Published
2 years agoon
By
adminReviewed by Emily Henderson, B.Sc. Mar 28 2023
Some adults who take prescription medication for attention-deficit/hyperactivity disorder are required to have their urine tested for drugs several times a year. Others never are tested.
Such screenings are designed to check if ADHD patients are safely taking their pills, such as Adderall, and not selling them, taking too many, or using other drugs.
Several doctors told KHN there are varying opinions and no national standards on the role of urine testing to monitor adults who take ADHD medication. So patients face dramatically different requirements, depending on their clinics' and health insurers' policies.
"There really isn't much literature to guide you on how to do this," said Dr. Margaret Chaplin, a Connecticut psychiatrist who treats patients with ADHD, mental illnesses, or substance use disorders.
Chaplin first noticed the lack of testing standards about eight years ago, when she and colleagues proposed ways to prevent stimulant misuse in adult ADHD patients.
Her team recommended urine tests only if patients exhibit "red-flag behavior," such as appearing intoxicated, repeatedly reporting lost prescriptions, or frequently switching doctors. Some doctors and clinics make testing decisions on a patient-by-patient basis taking into account those red flags or patient history. Others apply universal policies, which may be aimed at preventing discrimination. Some insurance companies and state Medicaid systems also have testing requirements.
ADHD stimulants, opioid pain medications, and some other drugs are classified as controlled substances, which are tightly regulated because they can be addictive or misused.
ADHD patients subjected to frequent drug screens say the tests can be time-consuming and expensive. Some feel stigmatized.
A.C. Shilton felt relieved when she was diagnosed with ADHD in her mid-30s. The farmer and freelance journalist from rural Tennessee said the diagnosis explained why she felt so disorganized and forgetful, and as if her brain were a motor running all day. Shilton said her medication slows that motor down.
The 38-year-old Jamestown resident said her first doctor ordered urine tests once a year. That doctor eventually closed his practice, and Shilton said her next physician made her take a test at nearly every visit.
"You go in to get the standard of care, which is this medicine, and you're kind of treated like you're a bad person again; there's some shame associated with that," Shilton said.
She was also upset after learning office staffers were incorrect when they told her that urine testing was required by law — something that other ADHD patients posting on social media forums said had happened to them too.
Shilton said few doctors treat adult ADHD patients in her rural community. She now drives more than an hour to a different clinic, which doesn't require her to take as many drug tests.
Travis Gordon, 47, of Charlotte, North Carolina, has gone to the same ADHD clinic for more than 10 years. Gordon said he wasn't drug-tested in the first few years. Then, for several years, he had to give a urine sample every three months. During much of the covid-19 pandemic, he wasn't tested. Now, he's screened every six months.
"We shouldn’t have to feel like street criminals to get drugs that are needed for our daily success," Gordon said.
Gordon said it would make sense for doctors to order tests more frequently as they get to know new patients. But he said he doesn't understand why such testing should continue for people like him, established patients who properly take their medication.
Traci Camper, 50, of northeastern Tennessee, said she has "never even tried a cigarette," much less used illicit drugs, but her doctor has required urine tests every three months for more than 10 years. Camper said the process can be inconvenient but she's ultimately OK with the tests, especially since she lives in an area with high rates of drug abuse.
The clinics that Shilton, Gordon, and Camper went to did not respond to KHN's requests for interviews about their testing policies.
Adults are diagnosed with ADHD if they have multiple, frequent symptoms so severe they interfere with work, relationships, or other aspects of life. Treatments include therapy and medication, most often stimulants.
ADHD patients have been affected by the response to the opioid crisis, which has led to more scrutiny for all controlled medications. Some have reported trouble filling their prescriptions as drug distribution companies limit sales to certain pharmacies. Some patients, especially rural ones, could face obstacles if the federal government reverts to pre-pandemic rules that require at least one in-person appointment to receive controlled drugs via telehealth. Forensics And Toxicology eBook Compilation of the top interviews, articles, and news in the last year. Download a free copy
Chaplin said doctors who treat ADHD may feel the need to be extra vigilant with drug testing because of this increased scrutiny, or due to the risk of misuse.
An estimated 3.7 million Americans 12 or older misused prescription stimulants in 2021, and 1.5 million had a prescription stimulant use disorder, according to the National Survey on Drug Use and Health. Americans are more likely to misuse or be addicted to prescription opioids, sedatives, and tranquilizers, the agency said.
Adults with ADHD are more likely to have a substance use disorder than those without the condition, according to the Substance Abuse and Mental Health Services Administration.
Although there aren't formal standards, several health care organizations and professionals have made recommendations to prevent and detect adult ADHD stimulant misuse. Suggestions include requiring patients to sign prescription-agreement contracts and regularly checking databases that show all controlled medications each patient is buying.
Chaplin said there's little research into how effective any method is at preventing medication misuse.
A recent survey found that 42% of family physicians and 21% of college health professionals who treat adult ADHD require their patients to submit random urine drug screens.
Gordon, Camper, and some ADHD patients on social media forums said their drug screens have come at predictable intervals, instead of random ones.
Dr. Sidarth Wakhlu, a psychiatrist who specializes in treating substance use disorders at the University of Texas Southwestern Medical Center in Dallas, said some of his patients also have ADHD. He suggests drug-testing most ADHD patients once or twice a year. For "someone who has no addiction history, has no red flags, every three months is an overkill," he said.
The cost of drug testing is as variable as the frequency.
For example, Dr. Michael Fingerhood at Johns Hopkins University uses urine tests that cost as little as $60 before insurance. Fingerhood makes testing decisions case by case for patients who take controlled substances to treat ADHD, pain, or opioid addiction.
Gordon used to pay $110 for each of his tests when he had insurance his doctor did not accept. Shilton's insurance was billed $545 for a test. Shilton said she complained to a nurse who said, in the future, she could use a less expensive test.
Shilton said she replied, "Well, why aren't we doing that to begin with? Why are we doing this extremely fancy drug testing?"
Wakhlu said the more expensive urine tests can identify specific types and quantities of drugs. Such tests are usually used to confirm the results of initial, less pricey tests, according to the Centers for Disease Control and Prevention.
Wakhlu said that when test results show a patient might be misusing stimulants, doctors should initiate a non-accusatory conversation to discuss the results and, if needed, offer help. He also said it's important to emphasize safety, such as how taking too much ADHD medication or combining it with other stimulants, such as methamphetamine, can be dangerous.
This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

