Waiting times
NHS waiting times for adult ADHD assessment are currently between three and five years in most parts of England, with some local services reporting waits of six years or longer. Waiting times vary significantly by area: rural and underfunded areas tend to have longer waits than major urban centres, though even in London the wait is typically well over two years.
Private assessment with a quality provider can typically be arranged within days to a few weeks of booking. Distinct assessments are generally available within a week of booking, with the written report following within a further seven days. For someone who has been experiencing significant difficulties and has been waiting, the contrast is substantial.
Clinical standards
The diagnostic criteria are the same regardless of route. Both NHS and private assessments follow DSM-5 criteria and NICE guidelines for adult ADHD. A correct diagnosis is a correct diagnosis: the clinical validity of the outcome does not depend on whether it was reached through an NHS or private service.
In practice, NHS assessments vary considerably in quality depending on the service. Some NHS ADHD services are excellent: well-staffed, thorough, and with robust follow-up support. Others are under significant pressure and may offer briefer assessments with less comprehensive follow-up. Similarly, private assessments vary in quality depending on the provider and the seniority of the assessing clinician.
Both NHS and well-run private services typically use the DIVA-5 structured interview alongside validated symptom rating scales. The key clinical variable in both settings is the seniority of the clinician conducting the assessment and the time available for the consultation.
Cost
The NHS route is free at the point of use for those eligible. There are no assessment costs, and if medication is prescribed through the NHS, it is available at the standard prescription charge (currently £9.90 per item in England, or free for those with exemptions).
Quality private assessments cost between £700 and £1,200 for a consultant psychiatrist-led assessment. Distinct charges £799 all inclusive. Following a private diagnosis, medication obtained through NHS shared care is available at standard prescription charges. Private prescribing, if shared care is not available, adds an ongoing monthly cost for medication and monitoring.
"The NHS route is free but not fast. The private route is fast but not free. Which matters more depends entirely on your circumstances."
Medication access
Following an NHS diagnosis, medication is prescribed and monitored directly through the NHS. The GP typically initiates prescribing based on a recommendation from the assessing service, with ongoing monitoring at the practice level or under a shared care arrangement with the specialist service.
Following a private diagnosis, medication access depends on whether the GP will enter into a shared care arrangement. NHS England guidance indicates that GPs should not routinely refuse to take on prescribing following a diagnosis from a qualified specialist, but practice-level variation is significant and some GPs do decline. For people whose GP is willing to engage, the practical experience of medication access is similar to the NHS route once shared care is established.
The medication itself is the same regardless of route: the same drugs, in the same doses, at the same standard prescription charge if obtained through the NHS. For more detail on navigating the GP conversation after a private diagnosis, see our guide to sharing your report with your GP.
The written report
NHS services do not always produce a comprehensive written diagnostic report in the format expected by employers, universities, and the DVLA. Some do, but the specific format and content varies between services. People who need documentation for workplace adjustments, DSA applications, or DVLA disclosure following an NHS diagnosis sometimes find that they need to request additional documentation from the service, which can take time.
Private assessments with quality providers typically produce a comprehensive written report as a standard part of the assessment package. A Distinct report includes the full diagnostic document, a GP letter, and supporting letters for employers and universities on request, delivered within seven days of the assessment.
Right to Choose: a middle option
Right to Choose is a statutory right that allows patients on an NHS waiting list to request assessment by any CQC-registered provider offering the relevant NHS service. It is an NHS-funded route that can provide faster access than the local waiting list, without the full cost of a private assessment.
In practice, Right to Choose does not eliminate waiting times: the chosen provider may itself have a waiting list, and national capacity for Right to Choose services is limited. It does, however, represent a legitimate route to faster NHS assessment for those who are on a waiting list and cannot afford private assessment. For a fuller account, see our guide to Right to Choose for ADHD assessment.
Don't want to wait three to five years?
Distinct assessments are typically available within days. Full report within 7 days.
Which route is right for you?
The NHS route remains a good option for people who are not experiencing severe difficulties, who have time to wait, and for whom the financial cost of private assessment would represent hardship. The NHS produces valid diagnoses and, once assessment is complete, offers integrated treatment and support through the same service.
The private route makes most sense for people who are experiencing significant difficulties at work, in relationships, or in daily functioning that they cannot sustain for three to five more years without support; for people who need documentation now for an employer, university, or the DVLA; and for people for whom the cost of the assessment is manageable relative to the benefit of faster access to diagnosis and treatment.
Going private does not remove you from the NHS waiting list, and some people choose to pursue a private assessment while remaining on the NHS list. A private diagnosis can also be used to inform a Right to Choose referral, or to support a GP conversation that would not otherwise have been possible.
NHS waiting times quoted reflect the position in England as of April 2026 and vary significantly by area. Check with your local ADHD service or GP for current waiting times in your area.