NHS, Right to Choose or private?

Written by Peter Corkhill MSc, Content Editor. Last reviewed September 2026.

I’m writing this in mid-September 2026, as the already considerable number of people on waiting lists for an ADHD assessment in England is still rising.

For a growing number of adults and children, receiving their formal diagnosis of ADHD (a recognised neurodevelopmental condition affecting attention, activity and impulse control) has brought hope and relief that a doorway to useful support and a better understanding of how ADHD affects that particular person is now open. It shouldn’t be underestimated how this diagnosis can also help people stop blaming themselves for ways they handled situations in the past that felt confusing, upsetting or beyond their control.

The chance for people not yet diagnosed to get to the bottom of these difficulties with the help of an NHS-funded specialist assessment therefore has real appeal. Where ADHD is diagnosed, the next step may involve understanding it better, finding practical ways to manage its effects, making adjustments at work, school or home, or considering medication.

For those who choose medication, there are often several stages involved. You may have heard the word titration, and wondered what it means. So, titration is the process of starting your meds at an appropriate dose and then adjusting and monitoring that dose to find the one that provides useful benefits without unacceptable side effects. Sometimes, though, this needs to be repeated with different medications until the right one is found, although of course, not everyone with ADHD needs or wants medication, and the right approach will always depend on the individual.

Assessment routes

Within the United Kingdom, the assessment routes open to you are the local NHS pathway and a private, self-funded assessment. In England, however, if you’re eligible for an assessment, you can also ask your GP for an NHS referral, which is still funded by the NHS, through Right to Choose with a qualifying provider.

Preparing for assessment

The nature of ADHD itself, and those it affects, means that no two people are affected in exactly the same way, so the most useful preparation will also be personal, and while rehearsing answers or seeking ways to make it more obvious that you have ADHD may seem like a safer bet, they can and probably will work against you. The best approach is to think about how the symptoms you think you’ve identified have affected you in different areas of your life, to gather relevant information and to consider actual examples that come to mind or that you can recall. These really are ways that may help the clinician obtain a clearer picture. Check out the reflection record or the interactive checklists on the main site to see these and other ways to identify symptoms and recall things which might help.

Pressure on the system

There are bigger problems in the ADHD diagnosis world though and they are not only the long waiting lists. On 28 August 2026, The Guardian newspaper reported that the NHS Alliance, a body representing health managers, had issued warnings that the costs of meeting the huge demand for ADHD and autism services in England were “running out of control” and that the current position had become “unsustainable”. The report was worrying for many of those wanting assessment and although it did consider ADHD and autism services together (rather than providing separate figures for each condition) it was still enough to ring some alarm bells in the ADHD community. In fact, one integrated care board (ICB or a local NHS body responsible for planning and funding health services in its area) reported that its monthly spending had risen from £146,000 in 2024–25 to £1.5 million in the following year. One ICB was now working with 80 providers, while another had seen the number of providers submitting invoices rise from between 12 and 14 to 48 in just two years.

CQC registration

One concerning point was that ICBs had also raised questions about quality assurance and regulation, particularly where providers were able to offer assessments but not continuing care. However, the reference to “non-regulated providers” risked placing some providers in an unfairly poor light. The Care Quality Commission (CQC), the independent regulator of health and social care services in England, had clarified in March 2026 that providers offering ADHD or autism diagnosis without treatment did not need to register with it. These providers which now lie outside the requirement to register with the CQC can still employ well-qualified practitioners and carry out thorough and high-standard assessments. For services which do not offer anything beyond the assessment itself, anyone wanting or needing further treatment or support, however, should check in advance who would or could provide it and how it would be accessed in practice.

NHS guide prices

I also want to clear up any confusion with NHS England’s 2026/27 introduction of non-mandatory guide prices for ADHD services funded by the NHS. These shouldn’t be used to estimate the cost of a private assessment and are only guide prices or average prices and are there to help the NHS agree a payment rate with the providers. For an adult ADHD assessment it is £850 face-to-face and £700 virtually. For a child or young person, it’s £950 face-to-face while the price of a virtual assessment is agreed between the parties.

You may have seen these figures published but they are nothing to do with what a completely self-funding private patient might be charged. Private providers do still set their own prices and decide what’s included in those prices such as the assessment fee or perhaps a written report, medication, titration, follow-up appointments and continued prescriptions if a GP declines shared care.

Free preparation tools

The ADHD Junction site has been developed for you to zero in on the information you actually need without having to work through loads of other stuff until you get to it. There are a few interactive reminders and checklists which we hope you might find useful before you book an assessment or go to one you’ve already booked. Check them out if you like, they don’t cost anything and anything you save is stored locally on your device for your eyes only unless you share or save a copy elsewhere. It’s not sent to ADHD Junction.