If you’re registered with a GP in England, NHS Right to Choose lets you ask for an NHS-funded ADHD assessment with a provider you choose, so you don’t pay for the assessment. But in October 2026 some areas limit or prioritise these referrals, and waits depend on the provider and your area. A private assessment costs money, but the clinic sets the wait, and you pay for treatment too unless your GP later agrees to shared care.
In short
- Right to Choose applies in England only. Scotland, Wales and Northern Ireland have no equivalent, and NHS access there goes through your local health board or trust.
- In October 2026 some integrated care boards (ICBs) cap, waitlist or prioritise Right to Choose ADHD referrals. Hampshire and Isle of Wight, for example, says people already waiting will only be offered an assessment in 2027 if they meet its criteria.
- A private assessment is paid for by you, with a wait set by the clinic. Medication and reviews are also private unless your GP agrees to shared care.
- Shared care is voluntary on both routes. Your GP can say no for any reason.
- Some areas allow you to wait in only one assessment pathway at a time, so check before you pay for a private assessment while on an NHS list.
Status in October 2026 (checked 8 October 2026)
- NHS England. The 2026/27 payment guidance (March 2026) sets non-mandatory guide prices. It says independent providers’ diagnostic reports “should be accepted by NHS commissioned titration services, unless there is a clear clinical reason not to”. It doesn’t set local activity limits: ICBs agree those with providers.
- Hampshire and Isle of Wight ICB (September 2026). People waiting for a Right to Choose assessment “will only be offered an assessment in 2027 if they meet prioritisation criteria”. A single point of access starts in phases from 1 October 2026, and patients “can only be actively waiting within one assessment pathway at a time”.
- Bristol, North Somerset and South Gloucestershire ICB (7 January 2026). Providers have an indicative activity limit for the year. Once it’s reached, new referrals “should not be declined” but waitlisted “until the following financial year”.
- Reported elsewhere. North East and North Cumbria ICB agreed temporary revised activity plans with providers for January to March 2026. The ICB said referrals weren’t being stopped, while a local GP committee chair described a pause (Healthcare Leader, 28 January 2026).
- Tracker (secondary source). Finally Seen reported in June 2026 that adult ADHD Right to Choose was “capped or paused” in 12 of the 30 commissioners that still exist. Its list is illustrative, so check your own ICB.
- Health Service Ombudsman (August 2026). ADHD and autism complaints rose from 410 in 2021/22 to 1,257 in 2025/26. In one case an ICB wrongly refused a patient their chosen provider, and the ombudsman recommended it reimburse the patient’s private costs.
If you’re weighing it up, read this alongside what a private ADHD assessment costs, and see how our adult ADHD assessment and child and young person ADHD assessment work.
How does NHS Right to Choose work for ADHD?
The NHS Choice Framework says that when you’re referred for a mental health service “led by a consultant or mental health professional”, you can choose the provider for your first outpatient appointment. It applies to people of all ages in England. The steps are:
- Check the right applies to you. You have no legal right to choose if you’re already receiving care and treatment for the condition and this is an onward referral, if you’re using urgent or crisis services, if you’re a prisoner, held under the Mental Health Act, or a serving member of the armed forces.
- Ask your GP practice to refer you. Your GP decides whether a referral is clinically appropriate and may need to follow local steps, so check your ICB’s website or ask the practice how it works in your area.
- Choose a provider with an NHS contract. Ask whether it accepts referrals from your area, its current wait for new patients (one ICB says providers should publish this), whether it sees children, and whether it offers titration and ongoing prescribing rather than diagnosis only. LMC guidance says GPs should warn patients if a provider can’t commit to local shared care protocols.
- Wait for triage and assessment. If the provider has reached its yearly limit, your referral may be waitlisted until the next financial year. Keep a note of your referral date.
- After the assessment. The provider sends a report. What comes next, such as titration and NHS prescriptions, depends on its NHS contract. Shared care with your GP is still voluntary.
What if your GP won’t refer you, or your ICB says no?
If a referral is clinically appropriate, you’re entitled to a choice of eligible providers. If you think you’ve been refused that choice, ask the practice for the reason in writing, then contact your ICB. If you’re still not satisfied, you can complain to the Parliamentary and Health Service Ombudsman, whose August 2026 report found a case where an ICB wrongly refused a patient their chosen provider.
