ADHD diagnosis UK: NHS, private & Right to Choose

Getting an ADHD diagnosis in the UK has never been more visible — but navigating the route there has never felt more confusing. Waiting lists that stretch to years, GPs who are unsure what they can offer, and a patchwork of private options that vary hugely in quality and cost. This guide explains your options clearly, including one that many parents and adults don't know exists: the NHS Right to Choose scheme.

What is the Right to Choose for ADHD?

The NHS Right to Choose (RtC) scheme is a legal right, not a favour. Under the NHS Choice Framework (which sits within the Health and Social Care Act 2012), patients in England who are referred to a specialist for a first outpatient appointment have the right to choose any clinically appropriate provider — including independent sector providers who hold an NHS contract.

For ADHD, this means that rather than joining your local NHS waiting list (which in some areas stretches to five or more years), you can ask your GP to refer you to an approved Right to Choose provider instead. These providers are accredited by NHS England and offer ADHD assessments funded by the NHS at no cost to you.

It is worth noting that Right to Choose currently applies to England only.

How Right to Choose ADHD works step by step

The whole process typically takes between three months and a year depending on the provider, compared to several years on a local NHS waiting list.

Right to Choose ADHD and autism: can you use it for both?

Yes — but they are separate referrals. ADHD and autism assessments are handled by different pathways and different providers, so you will need to request each one separately from your GP.

For autism Right to Choose, NHS England has been expanding approved providers, though availability varies more than for ADHD. Providers such as Healios offer autism assessments under Right to Choose in some areas. It is worth checking the NHS England list of approved providers, or asking your GP surgery to confirm which autism providers are currently contracted in your area.

If you are seeking both an ADHD and an autism assessment, you can request both referrals at the same appointment. They will run independently and may complete at different times.

NHS vs private ADHD assessment: costs, waiting times, and what you get

There are three main routes to an ADHD assessment in the UK, each with different trade-offs.

The standard NHS pathway is free and results in a fully NHS diagnosis, but waiting times in many areas are two to seven years or more.

The Right to Choose pathway is also NHS-funded and free, available in England only, with waiting times currently running at roughly three to twelve months depending on the provider.

Private assessment is available to anyone who can pay, with waiting times of four to twelve weeks, but costs between £500 and £1,500 or more.

All three routes can result in an ADHD diagnosis that is accepted for the purposes of medication and support. A private diagnosis is now widely accepted by NHS GPs, though some surgeries require a private clinician to initiate treatment before they will prescribe on the NHS.

How much does a private ADHD assessment cost in the UK?

Private ADHD assessments in the UK typically cost between £500 and £1,500, depending on the provider, the type of assessment, and what is included in the fee.

A shorter online assessment from a telehealth provider may cost less than £600. A face-to-face assessment with a consultant psychiatrist at a specialist clinic may cost upwards of £1,200. Prices vary depending on whether the assessment is in person or online, the seniority of the clinician, whether a detailed written report is included, and whether any follow-up is part of the package.

It is worth asking providers specifically what is included before booking — some quote a headline price that does not include the full report or a follow-up appointment.

A private diagnosis is generally accepted by NHS GPs for the purposes of medication, but acceptance of shared care arrangements varies by GP surgery and local Integrated Care Board area. It is worth checking with your GP surgery before investing in a private assessment.

Other costs to factor in: once diagnosed you will need to pay for your prescription for a few months during titration before you move to shared care. This is to make sure you are on the correct dosage and that the medication agrees with you. For children especially, there may also be an annual cost payable to the clinic so you can remain on their books — this means you can contact them if something isn't right, and they do regular checks and report back to your GP.

What is a shared care agreement for ADHD medication?

Once you have an ADHD diagnosis — whether via Right to Choose or private assessment — medication is often the next step. Stimulant medications such as methylphenidate and lisdexamfetamine are the most commonly prescribed and require a prescription from a qualified clinician.

A shared care agreement is an arrangement where the specialist manages the initial prescription and any dose titration, and then transfers ongoing prescribing and monitoring responsibility to your NHS GP. This is standard practice and saves you from paying for private prescriptions long-term.

