NHS vs Private ADHD Assessment: An Honest Comparison

If you suspect you have ADHD, the question of NHS versus private is usually the most practical one to answer first. This article gives an honest comparison of the three UK routes (standard NHS, Right to Choose in England, and private) covering what each offers, what each costs, how long each takes, and what each means for ongoing medication.

The three routes

In England:

• Standard NHS ADHD assessment via GP referral to your local adult ADHD service.
• Right to Choose in England, where the GP refers you to any NHS-contracted provider you choose.
• Private assessment with a CQC-registered provider, self-funded.

In Scotland, Wales and Northern Ireland, Right to Choose does not apply in the same form. The realistic options are NHS referral or private assessment.

Waiting times

The most significant practical difference between the three routes.

• Standard NHS: waits run from many months to several years depending on region. In some ICB areas, the wait for adult ADHD assessment exceeds three years.
• Right to Choose: waits are typically considerably shorter than the local NHS service, though they vary by provider. Some providers offer assessment within months.
• Private: depends on the provider. NeuroFX typically offers assessment within weeks rather than months.

The long NHS wait is a question of NHS capacity rather than any individual service, and the situation has worsened over the past decade as recognition has outpaced commissioning. This is why both Right to Choose and private assessment exist as alternatives.

What the assessment covers (all three routes)

NICE NG87 sets the same diagnostic standard regardless of route ^[1]. A NICE-aligned assessment covers:

• A full clinical interview with a clinician trained in adult ADHD
• A developmental history, ideally with informant input where possible
• Use of a structured tool such as the DIVA-5 to support the diagnostic decision
• A differential diagnosis review for anxiety, depression, sleep, trauma, autism and other co-occurring conditions
• A written report with diagnostic conclusion and treatment recommendations

What varies between routes is not the standard but the time, the cost, the choice of clinician, and what happens with medication afterwards.

Cost

• Standard NHS: free at the point of use.
• Right to Choose: free at the point of use. The provider invoices the NHS.
• Private: paid out of pocket. NeuroFX adult ADHD assessment is currently £950, with separate fees for any subsequent prescribing, medication review and QbCheck where used. Specific current fees are listed on the booking page.

For a wider read on private assessment cost, what private adult ADHD assessment actually looks like covers it in detail.

Medication and shared care

This is the most important practical difference between routes.

Standard NHS

Medication is prescribed and managed by the NHS service. Long-term shared care with the GP is the norm once stable.

Right to Choose

Medication is initiated under the NHS contract. Once stable, shared care with the GP is requested. Whether the local ICB accepts shared care varies. Where the ICB does accept it, the patient transitions to NHS prescribing through their GP. Where the ICB does not accept it, the Right to Choose provider continues prescribing under NHS funding.

Private

Medication is initiated privately by the assessing clinician. Once stable, the patient can ask the GP for shared care. ICB acceptance again varies. Where shared care is accepted, the patient transitions to NHS prescribing through their GP, with the GP usually requesting an annual review by the private clinician. Where shared care is declined, ongoing prescribing remains private.

NeuroFX private prescribing is currently £55 per month, with medication reviews every 6 to 12 months at £250. A detailed read on the shared care question is in what does a good ADHD diagnosis look like.

What about the quality of the assessment?

A common concern is whether a private assessment will be taken seriously by the NHS afterwards. The honest picture:

• A NICE NG87-aligned assessment from a CQC-registered provider should be accepted by the NHS. CQC registration is the regulatory benchmark.
• Some GPs and ICBs are more cautious about private diagnoses than others, often because of historical experience with rushed online providers.
• Choosing a provider that follows the full NICE pathway, uses standard assessment tools (DIVA-5, full clinical interview, informant input) and produces a clear written report makes onward acceptance considerably more likely.
• The reverse can also be true: a NICE-aligned private report sometimes opens NHS doors that the patient could not access through standard referral.

NeuroFX is CQC-registered and follows the NICE NG87 pathway in full. Reports include all elements needed for the NHS to consider shared care where the ICB allows it.

Choosing between the three routes

Most patients consider:

• How urgent the question is. Standard NHS waits make this the slowest route. Right to Choose is faster; private is fastest.
• The cost they can absorb. Standard NHS and Right to Choose are NHS-funded. Private requires out-of-pocket payment.
• Whether they want a specific clinician or provider. Right to Choose and private both offer this.
• What they want from medication management. Standard NHS and Right to Choose are more likely to lead to NHS shared care. Private depends on the ICB.
• Geography. In Scotland, Wales and Northern Ireland, only NHS referral and private are available.

For many patients in England, Right to Choose is the first option to consider, with private as a fallback when Right to Choose waits are still longer than they need or when the provider they prefer is not available through Right to Choose.

What this means in practice

• Get the question of waiting time answered first: ask your GP what the local NHS service offers, then look at Right to Choose options in England, then consider private if neither fits.
• Choose any provider on the basis of CQC registration and NICE-aligned methodology, not on price or speed alone.
• Be clear about your medication plan before committing. The shared care question matters more than the assessment question for long-term cost.
• A private report from a NICE-aligned CQC-registered provider should travel well through NHS systems. Some ICBs are more cautious than others; it is worth checking yours in advance.

When to speak to a professional

Speak to your GP first; that is the entry to standard NHS and Right to Choose, and also a useful conversation if you are considering private. NeuroFX offers private adult ADHD assessment from our Bedford clinic and also accepts Right to Choose referrals for ADHD in England. Seek same-day help via 111 (or 999 in an emergency) for any mental health crisis.

Sources

1. NICE. Attention deficit hyperactivity disorder: diagnosis and management. NG87. National Institute for Health and Care Excellence. https://www.nice.org.uk/guidance/ng87
2. NHS England. Your choices in the NHS. https://www.england.nhs.uk/contact-us/yhc/your-choices-in-the-nhs/
3. Care Quality Commission. CQC registration. https://www.cqc.org.uk/
4. British National Formulary. https://bnf.nice.org.uk/