You may like
Entertainment
Pete Townshend’s Quadrophenia talked about modern masculinity before Gen Z was born
Published
6 mins agoon
April 5, 2025By
admin
Despite The Who’s Quadrophenia being set over 60 years ago, Pete Townshend’s themes of identity, mental health, and modern masculinity are just as relevant today.
The album is having a renaissance as Pete Townshend’s Quadrophenia A Mod ballet is being brought to life via dance at Sadler’s Wells East, and Sky News has an exclusive first look.
As Townshend puts it, the album he wrote is “perfect” for the stage.

Pete Townshend
“My wife Rachel did the orchestration for me, and as soon as I heard it I said to her it would make a fabulous ballet and we never really let that go,” he tells Sky News.
“Heavy percussion, concussive sequences. They’re explosive moments. They’re also romantic movement moments.”
If you identify with the demographics of Millennial, Gen Y or Gen Z, you might not be familiar with The Who and Mod culture.
But in post-war Britain the Mods were a cultural phenomenon characterised by fashion, music, and of course, scooters. The young rebels were seen as a counter-culture to the establishment and The Who, with Roger Daltry’s lead vocals and Pete Townshend’s writing, were the soundtrack.
More on The Who
Related Topics:
Quadrophenia the album is widely regarded as an essay on the British adolescent experience at the time, focusing on the life of fictional protagonist Jimmy – a young Mod struggling with his sanity, self-doubt, and alienation.
Townshend sets the rock opera in 1965 but thinks its themes of identity, mental health, and modern masculinity are just as relevant today.
He says: “The phobias and the restrictions and the unwritten laws about how young men should behave. The ground that they broke, that we broke because I was a part of it.
“Men were letting go of [the] wartime-related, uniform-related stance that if I wear this kind of outfit it makes me look like a man.”

