Right to Choose ADHD Medication Waiting Times: Is Private ADHD Assessment a Faster Option?
If you've started looking into an ADHD assessment, you've probably come across Right to Choose (RTC). For many adults in England, Right to Choose has transformed access to ADHD assessments by allowing patients to choose an NHS-funded independent provider rather than waiting for their local NHS ADHD service.
However, while many people are diagnosed more quickly through Right to Choose, an increasing number are discovering that the longest wait often comes after diagnosis—when trying to access ADHD medication.
In this article, we'll explain why medication waiting times have become so long, how private ADHD assessment compares with Right to Choose, and why many patients ultimately end up in exactly the same place: receiving NHS prescriptions through a Shared Care Agreement with their GP.
What is Right to Choose for ADHD?
Right to Choose is a legal right available to most NHS patients registered with a GP in England. It allows patients to choose an NHS-contracted provider for their first outpatient appointment, including ADHD assessments where eligible.
For many years, this pathway has helped patients avoid local NHS waiting lists, which in some areas can exceed several years.
However, although assessment waiting times have often been shorter, the same has not always been true for medication.
Why are Right to Choose medication waiting times so long?
1. Demand has increased dramatically
Over the last five years, awareness of ADHD has grown significantly. More adults are recognising symptoms that have affected them throughout their lives and are seeking assessment and treatment.
While this is undoubtedly positive, demand has increased much faster than the number of clinicians available to provide specialist prescribing.
2. Medication requires specialist monitoring
Unlike many other medications, ADHD treatment requires careful titration.
Patients usually need several appointments to:
select the most appropriate medication
gradually increase the dose
monitor blood pressure, pulse and weight
assess effectiveness
identify side effects
ensure treatment remains safe.
These appointments must usually be provided by specialist prescribers, and there simply are not enough clinicians to meet current demand.
3. Medication shortages
National shortages of ADHD medication have also slowed treatment pathways over recent years. Prescribers have had to adjust treatment plans, delay titration or switch medications depending on availability.
4. Assessment capacity has grown faster than prescribing capacity
Many providers have successfully increased the number of assessments they offer. Unfortunately, prescribing services have not expanded at the same pace.
This means that while patients may receive a diagnosis relatively quickly, they can then join another waiting list before medication can begin.
A changing Right to Choose landscape
Another important consideration is that the Right to Choose pathway itself is becoming increasingly complex.
Recent NHS England consultation documents have acknowledged the rapid growth in ADHD assessments delivered through Patient Choice and the considerable financial pressures this has created for NHS commissioners. NHS England is reviewing commissioning arrangements, costs and service specifications as part of wider reforms. (NHS England)
At the same time, investigations have found that a growing number of Integrated Care Boards (ICBs) have introduced limits or financial controls on ADHD assessment activity through Right to Choose providers. These arrangements vary considerably across England and continue to evolve. (The Guardian)
For patients, this means there is increasing uncertainty about:
which providers are available through Right to Choose
how long waiting lists may become
whether providers can continue accepting new referrals at the same rate
how quickly medication services can be accessed.
Although Right to Choose remains an important legal entitlement for many patients, local commissioning decisions are making access more variable than it was only a few years ago.
Is private ADHD assessment faster?
In many cases, yes.
Private ADHD clinics generally have much shorter waiting times because they are not constrained by NHS commissioning budgets or referral allocations.
Patients can often expect:
assessment within a few weeks
diagnosis on the day of assessment where appropriate
medication titration to begin shortly afterwards
rapid access to follow-up appointments
direct communication with their GP.
For people whose ADHD symptoms are significantly affecting employment, education, relationships or mental health, earlier treatment can make a substantial difference.
Will I have to pay privately forever?
This is probably the biggest misconception about private ADHD care.
The answer is usually no.
Once medication has been stabilised and the correct dose established, many private specialists will write to your GP requesting a Shared Care Agreement.
If your GP agrees—and many do when they are provided with a comprehensive specialist assessment and treatment plan—they can take over prescribing your medication on the NHS while your ADHD specialist continues to provide periodic reviews.
This means many patients pay privately only for:
their assessment
medication titration
follow-up appointments until stable.
After that, ongoing prescriptions are frequently issued by the GP under shared care arrangements.
Although shared care is always at the discretion of the GP practice and local NHS policies, many patients ultimately receive exactly the same long-term outcome as those who entered treatment through NHS or Right to Choose pathways.
Right to Choose vs Private ADHD Assessment
The biggest difference is often time—not the end result.
Right to Choose
Private ADHD Assessment
NHS funded assessment
Self-funded assessment
Waiting times vary considerably
Usually much shorter waiting times
Medication waiting lists may be several months or longer
Medication often starts shortly after diagnosis
Subject to local commissioning arrangements
Independent of ICB commissioning restrictions
Shared care may be offered once stable
Shared care may also be offered once stable
For many patients, both routes ultimately lead to the same destination: effective treatment, ongoing specialist reviews and NHS prescribing through shared care where this is agreed by their GP.
Which option is right for you?
There is no single right answer.
If cost is the most important factor and you are happy to wait, Right to Choose remains an excellent option for many people.
However, if your ADHD symptoms are having a major impact on your quality of life, work, studies or relationships, investing in a private assessment may allow you to begin effective treatment much sooner.
As the Right to Choose landscape continues to evolve and NHS commissioning arrangements change, many patients are choosing private assessment because it provides greater certainty about waiting times and access to treatment.
Frequently Asked Questions
Is Right to Choose faster than the NHS?
Usually yes, although waiting times vary depending on the provider and local commissioning arrangements.
Why is ADHD medication taking longer than the assessment?
Medication requires ongoing specialist appointments, careful dose adjustments and monitoring, creating a bottleneck due to limited prescribing capacity.
Can I move from private ADHD care to NHS prescriptions?
Often yes. Once medication has been stabilised, many patients transfer prescribing to their GP under a Shared Care Agreement, subject to GP agreement and local NHS policy.
Is Right to Choose changing?
National discussions around commissioning, costs and funding mean that some Integrated Care Boards are introducing local restrictions or activity limits. While Right to Choose remains available, access is becoming more variable across England.
Final thoughts
Whether you choose Right to Choose or a private ADHD assessment, the goal is the same: obtaining an accurate diagnosis, accessing effective treatment and improving your quality of life.
For many people, the deciding factor is simply how quickly they want to begin that journey.
References
ADHD UK. (2026). Right to Choose. https://adhduk.co.uk/right-to-choose/
NHS England. (2025). 2026/27 NHS Payment Scheme – A consultation notice: Part A – Policy proposals. https://www.england.nhs.uk/long-read/2026-27-nhsps-consultation-proposals/
NHS England. (2026). Changes to the 2026/27 NHS Payment Scheme following consultation. https://www.england.nhs.uk/long-read/2026-27-nhsps-consultation-change-log/
NHS England. (2026). 2026/27 NHS Payment Scheme: ADHD and Autism payment guidance. (Supporting guidance published alongside the NHS Payment Scheme.) https://www.england.nhs.uk/long-read/2026-27-nhsps-consultation-proposals/
NHS England. (2026). Medium-term planning framework: Delivering change together 2026/27 to 2028/29. (Planning guidance for Integrated Care Boards and NHS organisations.) (Use the NHS England planning framework URL if cited in your article.)
The Guardian. (2026, January 15). NHS limiting number of ADHD assessments despite soaring demand.
The Guardian. (2025, July 7). Charity prepares legal challenge after NHS board pauses ADHD referrals for over-25s.