However, shared care is not always straightforward. Some GP surgeries refuse to enter into shared care agreements, particularly when the diagnosis came from a private provider. If this happens, you are left either paying for ongoing private prescriptions or returning to the specialist each time.

If your GP refuses a shared care agreement, ask for the refusal in writing with a clinical reason stated. You can then request a review through your local Integrated Care Board, contact PALS (Patient Advice and Liaison Service), or seek support from advocacy organisations such as ADHD UK.

Once diagnosed, the next question is usually school support. See our guide to ADHD and EHCPs for how to get reasonable adjustments and, where needed, a legally-binding plan.

ADHD Right to Choose waiting times: what to realistically expect

Waiting times via Right to Choose vary by provider and change regularly. Many providers are currently quoting waiting times of between four and twelve months for an initial assessment — significantly shorter than local NHS pathways, but not instant.

To get the most accurate picture, check each provider's website directly, as most publish current waiting times. You can also contact providers directly before your GP makes a referral to ask what they are currently quoting.

Some providers have experienced difficulties managing demand and have temporarily paused new referrals. It is worth having a shortlist of two or three approved providers so that if your first choice has a long wait or is closed to referrals, you have alternatives ready.

What to do if your GP refuses Right to Choose

Legally, your GP cannot refuse to make a Right to Choose referral without a valid clinical reason. Being unfamiliar with the scheme or preferring to use local services are not valid clinical reasons.

If your GP refuses, ask for the refusal in writing with the clinical reason clearly stated. Bring a copy of the NHS England Right to Choose guidance to your next appointment — your GP may simply not be aware of the scheme. You can also ask to speak to the practice manager, or contact PALS at your local hospital trust for advice and advocacy support.

If the issue is not resolved at practice level, you have the right to escalate to your local Integrated Care Board. Template letters for Right to Choose referral requests are available through organisations such as ADHD UK and can be helpful to have in hand before your appointment.

Getting the most out of your ADHD assessment

Whether you go via Right to Choose, the standard NHS pathway, or privately, being prepared for your assessment will help you get the most accurate outcome.

Before your appointment, gather any evidence you have. For children, this means school reports, teacher observations, and any previous assessments. For adults, it means thinking back across your life — not just your current challenges, but how you functioned at school, in relationships, and across different jobs or environments. ADHD is a lifelong condition, and assessors will want to understand the pattern over time, not just your current presentation. There are also free screening tools available through ADHD UK where you can complete, print, and give to your GP.

It is also worth knowing that ADHD can look different depending on the person. Inattentive ADHD — which is more common in girls and often goes undiagnosed — tends to be less visible than the hyperactive presentation. People with inattentive ADHD may have developed coping strategies that mask their difficulties in an assessment setting. If this is a concern, mention it explicitly at the start of your appointment.

After diagnosis, take time to understand what the report says and ask questions if anything is unclear. A good report will not only confirm a diagnosis but explain how ADHD manifests for you specifically — and that information is useful for everything that follows: medication decisions, workplace adjustments, school support, and your own understanding of how you are wired.

Preparing for the conversation with your GP

Many people find the GP appointment the most daunting part of the process — particularly if they have been dismissed before.

It helps to go in prepared. Write down your key concerns before the appointment rather than trying to recall them in the moment. Be specific about how ADHD symptoms affect daily functioning — not just "I find it hard to concentrate" but what that means in practice at work, at home, and in relationships. If you are requesting a referral for a child, describe the impact at school, socially, and at home.

If your GP is unfamiliar with Right to Choose, you can bring a printed copy of the NHS England guidance or a short summary of the scheme. You are entitled to ask for a referral, and a prepared, calm, specific request is more likely to lead to a productive conversation than a general description of difficulties.

If your first GP appointment does not go as hoped, you can request a second appointment, ask to see a different GP at the same practice, or seek support from patient advocacy organisations before returning. Persistence, unfortunately, is often part of the process — but you are entitled to this referral, and knowing your rights makes the conversation considerably easier.