Paris Fitzpatrick and Pete Townshend. Pic: Johan Persson
This struggle of modern masculinity and identity appears to be echoing today as manosphere influencers like Andrew Tate, incel culture, and Netflix’s Adolescence make headlines.
For dancer Paris Fitzpatrick, who takes on the lead role of Jimmy, the story resonates.

Paris Fitzpatrick, who takes on the lead role of Jimmy in the ballet
“I think there’s a connection massively and I think there may even be a little more revival in some way,” he tells Sky News.
“I love that myself. I love non-conforming to gender norms and typical masculinity; I think it’s great to challenge things.”
Despite the album being written before he was born, the dancer says he was familiar with the genre already.
“I actually did an art GCSE project about Mods and rockers and Quadrophenia,” he says.
“I think we’ll be able to bring it to new audiences and hopefully, maybe people will be inspired to to learn more about their music and the whole cultural movement of the early 60s.”
Read more from Sky News:
Tributes to ‘genius’ Kilmer
Richest billionaires named
Springsteen’s seven new albums
In 1979, the album was adapted into a film directed by Franc Roddam starring Ray Winstone and Sting but Townshend admits because the film missed key points he is “not a big fan”.
“What it turned out to be in the movie was a story about culture, about social scenario and less about really the specifics of mental illness and how that affects young people,” he adds, also complimenting Roddam’s writing for the film.
Perhaps a testament to Pete Townshend’s creativity, Quadrophenia started as an album, was successfully adapted to film and now it will hit the stage as a contemporary ballet.
It appears that over six decades later Mod culture is still cool and their issues still relatable.
Quadrophenia, a Mod Ballet will tour to Plymouth Theatre Royal from 28 May to 1 June 2025, Edinburgh Festival Theatre from 10 to 14 June 2025 and the Mayflower, Southampton from 18 to 21 June 2025 before having its official opening at Sadler’s Wells Theatre, London on 24 June running to 13 July 2025 and then visiting The Lowry, Salford from 15 to 19 July 2025.
Business
‘We will see closures’: The industries hit the hardest by national insurance hike
Published
6 mins agoon
April 5, 2025By
admin
The cost of having staff is going up this Sunday as the increase in employers’ national insurance kicks in.
Chancellor Rachel Reeves announced in the October budget employers will have to pay a 15% rate of national insurance contributions (NIC) on their employees from 6 April – up from 13.8%.
She also lowered the threshold at which employers pay NIC from £9,100 a year to £5,000 a year, meaning they start paying at an earlier point on staff salaries.
This is on top of the national minimum wage rising, the business relief rate for hospitality, retail and leisure reducing from 75% to 40% and the rising cost of ingredients and services.
Sky News spoke to people working in some of the industries that will be hardest hit by the rise in NIC: Nurseries, hospitality, retail, small businesses and care.
NURSERIES
Nearly all (96% of 728) nurseries surveyed by the National Day Nurseries Association (NDNA) said they will have no choice but to put up fees because of the NIC rise, leaving parents to pick up the shortfall.
More on Cost Of Living
Related Topics:
The NDNA has warned nurseries could close due to the rise, with 14% saying their business is at risk, 69% reducing spending on resources and 39% considering offering fewer places with government-funded hours as 92% said they do not cover their costs.
Sarah has two children, with her youngest starting later this month, but they were just informed fees will now be £92 a day – compared with £59 at the same nursery when her eldest started five years ago.
“I’m not sure how we will afford this. Our salaries haven’t increased by 50% during this time,” she said.
“We’re stuck as there aren’t enough nursery spaces in our area, so we will have to struggle.”
Karen Richards, director of the Wolds Childcare group in Nottinghamshire, has started a petition to get the government to exempt private nurseries – the majority of providers – from the NIC changes as she said it is unfair nurseries in schools do not have to pay the NIC.
She told Sky News she will have to find about £183,000 next year to cover the increase across her five nurseries and reducing staff numbers is “not off the table” but it is more likely they will reduce the number of children they have.

