inadequate, against 9% of similar independent clinics (82 of 956). 24% had breached at least one regulation (16 of 66), against 14% of similar clinics.

The breaches cluster in three regulations. Among ADHD and autism clinics with a breach:

• 88% breached Regulation 17 (good governance)
• 75% breached Regulation 12 (safe care and treatment)
• 38% breached Regulation 18 (staffing)

Similar clinics breach Regulation 18 much less often (15%), which points to training and supervision as a particular weak spot for ADHD and autism services.

ADHD and autism clinics are rated below Good about twice as often as similar clinicsShare of clinics, from each clinic's newest CQC report or assessmentADHD and autism clinicsSimilar independent clinics (in brackets)Rated Requires improvement or InadequateADHD and autism clinics 16%, similar independent clinics 9%16%(9%)Breached at least one regulationADHD and autism clinics 24%, similar independent clinics 14%24%(14%)64 rated ADHD and autism clinics and 956 rated similar clinics. The ADHD and autism group is small, so treat the gap as a direction rather than an exact figure.Source and notes

Ratings fall on Safe and Well-led, almost never on Caring#

Share of rated ADHD and autism clinics rated below Good, by key question:

• Safe: 19% (similar clinics 13%)
• Well-led: 17% (similar clinics 11%)
• Effective: 5%
• Caring: 2%
• Responsive: 2%

Inspectors rarely fault ADHD and autism clinics on how they treat patients. They mark them down for gaps in the paperwork and oversight that show care is safe and that leaders know what is going on. Every ADHD and autism clinic rated below Good had problems with governance and audit, and with risk and incident management. Nine in ten also had problems with prescribing.

Ratings fall on Safe and Well-led, almost never on CaringShare of rated clinics rated Requires improvement or Inadequate for each key questionADHD and autism clinicsSimilar independent clinics (in brackets)SafeADHD and autism clinics 19%, similar independent clinics 13%19%(13%)Well-ledADHD and autism clinics 17%, similar independent clinics 11%17%(11%)EffectiveADHD and autism clinics 5%, similar independent clinics 6%5%(6%)ResponsiveADHD and autism clinics 2%, similar independent clinics 1%2%(1%)CaringADHD and autism clinics 2%, similar independent clinics 1%2%(1%)Source and notes

The problems inspectors raise most often#

These are the problems raised most often in the newest reports for ADHD and autism clinics, including clinics rated Good. Most are far more common than at similar clinics. The percentage in each heading is the share of ADHD and autism clinics whose report raised it.

The problems CQC inspectors raise most often at ADHD and autism clinicsShare of clinics whose newest report raised the problem, including clinics rated GoodADHD and autism clinicsSimilar independent clinics (in brackets)Risk assessments missing or poorADHD and autism clinics 20%, similar independent clinics 1%20%(1%)No ADHD or autism specific trainingADHD and autism clinics 17%, similar independent clinics 5%17%(5%)No clinical audit programmeADHD and autism clinics 17%, similar independent clinics 12%17%(12%)Prescribing audits missingADHD and autism clinics 14%, similar independent clinics 5%14%(5%)Incidents not logged or investigatedADHD and autism clinics 14%, similar independent clinics 6%14%(6%)Prescription stationery not securedADHD and autism clinics 14%, similar independent clinics 3%14%(3%)Physical health checks for medication missedADHD and autism clinics 12%, similar independent clinics 2%12%(2%)Records split across paper and systemsADHD and autism clinics 11%, similar independent clinics 1%11%(1%)Source and notes

Risk assessments missing or poor (20%)#

Inspectors read a sample of records and count. At one clinic rated Requires improvement in 2025: "In 4 of the 13 records risk levels were noted without any explanation of how these levels were determined." At another, also rated Requires improvement: "The provider did not consistently use a recognised risk assessment tool in line with guidance."

No training specific to ADHD and autism (17%)#

This includes training on learning disability and autism, which the law requires CQC-registered providers to give their staff; the Oliver McGowan Mandatory Training is the recommended programme. At a clinic rated Good in 2026, "only 42% of staff had completed the second part of the Oliver McGowan training programme, and this remained an area for improvement."

No clinical audit programme (17%), and prescribing audits missing (14%)#

Inspectors want a planned programme, with actions and repeat audits. Even at a clinic rated Good, inspectors wrote that "more could be done to carry out clinical audits particularly with monitoring outcomes for young people and for attention deficit hyperactivity disorder (ADHD) assessments."

