Right to Choose ADHD Assessments: Why Diagnosis Isn’t Always the End of the Wait
For many adults in England, NHS Right to Choose has made getting an ADHD assessment much more accessible.
Instead of facing a wait of several years through a local NHS service, eligible patients may be able to ask their GP for a referral to an NHS-funded Right to Choose provider. In some cases, that can reduce the wait for an assessment from years to weeks or months.
That can make an enormous difference.
But there is something that is easily overlooked when comparing providers:
Getting assessed more quickly does not always mean getting treated more quickly.
For a growing number of people, the longest wait now comes after the diagnosis.
An ADHD assessment is only one part of the process
Receiving a diagnosis can bring clarity and, for some people, a huge sense of relief.
But it does not necessarily mean treatment starts straight away.
Depending on what somebody needs, the next stage might involve medication, titration, physical health monitoring, follow-up appointments, psychological support or practical help with managing ADHD in everyday life.
This is where the experience can vary significantly between Right to Choose providers.
Some providers offer assessment, diagnosis and medication titration as part of the same pathway. Others may have much more limited prescribing capacity, or separate waiting lists for treatment.
So someone can go from:
“I’ve been waiting years to be assessed.”
to:
“I finally have a diagnosis, but now I’m waiting again for medication.”
Understandably, that can be difficult — particularly for someone who has already spent a long time trying to get help.
Why titration can become the next bottleneck
If medication is recommended, treatment does not usually begin and end with a single prescription.
There is normally a period of titration, where the medication and dose are adjusted gradually to find what works best for that individual.
During titration, the clinician will usually look at things such as how well symptoms are responding, whether there are side effects, and whether physical health monitoring is needed.
For some Right to Choose patients, the wait to begin titration can now be considerably longer than the wait for the assessment itself.
ADHD UK publishes regularly updated information about Right to Choose waiting times, and one of the clearest things this shows is how much variation there can be between providers — particularly when assessment and treatment waits are compared.
That is why it is worth asking more than one question when choosing a provider.
Not just:
“How long will I wait for an assessment?”
but also:
“If I’m diagnosed and want medication, how long will I wait for titration?”
and:
“What actually happens after the assessment?”
Those questions can give you a much clearer idea of the overall pathway.
Why are post-diagnosis waits getting longer?
There is no single explanation.
Demand for ADHD assessment has grown rapidly, while the number of clinicians able to prescribe and manage ADHD medication has not necessarily increased at the same pace.
At the same time, Right to Choose has created a much broader network of providers, and those providers do not all operate in exactly the same way.
NHS England has acknowledged variation in ADHD service models and the potential for care to become fragmented when different parts of the pathway are delivered by different organisations.
There are wider concerns too, including differences between providers, communication between services, continuity of care, access to medication, commissioning arrangements, regulation and the overall cost to the NHS.
The Parliamentary and Health Service Ombudsman has also highlighted problems caused by fragmented ADHD and autism pathways and called for clearer, more consistent national guidance.
For patients, the practical consequence is simple: a fast assessment is useful, but it is not the whole story.
Right to Choose can still be an excellent option
None of this means Right to Choose is a poor route to ADHD care.
For many people, it remains one of the best ways of accessing an ADHD assessment more quickly than they would through their local NHS service.
The important thing is to look at the whole pathway, not simply the first appointment.
Before choosing a provider, it is worth finding out what happens at each stage.
Ask about the assessment
How long is the current waiting time?
Who will carry out the assessment?
What does the assessment involve?
Ask about medication
Does the provider offer titration?
How long is the current titration wait?
Who will prescribe medication during treatment?
What happens once the right medication and dose have been found?
Ask what happens after diagnosis
Will you stay with the same provider?
Is ongoing care available?
What happens if the provider cannot offer the treatment you need?
Knowing the answers in advance can help avoid an unexpected second wait.
What if you already have an ADHD diagnosis?
If you have already been assessed, you may not necessarily need to begin the entire process again.
This is particularly relevant for people who have received an ADHD diagnosis through the NHS, Right to Choose or another provider but are now struggling to access medication, titration or ongoing care.
