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NHS Free vs Private Paid. Which ADHD Path Is Right for You?

Both routes lead to the same destination - a proper ADHD assessment. The difference is cost, speed, and how you get there.

Free vs £500-£3,000
Cost comparison
8-20 wks vs 1-4 wks
Wait comparison
Same
Clinical standard

Quick answer: Right to Choose is NHS-funded and free. Private assessment costs £500 to £3,000. Both use qualified specialists. RTC typically takes 8 to 20 weeks. Private can be 1 to 4 weeks. For most people, Right to Choose is the better option unless speed is critical.

What Is the Difference Between Right to Choose and Private?

Right to Choose and private ADHD assessment both lead to the same outcome: a clinical assessment by a qualified specialist who can diagnose ADHD. The key differences are in how you access the service, what it costs, and how long you wait.

Right to Choose (NHS-funded)

Free

  • Referred by your GP under NHS funding
  • You choose the provider
  • Legal right under NHS Act 2006
  • Results go into your NHS records
  • Medication via shared care with GP
  • Wait: typically 8 to 20 weeks

Private Assessment

£500 - £3,000+

  • You book and pay directly
  • No GP referral needed in most cases
  • No legal guarantee of NHS acceptance
  • Results are private unless shared
  • Medication may require GP agreement
  • Wait: typically 1 to 4 weeks

With Right to Choose, your GP sends a referral to an NHS-funded provider of your choice. The assessment is paid for by the NHS. With a private assessment, you contact a private clinic directly, pay their fee, and are seen on their schedule. The clinical process is similar, but the funding route and follow-up care differ significantly.

How Much Does Private ADHD Assessment Cost?

Private ADHD assessment costs vary depending on the clinic, the level of detail in the assessment, and whether follow-up care is included. Here is a typical breakdown.

Initial screening or pre-assessment

£100 to £300. Some clinics offer a shorter screening before committing to a full assessment. This is not a diagnosis but helps determine whether a full assessment is worthwhile.

Full diagnostic assessment

£500 to £1,500. This is the main assessment, usually lasting 1 to 3 hours. It includes a clinical interview, symptom history, and often standardised questionnaires. Some clinics include a written report in this price. Others charge separately.

Comprehensive assessment with report

£1,000 to £2,500. Includes a detailed written report suitable for workplace adjustments, educational support, or insurance claims. Often includes a follow-up appointment.

Ongoing medication management (private)

£150 to £400 per appointment. If your GP does not agree to shared care, you may need to pay for ongoing private prescribing. This adds up quickly - potentially £1,000+ per year on top of the assessment cost.

By comparison, Right to Choose costs you nothing. The assessment, report, and initial medication (if prescribed) are all covered by the NHS.

Is the Quality of Assessment the Same?

Yes. Both Right to Choose and private assessments are carried out by qualified professionals, typically psychiatrists or specialist nurse prescribers with ADHD training.

Right to Choose providers must meet NHS clinical standards to receive NHS funding. Private clinics set their own standards, but reputable ones follow the same NICE guidelines (NG87) that govern NHS assessments.

The assessment process is similar in both routes. It usually includes a detailed clinical interview covering childhood and adult symptoms, the impact on daily life, information from someone who knew you as a child (where possible), and standardised screening tools such as the DIVA or ASRS.

One advantage of Right to Choose is that the diagnosis automatically sits within your NHS records. A private diagnosis may need to be separately communicated to your GP, and some GPs are more willing to accept NHS-pathway diagnoses than private ones.

What Happens After Diagnosis on Each Route?

After RTC diagnosis

  • Diagnosis letter sent to your GP
  • Provider initiates medication if appropriate
  • Shared care agreement set up with GP
  • GP takes over ongoing prescriptions
  • Full NHS record of diagnosis
  • No additional cost to you

After private diagnosis

  • Report sent to you (and GP if you consent)
  • Private clinic may prescribe medication
  • GP may or may not accept shared care
  • If GP refuses, you pay for private prescribing
  • May need NHS re-assessment in some areas
  • Ongoing costs possible

The biggest difference after diagnosis is medication access. With Right to Choose, the pathway to NHS-funded medication is clearer. The provider sets up a shared care agreement, and your GP continues prescribing. With a private diagnosis, some GPs refuse to enter shared care arrangements, leaving you paying privately for ongoing medication management.

