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Background: Despite evidence-based national guidelines for ADHD in the United Kingdom (UK), ADHD is under-identified, under-diagnosed, and under-treated. Many seeking help for ADHD face prejudice, long waiting lists, and patchy or unavailable services, and are turning to service-user support groups and/or private healthcare for help. Methods: A group of UK experts representing clinical and healthcare providers from public and private healthcare, academia, ADHD patient groups, educational, and occupational specialists, met to discuss shortfalls in ADHD service provision in the UK. Discussions explored causes of under-diagnosis, examined biases operating across referral, diagnosis and treatment, together with recommendations for resolving these matters. Results: Cultural and structural barriers operate at all levels of the healthcare system, resulting in a de-prioritization of ADHD. Services for ADHD are insufficient in many regions, and problems with service provision have intensified as a result of the response to the COVID-19 pandemic. Research has established a range of adverse outcomes of untreated ADHD, and associated long-term personal, social, health and economic costs are high. The consensus group called for training of professionals who come into contact with people with ADHD, increased funding, commissioning and monitoring to improve service provision, and streamlined communication between health services to support better outcomes for people with ADHD. Conclusions: Evidence-based national clinical guidelines for ADHD are not being met. People with ADHD should have access to healthcare free from discrimination, and in line with their legal rights. UK Governments and clinical and regulatory bodies must act urgently on this important public health issue., Competing Interests: SY, SCu, BZ, CJ, HR, ND, AL, WC, and PM have pecuniary affiliations with consultancy organizations and/or private practices. CS was employed by the company Cambridge Cognition. SY received honoraria for consultancy and educational talks years from Janssen, HB Pharma and/or Shire. She is author of the ADHD Child Evaluation (ACE) and ACE+ for adults. She is a consultant at the Cognitive Center of Canada, who publish R&R2 for ADHD Youths and Adults. PM received honoraria for consultancy and educational talks from Shire, Takeda, and Flynn Pharma. KvR received honoraria for educational talks from Shire/Takeda, Lilly, Janssen, Medice, and Flynn. CJ provided educational talks for Lilly and Janssen. MP received honoraria for talks and advisory board participation, and travel support for conference attendance, from Shire/Takeda & Flynn Pharma. TN-D reported travel and consultation fees paid for attendance at Transition into Adulthood ADHD (TiAA) Advisory Board Meeting hosted by Shire, October 2018. BZ reported paid lectures for Flynn Pharma. MAr received sponsorships to educational/scientific meetings and honoraria for consultancy and educational talks from Janssen, Lily, Takeda (Shire), and Flynn-pharma. SCo declares reimbursement for travel/accommodation expenses and honoraria in relation to lectures/courses delivered for the Association for Child and Adolescent Health (ACAMH), Canadian ADHD Alliance Resource (CADDRA), British Association of Psychopharmacology (BAP), and Healthcare Convention. PA/King's College London (KCL) received honoraria for consultancy to Takeda/Shire, Eli-Lilly, Medice, Novartis and Janssen, and for speaking at sponsored events for Shire, Lilly, Flynn Pharma, Medice, Novartis and Janssen. KCL was supported by funds for education and research from Shire, Medice, Flynn, Janssen, Vifor Pharma, GW Pharma, and QbTech. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Young, Asherson, Lloyd, Absoud, Arif, Colley, Cortese, Cubbin, Doyle, Morua, Ferreira-Lay, Gudjonsson, Ivens, Jarvis, Lewis, Mason, Newlove-Delgado, Pitts, Read, van Rensburg, Zoritch and Skirrow.)