Attention to Health offers a private transfer-of-care pathway for people who already have an ADHD diagnosis, subject to clinical suitability.
This begins with a transfer-of-care appointment, where the existing assessment, diagnosis and supporting documentation are reviewed.
Where appropriate, care can then include medication continuation, medication review, titration and ongoing prescribing.
So if you already have a diagnosis but feel you are stuck waiting for the next stage, there may be another route forward.
Already diagnosed and waiting for medication?
You can approach Attention to Health for titration and ongoing medication care, subject to a clinical review and suitability.
This can be particularly helpful for people who have completed an assessment but are facing a long delay before treatment begins.
Still need an ADHD assessment?
Attention to Health also provides a full private ADHD assessment pathway.
This can include assessment, diagnosis and treatment planning, so people who are at the beginning of the process can access support through the same service.
Already taking ADHD medication?
For people who are already on treatment, Attention to Health may also be able to provide transfer of care, medication reviews, ongoing prescribing and annual reviews, again subject to clinical suitability.
The aim is to support people at different points in the process rather than assuming everybody starts in the same place.
Some people need an assessment from the beginning.
Others already know they have ADHD and simply need help moving on to treatment.
Look beyond the assessment waiting time
When you have already been waiting a long time for answers, it is natural to focus on one question:
“How quickly can I get diagnosed?”
But diagnosis is only one stage of ADHD care.
If medication or ongoing treatment is likely to be important to you, it makes sense to look at the full pathway:
Assessment → Diagnosis → Titration → Medication → Ongoing care
rather than only:
Assessment → Diagnosis
For some people, Right to Choose will still be the most suitable route.
For others — particularly those who already have a diagnosis but are facing a long wait for medication — private transfer of care or titration may provide a more direct route into treatment.
At Attention to Health, we work with people at both stages: those who need a full ADHD
References and further information
NICE — Attention deficit hyperactivity disorder: diagnosis and management (NG87)
Guidance on the assessment, diagnosis and management of ADHD, including medication and non-pharmacological treatment.
https://www.nice.org.uk/guidance/ng87
NHS England — Patient Choice Guidance
Information about patient choice and NHS referral rights, including Right to Choose.
https://www.england.nhs.uk/long-read/patient-choice-guidance/
NHS England — 2026/27 ADHD and Autism Payment Guidance
Guidance on commissioning and payment arrangements for ADHD and autism assessment and treatment services, including assessment, titration and ongoing care.
https://www.england.nhs.uk/wp-content/uploads/2026/03/26-27NHSPS-SD-ADHD-and-Autism-Payment-Guidance.pdf
Parliamentary and Health Service Ombudsman — National guidance needed to improve ADHD and autism care
Findings on increasing complaints, fragmented care and the need for more consistent ADHD and autism services.
https://www.ombudsman.org.uk/news-and-blog/news/national-guidance-needed-improve-adhd-and-autism-care
Parliamentary and Health Service Ombudsman — Improving access to ADHD and autism assessment and treatment
Further information about the challenges identified through complaints and engagement with patients and services.
https://www.ombudsman.org.uk/publications/improving-access-adhd-and-autism-assessment-and-treatment-commissioning
BBC News — Concerns about the cost of Right to Choose ADHD and autism services
Reporting on rapidly increasing NHS expenditure on Right to Choose services.
https://www.bbc.co.uk/news/articles/cy4zgpynwdjo
The BMJ — ADHD and autism assessment and treatment services
Discussion of current issues around commissioning, regulation and access to ADHD and autism assessment.
https://www.bmj.com/content/394/bmj-2026-100679
The Guardian — Rising complaints and problems accessing ADHD and autism care
Reporting on increasing complaints, regional variation and delays in ADHD and autism treatment.
https://www.theguardian.com/society/2026/aug/26/autism-adhd-care-complaints-england-triple-five-years
ADHD UK — Right to Choose waiting times
Information and regularly updated waiting-time information for Right to Choose ADHD providers.
https://adhduk.co.uk/right-to-choose/right-to-choose-wait-times/
Attention to Health — Our Process
Information about ADHD assessment, transfer of care, medication and titration at Attention to Health.
https://athealth.uk/what-we-offer/our-process
