Right to Choose compared with a private assessment
The comparison people make is price against speed. The comparison that matters is what happens to prescribing afterwards, and what the NHS will accept if you come back.
The short version
- One ICB states Right to Choose covers ongoing prescriptions if a GP declines shared care; the private route has no equivalent published position.
- NHS West and North London ICB warns that the NHS may not pay for private prescription costs.
- Transferring to the NHS after a private assessment generally means joining at the beginning of the waiting list.
- A new assessment may be required even if one has already been carried out privately.
Both routes end with a diagnostic opinion, which is why they get compared on price and waiting time. The difference that actually shapes the following decade is what each one leaves behind it.
Prescribing after the diagnosis
On Right to Choose, NHS South West London ICB states that the cost of any ADHD prescriptions, from both NHS and private organisations, will be covered, including first prescriptions to help stabilise medication, and ongoing prescriptions if a GP does not agree to take over prescribing through a shared care protocol.
That last clause is the one that matters, and it is one board's position about its own area rather than a national rule. It is also not a guarantee that the arrangement holds: NHS England's final ADHD Taskforce report of November 2025 says many shared care arrangements are no longer in place, and gives a Right to Choose case study in which a practice's refusal caused long delays in the patient getting medication.
On a wholly private route there is no equivalent. NHS West and North London ICB raises it as a careful consideration about follow-up care, noting ongoing responsibility for the costs of any medication and prescribing, because the NHS may not pay for private prescription costs.
Coming back to the NHS
People often plan to go private and then transfer. NHS South West London ICB describes what that involves: to join an NHS service for assessment, or to transfer mid-treatment to the NHS, you or your child will generally join at the beginning of the waiting list, and a new assessment may also be required even if one has already been carried out by a private provider.
Read that twice before paying. A private assessment buys an answer. It does not buy a position in an NHS queue, and it may not be accepted as the assessment when you reach the front of one.
What the comparison looks like honestly
| Question | Right to Choose | Wholly private |
|---|---|---|
| Who pays for the assessment | The NHS, as an ICB describes it: providers, NHS and private, paid for by the NHS | You, at a price set by the clinic |
| Who can refer | Only a GP | Usually self-referral to the clinic |
| If your GP declines shared care | One ICB states ongoing prescriptions are covered, though boards differ and the national report records arrangements failing | You may be responsible for medication and prescribing costs |
| Transferring into NHS care later | Already NHS-funded care | Generally join at the beginning of the waiting list, and a new assessment may be required |
| Waiting time | Not promised, and capped funded volumes sit behind it | Set by the clinic, and paid for |
The decision underneath the decision
The right question is not which route is faster. It is which route leaves you with someone willing to prescribe and review in two years' time.
That makes the shared care conversation worth having with your GP practice before you commit to either route, because the answer changes which one is the cheaper mistake.
Questions people ask about this
Should I pay privately or wait for Right to Choose?
This site cannot decide that for you and does not know your wait. What the sources establish is the difference that outlasts the decision: on Right to Choose, NHS South West London ICB says ongoing prescriptions are covered even if a GP declines shared care, while NHS West and North London ICB warns that the NHS may not pay for private prescription costs. Transferring in from a private assessment generally means joining at the beginning of the waiting list.
Will the NHS accept a private ADHD diagnosis?
Not automatically. NHS South West London ICB states that when joining an NHS service for assessment, or transferring mid-treatment, a new assessment may also be required even if one has already been carried out by a private provider. Ask your GP practice what it and the local service will accept before you pay.
Where this came from
- NHS South West London ICB: ADHD and autism, Right To Choose.
- NHS West and North London ICB: ADHD and ASD.
- NHS England: Report of the independent ADHD Taskforce, part 2 (published 6 November 2025).
- NHS: NHS prescription charges.