Joeli Brearley, founder of Pregnant Then Screwed, said parents are yet again having to pay the price for the government’s actions. Pic: Pregnant Then Screwed
Joeli Brearley, founder of the Pregnant Then Screwed campaign group, told Sky News: “Parents are already drowning in childcare costs, and now, thanks to the national insurance hike, nurseries are passing even more fees on to families who simply can’t afford it.
“It’s the same story every time – parents pay the price while the government looks the other way. How exactly are we meant to ‘boost the economy’ when we can’t even afford to go to work?”
Purnima Tanuku, executive chair of the NDNA, said staffing costs make up about 75% of nurseries’ costs and they will have to find £2,600 more per employee to pay for the NIC rise – £47,000 for an average nursery.
“The government says it wants to offer ‘cheaper childcare’ for parents on the one hand but then with the other expects nurseries to absorb the costs of National Insurance Contributions themselves,” she told Sky News.
“High-quality early education and care gives children the best start in life and enables parents to work. The government must invest in this vital infrastructure to make sure nurseries can continue to deliver this social and economic good.”
HOSPITALITY
The hospitality industry has warned of closures, price rises, lack of growth and shorter opening hours.
Dan Brod, co-owner of The Beckford Group, a small southwest England restaurant and country pub/hotel group, said the economic situation now is “much worse” than during COVID.
The group has put plans for two more projects on hold and Mr Brod said the only option is to put up prices, but with the rising supplier costs, wages, business rates and NIC hike they will “stay still” financially.
Read more:
Reeves admits it won’t be easy for businesses to absorb NI hike
UK businesses issue warning over ‘deeply troubling’ Trump tariffs

Dan Brod, co-owner of The Beckford Group, said the government does not value hospitality as an industry. Pic: The Beckford Group
He told Sky News: “What we’re nervous about is we’re still in the cost of living crisis and even though our places are in very wealthy areas of the country, Wiltshire, Somerset and Bath, people are feeling the situation in their pockets, people are going out less.”
Mr Brod said they are not getting rid of any staff as their business strongly depends on the quality of their hospitality so they are having to make savings elsewhere.
“I’m still optimistic, I still feel that humans need hospitality but we’re not valued as an industry and the social benefit is never taken into account by government.”

Chef/owner Aktar Islam, who runs Opheem in Birmingham, said the rise will cost him up to £120,000 more this year. Pic: Opheem
Aktar Islam, owner/chef at two Michelin-starred Opheem in Birmingham, said the NIC rise will cost him up to £120,000 more in staff costs a year and to maintain the financial position he is in now they would have to make “another million pounds”.
He got emails from eight suppliers on Thursday saying they were raising their costs, and said he will have to raise prices but is concerned about the impact on diners.
The restaurateur hires four commis chefs to train each year but will not be able to this year, or the next few.
“It’s very short-sighted of the government, you’re not going to grow the economy by taxing hospitality out of existence, these sort of businesses are the lifeblood of our economy,” he said.
“They think if a hospitality business closes another will open but people know it’s tough, why would they want to do that? It’s not going to happen.”
The chef sent hundreds of his “at home” kits to fellow chefs this week for their staff as an acknowledgement of how much of a “s*** show” the situation is – “a little hug from us”.
RETAIL
Some of the UK’s biggest retailers, including Tesco, Boots, Marks & Spencer and Next, wrote to Rachel Reeves after the budget to say the NIC hike would lead to higher consumer prices, smaller pay rises, job cuts and store closures.
The British Retail Consortium (BRC), representing more than 200 major retailers and brands, said the costs are so significant neither small or large retailers will be able to absorb them.
Andrew Bailey, the governor of the Bank of England, told the Treasury committee in November that job losses due to the NIC changes were likely to be higher than the 50,000 forecast by the Office for Budget Responsibility (OBR).

