NHS and private routes compared

Two routes, one goal

Whether you go through the NHS or a private provider, the aim of an ADHD or autism assessment is the same: a thorough, evidence-based evaluation carried out by a qualified clinician, following recognised frameworks such as NICE guideline NG87 for ADHD and NICE guidance for autism. The difference lies mainly in how the assessment is funded, arranged and accessed, rather than in the clinical standard that should be applied.

The NHS route

To access an NHS assessment, you would typically start with your GP, who can discuss your concerns and, where appropriate, refer you to a local specialist service. NHS services are subject to national oversight and quality standards, and care is generally free at the point of use.

Waiting times for NHS assessments vary considerably depending on where you live and local demand, so it's best to ask your GP or local service directly for current information rather than relying on general figures. Many areas have significant demand for these services, and it's worth asking about interim support while you wait, such as guidance on managing symptoms, accessing school or workplace adjustments, or peer support groups.

The private route

Private assessments are arranged directly with an independent clinic or clinician, usually with payment made by the individual or family. This can offer more control over timing and clinician choice. As covered in our guide to private assessments, it's important to check the qualifications, registration and regulation of any provider you consider.

Costs vary widely between providers, and there is no fixed or "typical" price — always ask for a full, written fee schedule before booking, including whether reports, follow-up appointments, or medication reviews are included.

What is NHS Right to Choose?

NHS Right to Choose is a policy that, in principle, allows patients in England to ask to be referred to a different provider for their first consultant-led appointment, which in some cases can include independent providers who have an NHS contract for this purpose. This means some people can access an assessment via a provider outside their local NHS trust, while remaining within NHS-funded care.

Right to Choose is not available or applied in the same way everywhere, and eligibility, provider lists and processes can change. If you're interested in this option, the best step is to speak with your GP about what is currently available in your area and whether you meet any relevant criteria.

Comparing the routes

Some general, non-numerical points to consider:

• Cost: NHS and Right to Choose routes are typically free at the point of use; private assessments are paid for directly, with costs varying between providers.
• Waiting times: These vary by route, location and provider, and can change over time — always ask for current information rather than assuming.
• Choice of clinician: Private routes, and sometimes Right to Choose, may offer more flexibility in choosing who carries out your assessment.
• Continuity of care: Consider how any diagnosis will connect to ongoing support, including prescribing arrangements, follow-up care, and communication with your GP.
• Regulation: Look for clinicians registered with bodies such as the GMC, HCPC or NMC, and services regulated by the CQC or equivalent.

Making a decision that's right for you

There's no single "correct" answer — the right route depends on your circumstances, local availability, personal preferences and finances. Some people combine approaches, for example starting with their GP to explore Right to Choose options while also researching private providers as a backup.

Whatever you decide, keep your GP informed where possible. They can help coordinate care, are often central to prescribing arrangements after diagnosis, and can offer support regardless of which assessment route you take.

A note on medication and ongoing care

If an assessment leads to a diagnosis and medication is considered appropriate, decisions about specific medicines and doses are clinical matters for you and a qualified prescriber to discuss. This guide is educational and cannot offer medical advice — please speak to your GP or specialist clinician about your individual situation.

Final thoughts

Both NHS and private routes can lead to a proper, evidence-based diagnosis. The key is choosing regulated, transparent providers, asking plenty of questions up front, and keeping communication open with your GP throughout the process.

Thinking about your local NHS picture

Every part of the UK organises its NHS mental health and neurodevelopmental services slightly differently, and the demand for ADHD and autism assessments has grown substantially in many areas in recent years. This means the experience of accessing NHS assessment can differ significantly from one region to another, and even within the same area over time. Rather than comparing your experience to what you've heard about other areas, it's often more useful to ask your own GP practice or local service directly what the current situation looks like.

The role of your GP throughout the process

Your GP is often the central point of contact regardless of which assessment route you take. They can help you understand local referral pathways, discuss whether Right to Choose might apply to your situation, and provide continuity of care afterwards, including supporting any shared-care arrangements for prescribing that might be needed following a diagnosis. Keeping your GP informed, even if you pursue a private assessment independently, can make the overall journey smoother, particularly if you later need prescriptions, referrals, or letters for other purposes such as workplace or educational adjustments.

Weighing up personal circumstances

Beyond cost and waiting times, personal circumstances often shape which route feels right. Some people value the predictability of paying privately and having more control over scheduling, particularly around work or caring commitments. Others feel strongly that they would prefer to stay within NHS-funded care for continuity reasons, or simply cannot afford private fees, which is a completely valid consideration given that costs vary so widely.

It can also help to think about how urgently you feel you need answers, how flexible your schedule is, and whether ongoing prescribing and monitoring feel more straightforward through one route or the other in your local area. There is no obligation to decide quickly, and taking time to gather information from a few different services, plus a conversation with your GP, often leads to a more confident decision.