If you are looking into a private ADHD assessment, read this page first. There is an NHS route that costs you nothing, and for many people it is the better option. It is also, in a number of areas, currently blocked — and knowing which of those applies to you is the whole decision.
What Right to Choose actually is
In England, when a GP refers you for a physical or mental health condition, you generally have a legal right to say where that referral goes. The NHS puts it plainly: “If a GP needs to refer you for a physical or mental health condition, in most cases you have the legal right to choose the hospital or service you’d like to go to.” That includes independent providers, so long as they hold an NHS contract and the referral costs the NHS no more than a standard one.
Applied to ADHD, this means you are not restricted to your local NHS assessment service and its waiting list. You can name a provider that holds an NHS contract for adult ADHD assessment, and ask your GP to refer you there instead.
The assessment is then NHS-funded. You pay nothing. If you are asked for money, what you are being offered is not a Right to Choose referral.
Two limits are worth stating at the top. It applies in England only — not Scotland, Wales or Northern Ireland. And it covers your first outpatient appointment, not every part of what follows.
How to use it
Check the provider first. Look at who currently holds an NHS contract for adult ADHD assessment and will accept a referral from your area. Providers publish their own waiting times; those numbers move, so read them on the day rather than trusting a figure from a forum post.
Then book a GP appointment. You are asking for a referral to a named provider under Right to Choose. It helps enormously to arrive with the provider’s own referral form already downloaded, and a short covering note saying which provider you want and why you are asking. Practices process these faster when the paperwork is already in front of them.
Your GP does not need permission from the Integrated Care Board. A Right to Choose referral does not require prior ICB approval. This is the single most common reason referrals stall — a practice believing approval is needed and waiting for it. If that happens, saying so politely and in writing usually resolves it.
You cannot self-refer. The referral has to come from the practice.
Typical eligibility across providers is that you are 18 or over, registered with a GP in England, living in England at referral, assessment and treatment, and able to use a video appointment. If you move out of England partway through, you usually have to transfer to local services.
Why it may not be available where you live
This is the part that has changed, and most guidance online has not caught up.
In early 2025, NHS England proposed capping what it would pay Right to Choose providers at around £100,000 per Integrated Care Board area. ADHD UK campaigned against it and the proposal was dropped in April 2025. The right itself survived.
What happened instead was quieter and, for a lot of people, has the same effect. From late 2025, individual ICBs began issuing Activity Management Plans — agreements that cap how many assessments a provider may book once a funding threshold is reached. Special Needs Jungle reported in November 2025 that at least nine areas had told independent providers to stop booking new Right to Choose assessments, in some cases until April 2026, naming Hampshire and Isle of Wight, Surrey Heartlands, Frimley, Black Country, West Yorkshire, Greater Manchester, North Central London, and Coventry and Warwickshire, the last of these pausing referrals for people over 25.
North East and North Cumbria ICB told Pulse it had “temporarily agreed revised activity plans” with providers for new autism and ADHD assessments between January and March 2026, in response to “exceptionally high levels of demand”, and said people referred during 2025/26 “may experience longer initial waiting times”. GPs described the practical result differently. Dr Paul Evans, chair of Gateshead LMC, told the same publication that some providers were declining referrals because the activity plan prevented them progressing to assessment, and that there was “no end date for this freeze on activity”.
The legal right has not been removed. What has been restricted is the funding that makes it work. From where you are sitting the distinction is academic: either a provider will take your referral or it will not.
So check before you plan around it. Ask the provider directly whether they are accepting Right to Choose referrals from your ICB at the moment. ADHD UK maintains information on restrictions by area, and it is worth looking at before your GP appointment rather than after.
Deciding between the NHS route and paying
Here is the honest comparison, which is not the one a private clinic usually offers.
Right to Choose is the better option when it is open to you. It costs nothing, the assessment is done to NHS standards by a specialist service, and if you are diagnosed, medication titration is usually included. The trade-off is time. Waits at Right to Choose providers have lengthened substantially, and in the restricted areas above they are currently indefinite.
Your local NHS service remains an option and in some areas is no slower than the alternatives. It is worth asking what the actual wait is rather than assuming.
Paying privately makes sense in narrower circumstances than the marketing suggests. It is worth considering when Right to Choose is closed in your area and you do not want to wait for it to reopen; when the wait, wherever you look, is measured in years and the cost of those years is real — a job at risk, a course you are failing, a relationship under strain; or when you have already been assessed and need a second opinion or a medication review rather than a first diagnosis.
It is not worth paying if Right to Choose is open where you live and you can wait. You would be buying speed, nothing else.
What paying actually buys, and what it does not
If you do go privately, be clear about the boundaries before you spend anything.
An initial psychiatric assessment at Happy Clinic is £400 for 60 minutes, and follow-up or titration reviews are £200 for 20 minutes. Fees checked September 2026; the fees page has the current list.
The medication is where the cost keeps going. A diagnosis on its own changes little. What helps is finding the right medication at the right dose, and that takes a run of titration appointments, not one. Our guide to what a private psychiatrist costs sets out the realistic total rather than the headline figure.
Shared care is not guaranteed. The usual plan is that once you are stable, your GP takes over prescribing under a shared care agreement, at NHS prescription cost. GPs are entitled to decline, and some practices decline all private ADHD shared care as a matter of policy. If they do, you continue paying private prescription costs indefinitely. Shared care agreements explained covers how to ask your practice about this before you commit.
A private diagnosis is not a shortcut into NHS services. It does not move you up an NHS waiting list, and some NHS services will want to repeat the assessment themselves before taking over prescribing.
If you are waiting
Waiting badly is worse than waiting. A few things are worth doing regardless of which route you end up on.
Ask your GP practice now, in writing, what their position is on shared care for ADHD medication started elsewhere. The answer determines what any route costs you in the long run, and it is much better known in advance.
Keep a record while you wait — school reports, old appraisals, anything that documents difficulties before the age of 12. Assessment relies on evidence of childhood symptoms, and that evidence is easier to gather over months than in the week before an appointment.
And if what is actually happening is that you are struggling now, ADHD assessment is not the only thing available. In England you can refer yourself to NHS talking therapies without a GP, and those services treat the anxiety and depression that frequently sit alongside undiagnosed ADHD. That is not a substitute for assessment. It is something useful you can access this month rather than next year.
Where this site stands
Onlinepsychiatrist.co.uk is published by the people who run Happy Clinic, and Happy Clinic provides private assessments that you pay for. We have written a page telling you to try the free NHS route first because that is the honest order to try them in, and because a patient who pays for something they did not need is not a good outcome for anyone.
If Right to Choose is open where you live, use it. If it is not, and waiting is genuinely costing you something, what an ADHD assessment involves sets out what you would be paying for.
Speak to a Consultant Psychiatrist
Book a secure video consultation with Happy Clinic, for adults aged 18 and over anywhere in the UK. No GP referral is needed and appointments are often available within days.
This page is general information and is not a substitute for personal medical advice. Consultations, diagnosis and prescriptions are provided by Happy Clinic, which is registered with the Care Quality Commission (CQC). If you are in crisis, call 999, go to A&E, call NHS 111 or call Samaritans free on 116 123.