Big retailers have warned the NIC rise will lead to higher prices, job cuts and store closures. File pic: PA
Nick Stowe, chief executive of Monsoon and Accessorize, said retailers had the choice of protecting staff numbers or cancelling investment plans.
He said they were trying to protect staff numbers and would be increasing prices but they would likely have to halt plans to increase store numbers.
Helen Dickinson, head of the BRC, told Sky News the national living wage rise and NIC increase will cost businesses £5bn, adding more than 10% to the cost of hiring someone in an entry-level role.
A further tax on packaging coming in October means retailers will face £7bn in extra costs this year, she said.
“This huge cost burden will undoubtedly reduce investment in stores and jobs and is likely to lead to higher prices,” she added.
SMALL BUSINESSES
A massive 85% of 1,400 small business owners surveyed by the Federation of Small Businesses (FSB) in March reported rising costs compared with the same time last year, with 47% citing tax as the main barrier to growth – the highest level in more than a decade.
Just 8% of those businesses saw an increase in staff numbers over the last quarter, while 21% had to reduce their workforce.
Kate Rumsey, whose family has run Rumsey’s Chocolates in Wendover, Buckinghamshire and Thame, Oxfordshire, for 21 years, said the NIC rise, minimum wage increase and business relief rate reduction will push her staff costs up by 15 to 17% – £70,000 to £80,000 annually.
To offset those costs, she has had to reduce opening hours, including closing on Sundays and bank holidays in one shop for the first time ever, make one person redundant, not replace short-term staff and introduce a hiring freeze.
The soaring price of cocoa has added to her woes and she has had to increase prices by about 10% and will raise them further.

Kate Rumsey, who runs Rumsey’s Chocolates in Buckinghamshire and Oxfordshire, said they are being forced to take a short-term view to survive. Pic: Rumsey’s Chocolates
She told Sky News: “We’re very much taking more of a short-term view at the moment, it’s so seasonal in this business so I said to the team we’ll just get through Q1 then re-evaluate.
“I feel this is a bit about the survival of the fittest and many businesses won’t survive.”
Tina McKenzie, policy chair of the FSB, said the NIC rise “holds back growth” and has seen small business confidence drop to its lowest point since the first year of the pandemic.
With the “highest tax burden for 70 years”, she called on the chancellor to introduce a “raft of pro-small business measures” in the autumn budget so it can deliver on its pledge for growth.
She reminded employers they can claim the Employment Allowance, which has doubled after an FSB campaign to take the first £10,500 off an employer’s annual bill.
Please use Chrome browser for a more accessible video player
1:46
National Insurance rise impacts carers
CARE
The care sector has been warning the government since the October that budget care homes will be forced to close due to the financial pressures the employers’ national insurance rise will place on them.
Care homes receive funding from councils as well as from private fees, but as local authorities feel the squeeze more and more their contributions are not keeping up with rising costs.
The industry has argued without it the NHS would be crippled.
Raj Sehgal, founding director of ArmsCare, a family-run group of six care homes in Norfolk, said the NIC increase means a £360,000 annual impact on the group’s £3.6m payroll.
In an attempt to offset those costs, the group is scrapping staff bonuses and freezing management salaries.
It is also considering reducing day hours, where there are more staff on, so the fewer numbers of night staff work longer hours and with no paid break.

