A diagnosis is the start of an arrangement, not the end of one. Who prescribes, who reviews you and what happens if your GP declines shared care are the questions that decide how the next few years go.
The diagnosis appointment tends to be treated as the finish line. In practice it is the moment a long-running arrangement starts, and the terms of that arrangement were mostly set earlier, when a provider was chosen.
Two things have to be true for you to receive ADHD medication through this pathway. The provider has to prescribe, and someone has to keep prescribing after the initial period.
NHS South West London ICB is clear that the first is not universal: not all Right to Choose providers can start medicine or prescribe it, and some only offer an assessment or diagnosis. It tells patients to discuss this with their GP before choosing a provider.
Where the provider does prescribe, the usual sequence is titration, meaning a period of adjusting the medicine and the dose while the effect and any side effects are monitored. Psychiatry-UK notes on its own page that if you are referred to its titration service there will be a delay between your assessment and starting treatment.
Shared care is the arrangement under which a specialist hands routine prescribing and monitoring to a GP practice once a patient is stable. NHS West and North London ICB describes it as a formal arrangement, and advises patients to confirm whether your GP would accept the provider's notice for shared care should you be prescribed medication.
The word to notice is accept. A GP practice is not obliged to enter a shared care agreement, and some decline. This is the single most common place where an otherwise successful Right to Choose journey stalls, and it is worth asking about long before you need the answer.
One board has published what happens on cost if they decline. NHS South West London ICB states that Right to Choose covers ongoing prescriptions if a GP does not agree to take over prescribing through a shared care protocol. That is one integrated care board writing about its own area, not a national rule, and no national rule was found that settles it. Boards differ, so check what your own has published rather than assuming this applies to you.
Do not read it as a guarantee that treatment continues. NHS England published the final report of the independent ADHD Taskforce in November 2025, and it says shared care protocols for ADHD have been available for many years but these have become more problematic in recent years with many arrangements no longer in place. The report includes a case study of a woman assessed through Right to Choose who responded well to medication and whose practice then did not agree to shared care, which the report says resulted in long delays in her getting access to ADHD medication. This is the step where this pathway most often fails after a diagnosis.
The comparison with paying privately still holds. NHS West and North London ICB warns, about the wholly private route, that the NHS may not pay for private prescription costs. If you paid for a private assessment rather than using Right to Choose, a declined shared care agreement leaves you buying prescriptions with no published coverage to fall back on.
What you pay at the pharmacy counter in England
£9.90
per item, unless exempt
The National Health Service sets a single prescription charge of £9.90 per item in England, checked on 15 September 2026. A 12-month prepayment certificate costs £114.50, which the National Health Service says saves money above 11 prescribed items in a year.
Ongoing ADHD medication involves periodic review. Who does that review is part of the arrangement, and it is fragile in a way that is rarely explained up front.
NHS South West London ICB spells out the failure mode: if your provider stops offering annual reviews, you will need a new assessment with a new provider, you can go through the NHS or Right to Choose or pay privately for one, and either way you will go on a waiting list.
That is a real risk to price in when choosing a provider, and it is an argument for asking what the review arrangement is and how long the provider has been running it, rather than only asking how soon it can see you.
Supply of ADHD medicines has been disrupted, and this is not something providers have hidden. Psychiatry-UK states on its Right to Choose page that due to global drug shortages patients may experience additional delays in prescribing medication for ADHD, and that waiting times may also be affected by the national ADHD medication shortage.
NHS England's ADHD taskforce page refers to global medication supply shortages which have impacted some patients, and NHS Lancashire and South Cumbria ICB cites extremely high levels of additional support required due to medication shortages over the past 18 months as one of the pressures on its services.
This site does not track which medicines are in short supply at any given time, because that changes and getting it wrong would be worse than saying nothing. Your prescriber and your pharmacy are the current answer.
One point worth carrying back through the whole process. NICE guideline NG87 states that ADHD should only be diagnosed by a specialist psychiatrist, paediatrician or other appropriately qualified healthcare professional with training and expertise in diagnosing ADHD, on the basis of three things taken together: a full clinical and psychosocial assessment of the person, including discussion about behaviour and symptoms in the different domains and settings of the person's everyday life; a full developmental and psychiatric history; and observer reports and assessment of the person's mental state. All three are required, which is what makes a short assessment identifiable as a short one.
No questionnaire, online screener or website can do that, including the checker on this site. A screening tool can tell you whether a conversation is worth having. It cannot tell you the answer.
NHS South West London ICB states that Right to Choose covers ongoing prescriptions if a GP does not agree to take over prescribing through a shared care protocol, so in that ICB's area the specialist provider keeps prescribing. That is one board's published position. Boards differ and no national rule was found that settles it, so confirm your own board's position and confirm the provider prescribes at all, because some only assess. If you were assessed privately rather than through Right to Choose, that protection does not apply, and NHS West and North London ICB warns that the NHS may not pay for private prescription costs.
It covers prescriptions, including first prescriptions used to stabilise medication, according to NHS South West London ICB. It does not follow that every provider prescribes: the same ICB warns that not all Right to Choose providers can start medicine or prescribe it and that some only offer an assessment or diagnosis, so check before the referral is sent.
NHS South West London ICB states that you will need a new assessment with a new provider, that you can do this through the NHS or Right to Choose or pay privately, and that either way you will go on a waiting list. This is why the review arrangement is worth asking about when you choose a provider rather than after a diagnosis.
NICE guideline NG87 states that ADHD should only be diagnosed by a specialist psychiatrist, paediatrician or other appropriately qualified healthcare professional with training and expertise in diagnosing ADHD, on the basis of three things together: a full clinical and psychosocial assessment covering behaviour and symptoms across the different settings of the person's everyday life, a full developmental and psychiatric history, and observer reports and assessment of the person's mental state. Online questionnaires, including anything on this site, cannot diagnose ADHD.