How does Right to Choose compare with going private?
| Compare | NHS Right to Choose (England) | Private assessment |
|---|---|---|
| Cost of the assessment | Free to you | You pay. Typical ranges are about £500 to £1,500 for adults and £800 to £2,000 for children (see our cost guide) |
| Wait | Varies by provider and area. Some areas prioritise referrals, and some waitlist new ones until the next financial year | Set by each clinic. Ours is typically within days |
| Where it’s available | England only, usually through a GP referral | Anywhere in the UK. We assess people living in any UK nation |
| Your choice | You choose the provider and clinical team, not usually the individual clinician | You choose the clinic and can ask who will assess you |
| Medication after diagnosis | Depends on the provider’s NHS contract, because some only diagnose. NHS prescriptions carry the usual charge in England (£9.90 per item in 2026/27) unless you’re exempt | Private prescriptions, plus the pharmacy’s price for the medicine, unless your GP agrees to shared care |
| Shared care with your GP | Can be more straightforward if the provider follows local protocols, but your GP can still decline | Up to your GP and local policy. Some practices decline all private requests |
| Children and teens | The right applies at any age, but check that your provider sees children | Clinics set their own age limits. We assess ages 6 to 17 |
When might each route suit you?
Right to Choose may suit you if:
- you live in England and can wait
- you want the assessment funded by the NHS
- your ICB is accepting referrals and the provider’s wait is acceptable to you
- the provider also offers titration and ongoing prescribing under its NHS contract
A private assessment may suit you if:
- you need an answer sooner, for example before a job, course or school transition
- your area has paused or restricted Right to Choose, or you’ve been told you won’t be seen until next year
- you live in Scotland, Wales or Northern Ireland, where there’s no Right to Choose (read ADHD assessment in Scotland, Wales and Northern Ireland)
- you’re comfortable paying for the assessment and understand that treatment costs may follow
Neither route can promise a diagnosis or NHS prescribing. A private diagnosis isn’t a shortcut to NHS prescribing either: your GP makes that decision separately, as will the NHS accept a private ADHD diagnosis? explains.
Can you use both routes at once?
Some areas only let you wait in one assessment pathway at a time, so you may be asked to choose between your local NHS service and a Right to Choose provider. If you have a private assessment while on an NHS list, tell your GP and the NHS service, because it may change what happens to your referral. If you already hold a diagnosis, remember the Choice Framework gives no legal right to choose for an onward referral about a condition you’re already being treated for. The 2026/27 NHS England guidance says NHS-commissioned titration services should accept independent providers’ reports unless there’s a clear clinical reason not to, but local services differ.
Next step
Ready for an adult ADHD assessment?
A 60-minute assessment by secure video with a consultant psychiatrist, after short online questionnaires. You get a written report and plan within 48 hours. No GP referral needed. It costs £289.
Common questions
Can I use Right to Choose for my child?
Yes, the right applies at any age in England. Fewer providers may see children, so check the provider’s age range and wait for children before your GP refers you. Children’s pathways in some areas are commissioned separately, so ask your ICB.
Does Right to Choose cover ADHD medication?
Sometimes. The NHS pays for the assessment and, if the provider offers it, titration, within the limits your ICB has agreed with that provider. Prescriptions are NHS prescriptions, so the usual charge applies in England unless you’re exempt. Check what the provider offers before you choose.
How long is the Right to Choose wait in 2026?
There’s no single national figure. Waits depend on the provider and your ICB, and in some areas new referrals are waitlisted until the next financial year or prioritised (see the status box above). Check the provider’s published wait for people in your area, and ask your GP practice.
Can I switch to Right to Choose after a private diagnosis?
Right to Choose covers a first outpatient appointment, so it may not apply if you already have a diagnosis and are being treated for it. Ask your GP and ICB what your area offers to people with a private diagnosis, such as a review or NHS titration. Some services review private diagnoses before prescribing.
Sources
- GOV.UK. The NHS Choice Framework: what choices are available to me in the NHS? Updated 23 October 2024.
- NHS England. 2026/27 NHS Payment Scheme: ADHD and autism payment guidance, sections 2 and 4.4. March 2026.
- Hampshire and Isle of Wight ICB. Key updates: autism and ADHD assessment services. September 2026 update.
- NHS Bristol, North Somerset and South Gloucestershire ICB. Freedom of information response FOI.ICB-2526/326. 7 January 2026.
- Healthcare Leader. ICB sets limits on Right to Choose ADHD and autism assessments. 28 January 2026.
- Finally Seen. ICB Right to Choose status. Updated 17 June 2026. Secondary source.
- Parliamentary and Health Service Ombudsman. Improving ADHD and autism services: commissioning with confidence. August 2026.
- Wessex Local Medical Committees. Understanding shared care, NHS Right to Choose and private providers. July 2026.
- British Medical Association. Prescribing in general practice. Updated 28 April 2025.
- Community Pharmacy England. NHS prescription charges frozen for the second year running. 21 November 2025.