Raj Sehgal said his family-owned group of care homes will need £360,000 extra this year for the NIC hike
Mr Sehgal said: “But what that does do unfortunately, is impact the quality you’re going to be able to provide, at a time when we need to be improving quality, but something has to give.
“The government just doesn’t seem to understand that the funding needs to be there. You cannot keep enforcing higher costs on businesses and not be able to fund those without actually finding the money from somewhere.”
He said the issue is exacerbated by the fact local authority funding, despite increasing to 5%, will not cover the 10% rise.
“It’s going to be a really, really tough ride. And we are going to see a number of providers close their doors,” he warned.
Nadra Ahmed, executive co-chair of the National Care Association, said those who receive, or are waiting to access, care as well as staff will feel the impact the hardest.
“As providers see further shortfalls in the commissioning of care services, they will start to limit what they can do to ensure their viability or, as a last resort exit the market,” she said.
“This is very short-sighted, with serious consequences, which alludes to the understanding of this government.”
Government decided to ‘wipe the slate clean’
A Treasury spokesperson told Sky News the government is “pro-business” but has “taken the difficult but necessary decisions to wipe the slate clean and properly fund our public services after years of declines”.
“Our budget choices have already delivered an NHS with falling waiting lists, a £3.7bn rescue package for social care, and vital protection for Britain’s small businesses,” they said.
“We’re making tough choices today to secure a better tomorrow through our Plan for Change. By investing in economic growth and early years education while capping corporation tax, we’re putting more money in working people’s pockets and giving every child the best start in life.”
Politics
‘We will see closures’: The industries hit the hardest by national insurance hike
Published
6 mins agoon
April 5, 2025By
admin
The cost of having staff is going up this Sunday as the increase in employers’ national insurance kicks in.
Chancellor Rachel Reeves announced in the October budget employers will have to pay a 15% rate of national insurance contributions (NIC) on their employees from 6 April – up from 13.8%.
She also lowered the threshold at which employers pay NIC from £9,100 a year to £5,000 a year, meaning they start paying at an earlier point on staff salaries.
This is on top of the national minimum wage rising, the business relief rate for hospitality, retail and leisure reducing from 75% to 40% and the rising cost of ingredients and services.
Sky News spoke to people working in some of the industries that will be hardest hit by the rise in NIC: Nurseries, hospitality, retail, small businesses and care.
NURSERIES
Nearly all (96% of 728) nurseries surveyed by the National Day Nurseries Association (NDNA) said they will have no choice but to put up fees because of the NIC rise, leaving parents to pick up the shortfall.
More on Cost Of Living
Related Topics:
The NDNA has warned nurseries could close due to the rise, with 14% saying their business is at risk, 69% reducing spending on resources and 39% considering offering fewer places with government-funded hours as 92% said they do not cover their costs.
Sarah has two children, with her youngest starting later this month, but they were just informed fees will now be £92 a day – compared with £59 at the same nursery when her eldest started five years ago.
“I’m not sure how we will afford this. Our salaries haven’t increased by 50% during this time,” she said.
“We’re stuck as there aren’t enough nursery spaces in our area, so we will have to struggle.”
Karen Richards, director of the Wolds Childcare group in Nottinghamshire, has started a petition to get the government to exempt private nurseries – the majority of providers – from the NIC changes as she said it is unfair nurseries in schools do not have to pay the NIC.
She told Sky News she will have to find about £183,000 next year to cover the increase across her five nurseries and reducing staff numbers is “not off the table” but it is more likely they will reduce the number of children they have.

Joeli Brearley, founder of Pregnant Then Screwed, said parents are yet again having to pay the price for the government’s actions. Pic: Pregnant Then Screwed
Joeli Brearley, founder of the Pregnant Then Screwed campaign group, told Sky News: “Parents are already drowning in childcare costs, and now, thanks to the national insurance hike, nurseries are passing even more fees on to families who simply can’t afford it.
“It’s the same story every time – parents pay the price while the government looks the other way. How exactly are we meant to ‘boost the economy’ when we can’t even afford to go to work?”
Purnima Tanuku, executive chair of the NDNA, said staffing costs make up about 75% of nurseries’ costs and they will have to find £2,600 more per employee to pay for the NIC rise – £47,000 for an average nursery.
“The government says it wants to offer ‘cheaper childcare’ for parents on the one hand but then with the other expects nurseries to absorb the costs of National Insurance Contributions themselves,” she told Sky News.
“High-quality early education and care gives children the best start in life and enables parents to work. The government must invest in this vital infrastructure to make sure nurseries can continue to deliver this social and economic good.”
HOSPITALITY
The hospitality industry has warned of closures, price rises, lack of growth and shorter opening hours.
Dan Brod, co-owner of The Beckford Group, a small southwest England restaurant and country pub/hotel group, said the economic situation now is “much worse” than during COVID.
The group has put plans for two more projects on hold and Mr Brod said the only option is to put up prices, but with the rising supplier costs, wages, business rates and NIC hike they will “stay still” financially.
Read more:
Reeves admits it won’t be easy for businesses to absorb NI hike
UK businesses issue warning over ‘deeply troubling’ Trump tariffs

