NHS, Right to Choose, or private - what each route really costs you

If you are trying to work out how to get an adult ADHD assessment in England in 2026, you have three routes available. This article describes each honestly, including the downsides of our own private route, so you can make a decision that is right for your situation.

Route 1: standard NHS referral

Your GP refers you to your local NHS adult ADHD service. It is free at the point of use.

The catch is that almost every NHS adult ADHD service in England is running a waiting list of between two and six years. Many services are closed to new referrals. Some local areas have told GPs not to refer unless symptoms are severe. Even when you reach the top of the list, the initial assessment is usually time-pressured and the titration period may be managed by a different clinician each time.

NHS-diagnosed patients are usually prescribed by the NHS specialist service during titration, then transferred to NHS primary care under a shared care agreement for ongoing prescribing. When this works it is excellent. When it does not, usually because a local ICB has not funded shared care or because the patient's GP practice does not accept new shared care patients, the patient ends up paying privately for prescriptions despite having an NHS diagnosis.

Best choice if: your symptoms are manageable, you are prepared to wait years, and your local service is accepting referrals.

Route 2: NHS Right to Choose (RTC)

If you live in England, you have a legal right to choose any qualified NHS-approved provider for your mental health care, funded by your local Integrated Care Board. This is Right to Choose, and it is the single most underused entitlement in NHS mental health.

Several providers hold NHS contracts to deliver adult ADHD assessments under Right to Choose. Your GP surgery will hold the current approved list for your ICB. You ask your GP to refer you to the approved provider of your choice. The assessment is free to you. If you are diagnosed, the provider starts your medication and then transfers you to your GP under a shared care agreement for ongoing prescribing.

Right to Choose is now heavily used and typical waiting times with the approved providers run to 12 to 24 months. Smaller regional providers have shorter lists but vary in quality. Some ICBs have quietly imposed funding caps that pause new RTC assessments.

A further practical issue is the shared care gap. Many NHS GPs decline to take on shared care for ADHD medication because they feel under-resourced to do so safely. If your GP refuses, you get passed back to the RTC provider, who then prescribes privately. Some RTC providers charge for private prescriptions in this situation. Some do not.

Best choice if: you are not in urgent need, you live in a region whose ICB is actively funding RTC, your GP is confident they can take over the shared care afterwards, and you are happy to wait six to twelve months.

Route 3: fully private

You book and pay for the assessment. You get the result fast. You continue with the private provider for prescriptions and monitoring, or you transfer to an NHS shared care arrangement later if your GP agrees.

The UK private ADHD market broadly splits into three tiers:

• Volume digital clinics, where the assessment is video-only and the model is optimised for throughput. Typical prices range from around £199 to £300 for the assessment, with ongoing care charged at £99 to £189 per month, plus separate medication costs. The weaker operators in this bracket have histories of hidden-fee practices and high titration churn.

• Mid-market clinics, where the assessment is in the £350 to £600 range, ongoing care runs around £130 to £170 per month, and medication and dispensing are typically included or bundled.

• Premium consultant-psychiatrist-led clinics, where the assessment can be £900 to £1,500 and ongoing care is billed per visit at £165 to £250.

LoveMyLife operates in the mid-market tier. Assessment is £395 online or £595 in person, first month of medication is included, and ongoing care is £149 per month including your medication, dispensed by our own on-site pharmacy.

Best choice if: waiting is not feasible, you want the assessment done by someone with time to do it properly, and you want continuity of care with the same clinical team rather than a revolving door.

What each route actually costs in year one

Figures below are indicative year-one costs in 2026, combining assessment and first year of ongoing care including medication where that is possible:

Volume digital private can look cheap on a sticker price but year-one total often lands higher than a bundled mid-market plan once titration visits, consumable fees and private prescription handling are added.

Our honest view

For many adults Right to Choose is the right choice if you can wait. It is free and the approved providers are competent.

If you cannot wait, or if you want a clinical team with in-house pharmacy dispensing, same-day medication, and a physical London clinic you can visit, private is the right choice. LoveMyLife sits in that mid-market tier. We will also support a transfer back to NHS shared care if your GP accepts it, rather than locking you into our system indefinitely.

You should never feel pressured to go private. If the NHS or RTC route is available and suits you, take it.

Ready to start?

If this article has made you think it is time to find out, the next step is a short consultation with one of our ADHD-trained GPs.

Begin your consultation at this link. Online in 30 minutes, or in person at Westfield London.