Incidents not logged or investigated (14%)#

At one clinic rated Good in 2025, "there was no incident log in place to record such occurrences." At another, staff "could not explain how learning from incidents was shared or led to service-wide changes."

Prescription stationery not secured (14%)#

This rises to 17% among clinics that prescribe. At one clinic, "Prescriptions forms were not always stored in the same location and staff did not consistently monitor their use." At another service, inspectors found that "prescribers pre-signed prescriptions for clients based on the standard titration pathway."

Physical health checks for ADHD medication missed (12%)#

NICE guideline NG87 sets out the checks before and during treatment. One report found: "In four records, there was not evidence that an initial physical health check had been completed."

Records split across paper and several systems (11%)#

At one clinic rated Good in 2026: "A small number of staff were not using the electronic system and kept their notes in a separate place." At another, risk management was "recorded across email correspondence and informal case notes rather than within a clear, structured risk assessment."

What inspectors praise#

In the same reports, ADHD and autism clinics were praised for:

• Keeping prescription stationery secure and tracked (55%)
• Shared care agreements with GPs (41%)
• Investigating incidents and learning from them (38%)
• Audits that led to changes (32%)

One report noted: "Prescription stationery was stored securely, and auditable records were maintained detailing when prescriptions were issued to prescribers." At a clinic rated Good in 2026: "Staff completed and monitored outcomes of audits for records, ID checks, prescribing medicines, anti-psychotic drugs, ECGs and ADHD assessments."

What inspectors praise at ADHD and autism clinicsShare of ADHD and autism clinics whose newest report praised itPrescription stationery kept secure and tracked55%Shared care agreements with GPs41%Incidents investigated and learned from38%Audits that lead to changes32%Source and notes

Check your clinic before CQC does#

The CQC inspection readiness check turns these findings into a set of checks, grouped by CQC's five key questions. For each one it shows how often inspectors raised it at ADHD and autism clinics, what they expect to see, and quotes from real reports. Your gaps come back in order, starting with the problems inspectors raise most often.

How we did this#

We used CQC's public data to find:

• every location registered by the ADHD and autism providers we track
• every location with ADHD or autism in its name
• every community or online independent clinic in three CQC inspection groups: independent consulting doctors, remote clinical advice, and independent mental health services

We left out social care, GP practices and hospitals with beds.

We took inspection reports from 2017 and CQC's newer assessments from 2024 to 2026, which CQC publishes as commentary on each quality statement rather than as a report. From each one we recorded the ratings, any regulation breaches, what the service does, and each specific finding with a quote.

A clinic counts as an ADHD and autism clinic when its own reports say it assesses ADHD or autism or prescribes ADHD medication. Each clinic counts once, using its newest report. Findings were grouped into themes to count them, and a clinic counts once per theme. We quote the reports without naming the clinics.

The ADHD and autism group is small: 66 clinics, 64 of them rated. Percentages for this group move by about 1.5 points for each clinic, so read the gaps as directions. Older reports used CQC's previous framework, but the five key questions and the regulations are the same.

Where Cerebric fits#

Cerebric is a UK platform for ADHD and autism assessment services. It covers several of the problems inspectors raise most often:

• Records in one place. Screening, questionnaires, scheduling, the recorded assessment and the report sit in one patient record, not across email, paper and separate systems.
• Evidence behind every report. Every sentence of a draft report links to its source: a transcript timestamp, a questionnaire answer or a document. The clinician checks each one, edits and signs, so an inspector can trace each conclusion back to the evidence.
• An audit trail as you work. Every clinical and admin action is logged, each report keeps a version history, and a quality checklist runs when a report is approved.
• Prescribing and shared care. Shared care agreements are drafted for the clinician to review, the GP letter is shared securely, and titration follow-ups are booked and recorded.
• Questionnaires. Patient, parent, teacher and GP questionnaires are sent, chased and scored automatically.

At clinics using Cerebric, report writing time fell by 75% and admin staff got 9× as much done.¹ Cerebric is a registered UKCA Class I medical device and holds NHS DSPT (Standards Exceeded), DTAC, DCB0129 and Cyber Essentials Plus. Book a consultation to see how it works for your service.

Footnotes#

1. Measured at UK Right to Choose and private neurodevelopmental providers using Cerebric, 2025–26. ↩