Dan Brod, co-owner of The Beckford Group, said the government does not value hospitality as an industry. Pic: The Beckford Group
He told Sky News: “What we’re nervous about is we’re still in the cost of living crisis and even though our places are in very wealthy areas of the country, Wiltshire, Somerset and Bath, people are feeling the situation in their pockets, people are going out less.”
Mr Brod said they are not getting rid of any staff as their business strongly depends on the quality of their hospitality so they are having to make savings elsewhere.
“I’m still optimistic, I still feel that humans need hospitality but we’re not valued as an industry and the social benefit is never taken into account by government.”

Chef/owner Aktar Islam, who runs Opheem in Birmingham, said the rise will cost him up to £120,000 more this year. Pic: Opheem
Aktar Islam, owner/chef at two Michelin-starred Opheem in Birmingham, said the NIC rise will cost him up to £120,000 more in staff costs a year and to maintain the financial position he is in now they would have to make “another million pounds”.
He got emails from eight suppliers on Thursday saying they were raising their costs, and said he will have to raise prices but is concerned about the impact on diners.
The restaurateur hires four commis chefs to train each year but will not be able to this year, or the next few.
“It’s very short-sighted of the government, you’re not going to grow the economy by taxing hospitality out of existence, these sort of businesses are the lifeblood of our economy,” he said.
“They think if a hospitality business closes another will open but people know it’s tough, why would they want to do that? It’s not going to happen.”
The chef sent hundreds of his “at home” kits to fellow chefs this week for their staff as an acknowledgement of how much of a “s*** show” the situation is – “a little hug from us”.
RETAIL
Some of the UK’s biggest retailers, including Tesco, Boots, Marks & Spencer and Next, wrote to Rachel Reeves after the budget to say the NIC hike would lead to higher consumer prices, smaller pay rises, job cuts and store closures.
The British Retail Consortium (BRC), representing more than 200 major retailers and brands, said the costs are so significant neither small or large retailers will be able to absorb them.
Andrew Bailey, the governor of the Bank of England, told the Treasury committee in November that job losses due to the NIC changes were likely to be higher than the 50,000 forecast by the Office for Budget Responsibility (OBR).

Big retailers have warned the NIC rise will lead to higher prices, job cuts and store closures. File pic: PA
Nick Stowe, chief executive of Monsoon and Accessorize, said retailers had the choice of protecting staff numbers or cancelling investment plans.
He said they were trying to protect staff numbers and would be increasing prices but they would likely have to halt plans to increase store numbers.
Helen Dickinson, head of the BRC, told Sky News the national living wage rise and NIC increase will cost businesses £5bn, adding more than 10% to the cost of hiring someone in an entry-level role.
A further tax on packaging coming in October means retailers will face £7bn in extra costs this year, she said.
“This huge cost burden will undoubtedly reduce investment in stores and jobs and is likely to lead to higher prices,” she added.
SMALL BUSINESSES
A massive 85% of 1,400 small business owners surveyed by the Federation of Small Businesses (FSB) in March reported rising costs compared with the same time last year, with 47% citing tax as the main barrier to growth – the highest level in more than a decade.
Just 8% of those businesses saw an increase in staff numbers over the last quarter, while 21% had to reduce their workforce.
Kate Rumsey, whose family has run Rumsey’s Chocolates in Wendover, Buckinghamshire and Thame, Oxfordshire, for 21 years, said the NIC rise, minimum wage increase and business relief rate reduction will push her staff costs up by 15 to 17% – £70,000 to £80,000 annually.
To offset those costs, she has had to reduce opening hours, including closing on Sundays and bank holidays in one shop for the first time ever, make one person redundant, not replace short-term staff and introduce a hiring freeze.
The soaring price of cocoa has added to her woes and she has had to increase prices by about 10% and will raise them further.

