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 unsure what they can offer, and a patchwork of private options that vary hugely in quality and cost. This guide explains every option clearly, including one 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. Under the NHS Choice Framework (which sits within the Health and Social Care Act 2012), patients in England referred to a specialist for a first outpatient appointment can choose any clinically appropriate provider, including independent sector providers with 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. These providers are accredited by NHS England and offer ADHD assessments funded by the NHS at no cost to you. 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'll need to request each one separately from your GP. If you're seeking both, you can request both referrals at the same appointment; they will run independently and may complete at different times.

For autism Right to Choose, NHS England has been expanding approved providers, though availability varies more than for ADHD. It's worth checking the NHS England list or asking your GP surgery to confirm which autism providers are currently contracted in your area.

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

Three main routes exist, 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 accepted for 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 typically cost between £500 and £1,500. A shorter online assessment from a telehealth provider may cost less than £600; a face-to-face assessment with a consultant psychiatrist can cost upwards of £1,200. Ask providers what is included before booking: some quote a headline price that doesn't include the full report or a follow-up.

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

Other costs to factor in: once diagnosed you'll pay for prescriptions for a few months during titration before moving to shared care. For children especially, there may also be an annual clinic fee so you can remain on their books for regular checks and GP liaison.

What is a shared care agreement for ADHD medication?

Once you have an ADHD diagnosis, medication is often the next step. Stimulant medications such as methylphenidate and lisdexamfetamine are the most commonly prescribed. A shared care agreement is where the specialist manages initial prescribing and dose titration, then transfers ongoing prescribing responsibility to your NHS GP. This is standard practice and saves you from paying for private prescriptions long-term.

Shared care is not always straightforward. Some GP surgeries refuse, particularly when the diagnosis came from a private provider, which leaves you either paying for ongoing private prescriptions or returning to the specialist each time.

If your GP refuses, ask for the refusal in writing with a clinical reason. You can then request a review through your local Integrated Care Board, contact PALS, 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 currently quote four to twelve months for an initial assessment: significantly shorter than local NHS pathways, but not instant. Check each provider's website directly, as most publish current waiting times.

Some providers have temporarily paused new referrals due to demand. Keep a shortlist of two or three approved providers so you have alternatives ready if your first choice is closed or has a very long wait.

What to do if your GP refuses Right to Choose

Legally, your GP cannot refuse 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. You can also ask to speak to the practice manager, or contact PALS for advice and advocacy. Template letters for Right to Choose referral requests are available through organisations such as ADHD UK.

Getting the most out of your ADHD assessment

Before your appointment, gather evidence. For children: school reports, teacher observations, and any previous assessments. For adults: think back across your life, not just current challenges, but how you functioned at school, in relationships, and across different jobs. ADHD is a lifelong condition and assessors will want to understand the pattern over time. Free screening tools are available through ADHD UK to complete, print, and give to your GP.

Inattentive ADHD, more common in girls and often 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. A good report will confirm the diagnosis and explain how ADHD manifests for you specifically, which is useful for medication decisions, school or workplace adjustments, and your own understanding of how you're wired.

Preparing for the conversation with your GP

Write down your key concerns before the appointment. Be specific about how ADHD symptoms affect daily functioning: not just "I find it hard to concentrate" but what that means at work, at home, and in relationships. If requesting a referral for a child, describe the impact at school, socially, and at home.

If your GP is unfamiliar with Right to Choose, bring a printed copy of the NHS England guidance. You are entitled to ask for a referral, and a prepared, calm, specific request is more likely to lead to a productive conversation.

If your first appointment doesn't go as hoped, you can request a second, ask to see a different GP, or seek support from patient advocacy organisations before returning. Persistence is often part of the process, but knowing your rights makes the conversation considerably easier.