Adult ADHD Assessment UK: NHS vs Private

Compare NHS and private routes for an adult ADHD assessment in the UK — waiting times, costs, shared care, Right to Choose, and how to pick the best option.

A private ADHD assessment is often the quickest way to a firm diagnosis and a treatment plan if you want clarity fast and can afford it. If you’d rather not pay and can tolerate the wait, the NHS route is safe, evidence-based, and free at the point of use. In England, Right to Choose sits somewhere in between—NHS-funded but typically faster than a local service. The best choice depends on your timeline, budget, and whether your GP can support shared care for medication afterwards.

What does an adult ADHD assessment in the UK usually include?

A proper adult ADHD assessment in the UK looks at your story over time, not just today’s symptoms. It includes:

Pre-questionnaires, ADHD rating scales (e.g., ASRS), mental health screeners, and sometimes forms for a partner or family member.
A clinical interview that lasts 60–120 mins to know about childhood history, school reports if available, study/work patterns, sleep, mood, substance use, and medical history.
Check for other conditions, such as anxiety, mood disorders, autism traits, thyroid issues, and learning differences.
How symptoms affect your daily functions, such as deadlines, driving, money, relationships, and admin.
Feedback & plan, whether ADHD criteria are met, and what is next (skills, therapy, medication, adjustments).
A structured report you can share with your GP or workplace.

Whether you choose NHS or private, the bones of the process should be similar: careful history, evidence-based criteria, and a clear write-up.

NHS ADHD assessment: what to know?

On the NHS, you usually start with your GP. They’ll consider your history and, if appropriate, refer you to local adult ADHD services. Real talk: waiting times vary widely. In some areas, it’s months; in others, it can be over a year. For many, that wait is the biggest drawback.

Strengths of the NHS assessment

No direct cost to you for assessment, titration, or prescriptions.
Integrated care with access to psychology, occupational therapy, and other NHS services.
Medicines are managed within familiar NHS systems, and shared care is straightforward because you’re already “in-house”.

Common challenges

Long waits and fewer appointment slots.
Shorter follow-ups in busy clinics.
Less choice over clinician or appointment times.

Right to Choose (England only)
If local waits are long, you can ask your GP for Right to Choose—an NHS-funded assessment with an approved independent provider. It’s still NHS care, just delivered by a partner organisation, often with faster access. You’ll need to check the provider list and your GP’s process; it’s perfectly reasonable to bring printouts and politely ask.

Private ADHD assessment UK: what to know?

A private ADHD assessment in the UK can be booked directly—often within weeks rather than months. You’ll meet a psychiatrist or a suitably qualified clinician who specialises in adult ADHD. Costs vary by region and provider, but a realistic ballpark is:

Assessment (including report): typically £500–£1,200+.
Medication titration package: £300–£800+ (several follow-ups).
Ongoing reviews: £100–£250 each.
Prescriptions: private prescriptions carry medication costs; NHS ones do not (standard charges apply).

Strengths of private assessment

Speed and flexibility: evenings, remote options, and choice of clinician.
Extended consultation time, often with detailed reports useful for work or university support.
Potentially quicker start to titration (dose-finding) with closer monitoring at the outset.

Common challenges

Cost, obviously.
Shared care is not guaranteed: your GP is not obligated to take over prescribing after a private diagnosis. Many do—but they can decline if the report is weak or the provider isn’t aligned with NHS
You’ll need to check quality carefully (see “red flags” below).

Quick comparison: NHS vs private

Waiting time

NHS: free but can be long.
Private: fast, usually weeks.
Right to Choose: NHS-funded, often mid-range waits.

Cost

NHS: £0 for assessment and prescriptions (normal NHS charges apply).
Private: assessment + titration + follow-ups can run to four figures over a year.

Medication and titration

NHS: integrated titration, easy conversion to repeat prescriptions.
Private: titration is usually well supported; continuing on NHS relies on shared care from your GP (ask first).

Choice and convenience

NHS: limited choice; local clinic determines timing.
Private: broad choice of clinicians, remote appointments, and out-of-hours slots.

Aftercare

NHS: routine reviews, access to wider services.
Private: depends on provider; make sure reviews and letters are included or clearly priced.

Shared care agreements: the bit people forge

A shared care agreement means your GP is willing to continue prescribing the ADHD medication after a private specialist has stabilised your dose. This is where many plans wobble.

