Many people seeking an ADHD diagnosis in the UK face a difficult decision: wait for an NHS assessment, or pay privately.
NHS ADHD services are experiencing some of the longest waiting times in the health system, with many areas reporting waits of two to five years — and some exceeding ten years. As a result, thousands of patients consider private assessments each year.
Scale of the challenge
As of late 2025, approximately 527,000 open ADHD referrals exist in England, with around 62% of adults having waited over a year. These figures help explain why the choice of pathway matters.
However, the differences between NHS and private ADHD diagnosis go beyond waiting times. Costs, medication access, and shared care agreements with your GP can all affect your treatment journey.
This guide explains how both pathways work so you can make an informed decision.
ADHD Diagnosis Pathways in the UK
You can currently access an ADHD assessment in three main ways:
- Standard NHS referral
- NHS Right to Choose referral
- Private assessment
Pathway overview
NHS local service
Wait: often 2–10+ years
Right to Choose
Wait: often 3–18+ months
Private clinic
Wait: often 2–8 weeks
NHS ADHD Diagnosis
The NHS provides ADHD assessments through specialist mental health services, often within neurodevelopmental teams or adult ADHD clinics.
How the NHS process works
GP appointment
Referral to local ADHD service
Waiting list
Clinical assessment
Diagnosis and treatment plan
Advantages of the NHS pathway
- Free at the point of use
- Medication prescribed through the NHS
- Shared care with your GP usually straightforward
Disadvantages
- Very long waiting times
- Limited specialist capacity
- Some services restrict adult referrals
NHS Right to Choose (Alternative NHS Pathway)
England only: Right to Choose applies in England only. If you are in Wales, Scotland, or Northern Ireland, different referral pathways apply — please check with your local NHS service for options in your area.
Under NHS Right to Choose rules, patients in England can legally choose their provider for their first outpatient appointment.
This means your GP may refer you to an NHS-funded provider outside your local area, which can significantly reduce waiting times.
Referral comparison
Standard NHS
Local provider only
Right to Choose
Patient can choose an alternative NHS-funded provider
Note: Some ICBs have paused all new ADHD assessment activity under Right to Choose until at least April 2026. Access and waiting times vary significantly by region. Patients should check current availability with their GP or chosen provider before requesting a referral.
For a full breakdown — including current ICB caps and what to say to your GP — read our dedicated ADHD Right to Choose guide.
Weighing up NHS, Right to Choose or private?
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Private ADHD Diagnosis
Private ADHD assessments are carried out by independent clinics and psychiatrists. These services are not funded by the NHS, meaning patients pay directly for assessments and treatment.
Private assessments can often be scheduled within a few weeks.
Private pathway
Cost Comparison
| Pathway | Assessment Cost | Medication Costs |
|---|---|---|
| NHS | Free | NHS prescription charges may apply |
| Right to Choose | Free | NHS prescription charges may apply |
| Private | £530–£2,300+ | £80–£200+ per month during titration |
Costs vary between providers. The average private adult ADHD assessment cost is around £1,267 based on 2025 data. Online assessments tend to be at the lower end of the range. Some clinics charge separately for follow-up consultations and medication reviews.
Weighing up private vs NHS for ADHD?
A care navigator can talk through the trade-offs based on your situation, including Right to Choose — written plan within 48 hours.
20-minute call · Written plan within 48 hours · Independent guidance
Waiting Time Comparison
| Pathway | Typical Wait |
|---|---|
| NHS local services | 2–10+ years in some areas (e.g. Herefordshire & Worcestershire, Leeds) |
| Right to Choose providers | 3–18+ months |
| Private clinics | 2–8 weeks |
Medication Access
ADHD medication is often recommended after diagnosis and may include:
- Methylphenidate
- Lisdexamfetamine
- Atomoxetine
- Guanfacine
NHS pathway
Medication is usually prescribed and monitored through the NHS. Standard NHS prescription charges apply, or patients may benefit from a Prescription Prepayment Certificate (PPC).
Private pathway
Patients typically pay privately for medication and titration appointments. Private medication costs can range from £80 to £200+ per month during the titration phase.
Shared Care Agreements
A shared care agreement allows a patient diagnosed privately to have medication prescribed by their NHS GP while the specialist continues to oversee treatment.
However:
- GPs are not legally required to accept shared care
- Some GP practices decline shared care agreements
- If shared care is refused, medication may remain private
Important
Shared care refusals have become a widespread and serious barrier. Several Local Medical Committees (LMCs) and Primary Care Networks (PCNs) have actively advised GPs to stop accepting new ADHD shared care agreements due to workload pressures. Patients should discuss this with their GP before committing to private assessment.
Read our full guide: Shared Care Agreements for ADHD
Which Pathway Is Right for You?
| Priority | Best option |
|---|---|
| Lowest cost | NHS referral or Right to Choose |
| Faster diagnosis | Right to Choose or private |
| NHS medication access | NHS or Right to Choose |
| Immediate assessment | Private clinic |
How Find Care Compare Can Help
Find Care Compare helps patients:
- Understand ADHD referral pathways
- Compare providers
- Explore NHS and private options