Can I Start Private and Switch to NHS?

Yes, but it is not always straightforward. Here is what typically happens.

If you get a private diagnosis and your GP accepts it, they may agree to prescribe medication under shared care. In this case, you have effectively "switched" to NHS management after the initial private cost.

However, some GPs and some local areas do not accept private ADHD diagnoses. In these cases, you may be asked to join the local NHS waiting list for a second opinion, or you may need to continue paying privately.

You can also start a Right to Choose referral while pursuing a private assessment. This way, if the private route works out, you are covered. If not, you still have the NHS referral progressing. There is no rule against having both in progress at the same time.

Key point

Starting with Right to Choose gives you a cleaner path to ongoing NHS care. Starting private can be faster but may create complications if your GP does not accept the diagnosis or refuses shared care.

Which Route Should I Choose?

The right choice depends on your situation. Here is a simple way to think about it.

If budget is tight

Choose Right to Choose

It is free. The assessment and initial medication are NHS-funded. You pay nothing out of pocket.

If speed is critical

Consider Private

Private assessment can happen within 1 to 4 weeks. If waiting 8 to 20 weeks is not an option, private is faster.

If you want NHS records

Choose Right to Choose

The diagnosis sits in your NHS file automatically. Medication is prescribed through your GP. No acceptance issues.

For most people, Right to Choose is the better option. It costs nothing, produces an NHS-recognised diagnosis, and creates a clear path to medication and ongoing support. The only real advantage of private assessment is speed, and even then, the cost can be significant.

Full Comparison: RTC vs Private vs NHS Standard

Feature Right to Choose Private NHS Standard
Cost to patient Free £500 - £3,000+ Free
Typical wait 8 - 20 weeks 1 - 4 weeks 1 - 5+ years
Provider choice You choose from approved providers You choose any private clinic Assigned by local NHS
Medication access Via shared care with GP Private prescribing or GP (if accepted) Via NHS pathway
Ongoing care NHS-funded via GP Private (or GP if shared care agreed) NHS-funded via GP
Legal basis NHS Act 2006, Section 75 No legal right to NHS acceptance NHS Constitution
Assessment quality NICE-compliant, qualified specialists Varies by clinic (reputable ones follow NICE) NICE-compliant, qualified specialists
NHS records Automatic Only if GP accepts and records it Automatic
GP referral needed Yes Usually no Yes

Frequently Asked Questions

Is Right to Choose really free?

Yes. Right to Choose is NHS-funded. You do not pay for the assessment or the initial consultation. The cost is covered by the NHS in the same way as any other NHS referral.

Is a private ADHD diagnosis accepted by the NHS?

It depends on your GP and local area. Some GPs accept private diagnoses and will prescribe medication under shared care. Others may require a second NHS opinion before prescribing. There is no national policy guaranteeing acceptance.

Can I use Right to Choose if I have already had a private assessment?

Yes. Having a private assessment does not remove your right to an NHS-funded assessment through Right to Choose. You can still request a referral from your GP.

How long does Right to Choose take compared to private?

Right to Choose typically takes 8 to 20 weeks from referral to assessment. Private assessment can be as fast as 1 to 4 weeks, depending on the provider and your willingness to pay.

Do Right to Choose providers prescribe medication?

Yes. Most Right to Choose providers can initiate medication if you are diagnosed. They then set up a shared care agreement with your GP for ongoing prescriptions.

What if I cannot wait 8 to 20 weeks?

If speed is critical, private assessment is faster but more expensive. Some people choose to start a Right to Choose referral and pursue a private assessment in parallel, then decide which route progresses first.

Not Sure Which Route to Take?

My ADHD Path helps you navigate the entire ADHD journey, whether you choose Right to Choose, private, or both. Compare providers, understand your options, and get clear next steps.

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