Before you book privately:

Ask your GP (gently, in writing if possible) whether they’ll enter shared-care with your chosen provider.
Pick a provider known to the local ICB (integrated care board) and aligned with NHS
Ensure your private package includes clear titration notes and a detailed discharge letter with diagnosis, rationale, dose, and monitoring plan.

No shared care? You can still remain entirely private—but factor prescription and review costs into your long-term budget.

What “good quality” looks like (NHS or private)?

Qualified assessor: a consultant psychiatrist or an appropriately trained clinician supervised within a medical service.
Thorough history: childhood onset, functional impact, collateral information where possible.
Screening for other causes: thyroid, sleep disorders, substance use, mood/anxiety, autism traits.
Measured approach to meds: evidence-based choices, clear titration plan, side-effect monitoring (blood pressure, pulse, weight, sleep).
Comprehensive report: diagnostic criteria referenced, functional examples, and a plan you can follow.
Aftercare: how often reviews happen, who to contact, what to do if side effects appear.

Red flags

“Tick-box only” assessments with minimal interview time.
Guaranteed diagnosis language (“99% of clients qualify”).
No plan for titration or physical monitoring.
Vague reports your GP can’t use.

Costs in context: value vs price

An adult ADHD assessment in the UK is an investment either way—time or money. A good private assessment might cost more up front. But if it gets you treated three to twelve months sooner, the productivity gains (and stress reduction) can dwarf the fee. NHS care is free, yes, and equally valid; the opportunity cost is the wait. There’s no right answer for everyone—just the right answer for you.

Getting ready (whichever route you choose)

Keep a 2–4 week symptom diary: attention, forgetfulness, tasks started vs finished, impulsive moments, sleep, caffeine.
Collect collateral: old school reports, appraisals mentioning focus or deadlines, emails that show patterns (redact personal details).
List your top three difficulties:g., “losing track of multi-step tasks”, “time blindness in meetings”, “paperwork avoidance”.
Know your goals: fewer missed deadlines, safer driving focus, less anxiety around admin.
Plan support: employer adjustments, study support, coaching or CBT, and practical tools (timers, calendars, checklists).

After the diagnosis: what actually changes?

Diagnosis is the starting line, not the finish. Expect:

Titration: several short appointments to find the right dose and formulation.
Lifestyle tweaks: sleep hygiene, exercise, structured planning (chunk tasks, externalise reminders).
Skills and therapy: CBT for ADHD, coaching, or occupational therapy strategies.
Workplace or university support: reasonable adjustments, note-taking help, deadline flexibility.
Regular reviews: at least once a year, once stable.

With a decent plan, many people report calmer days, better follow-through, and much less shame about “why can’t I just do it?”. Because now you know why, and you’ve got tools.

Pros & cons at a glance

NHS

Pros: Free; integrated systems; easy prescriptions once onboard.
Cons: Long waits; fewer choices; time-pressed reviews.

Right to Choose (England)

Pros: NHS-funded with better availability; legitimate providers; faster than local in many areas.
Cons: Still some wait; provider choice is limited to the approved list.

Private

Pros: Fast access; choose your clinician; flexible scheduling; detailed reports.
Cons: Costly; shared care not automatic; need to vet quality carefully.

FAQs

Will my GP accept a private diagnosis?
Often, yes—if the report is robust and the provider is reputable. But GPs can decline shared care. Ask your practice about their policy before you book privately.
How long does titration take?
Anywhere from 4 to 12 weeks, sometimes longer, depending on response and side effects. Expect short check-ins every 1–3 weeks at first.
Can I start with therapy instead of medication?
You can. Many benefit from CBT for ADHD and coaching. Medication (when appropriate) can make those strategies easier to use.
Is remote assessment valid?
Yes—if it’s thorough, uses structured criteria, and includes identity checks, collateral, and physical monitoring arrangements.

So… NHS or private? Final thoughts

If you want the fastest path and have the budget, private is the path of least resistance—just secure shared care first. If you’re comfortable waiting and want integrated support without fees, the NHS is absolutely solid. If you live in England and the local queue is daunting, Right to Choose is a strong middle ground. Either way, a well-run adult ADHD assessment in the UK should feel detailed, collaborative, and respectful.