Kate Rumsey, who runs Rumsey’s Chocolates in Buckinghamshire and Oxfordshire, said they are being forced to take a short-term view to survive. Pic: Rumsey’s Chocolates
She told Sky News: “We’re very much taking more of a short-term view at the moment, it’s so seasonal in this business so I said to the team we’ll just get through Q1 then re-evaluate.
“I feel this is a bit about the survival of the fittest and many businesses won’t survive.”
Tina McKenzie, policy chair of the FSB, said the NIC rise “holds back growth” and has seen small business confidence drop to its lowest point since the first year of the pandemic.
With the “highest tax burden for 70 years”, she called on the chancellor to introduce a “raft of pro-small business measures” in the autumn budget so it can deliver on its pledge for growth.
She reminded employers they can claim the Employment Allowance, which has doubled after an FSB campaign to take the first £10,500 off an employer’s annual bill.
Please use Chrome browser for a more accessible video player
1:46
National Insurance rise impacts carers
CARE
The care sector has been warning the government since the October that budget care homes will be forced to close due to the financial pressures the employers’ national insurance rise will place on them.
Care homes receive funding from councils as well as from private fees, but as local authorities feel the squeeze more and more their contributions are not keeping up with rising costs.
The industry has argued without it the NHS would be crippled.
Raj Sehgal, founding director of ArmsCare, a family-run group of six care homes in Norfolk, said the NIC increase means a £360,000 annual impact on the group’s £3.6m payroll.
In an attempt to offset those costs, the group is scrapping staff bonuses and freezing management salaries.
It is also considering reducing day hours, where there are more staff on, so the fewer numbers of night staff work longer hours and with no paid break.

Raj Sehgal said his family-owned group of care homes will need £360,000 extra this year for the NIC hike
Mr Sehgal said: “But what that does do unfortunately, is impact the quality you’re going to be able to provide, at a time when we need to be improving quality, but something has to give.
“The government just doesn’t seem to understand that the funding needs to be there. You cannot keep enforcing higher costs on businesses and not be able to fund those without actually finding the money from somewhere.”
He said the issue is exacerbated by the fact local authority funding, despite increasing to 5%, will not cover the 10% rise.
“It’s going to be a really, really tough ride. And we are going to see a number of providers close their doors,” he warned.
Nadra Ahmed, executive co-chair of the National Care Association, said those who receive, or are waiting to access, care as well as staff will feel the impact the hardest.
“As providers see further shortfalls in the commissioning of care services, they will start to limit what they can do to ensure their viability or, as a last resort exit the market,” she said.
“This is very short-sighted, with serious consequences, which alludes to the understanding of this government.”
Government decided to ‘wipe the slate clean’
A Treasury spokesperson told Sky News the government is “pro-business” but has “taken the difficult but necessary decisions to wipe the slate clean and properly fund our public services after years of declines”.
“Our budget choices have already delivered an NHS with falling waiting lists, a £3.7bn rescue package for social care, and vital protection for Britain’s small businesses,” they said.
“We’re making tough choices today to secure a better tomorrow through our Plan for Change. By investing in economic growth and early years education while capping corporation tax, we’re putting more money in working people’s pockets and giving every child the best start in life.”
Trending
-
Sports2 years ago
‘Storybook stuff’: Inside the night Bryce Harper sent the Phillies to the World Series
-
Sports12 months ago
Story injured on diving stop, exits Red Sox game
-
Sports1 year ago
Game 1 of WS least-watched in recorded history
-
Sports2 years ago
MLB Rank 2023: Ranking baseball’s top 100 players
-
Sports4 years ago
Team Europe easily wins 4th straight Laver Cup
-
Environment2 years ago
Japan and South Korea have a lot at stake in a free and open South China Sea
-
Environment2 years ago
Game-changing Lectric XPedition launched as affordable electric cargo bike
-
Business3 years ago
Bank of England’s extraordinary response to government policy is almost unthinkable | Ed Conway