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Private ADHD assessment vs NHS Right to Choose: what the first year really costs
An NHS adult ADHD assessment in England, including via the free NHS Right to Choose route, costs nothing at the point of use, with medication at standard NHS prescription charges (£9.90 per item, or £114.50 for a 12-month prepayment certificate). A private route typically costs several hundred to a few thousand pounds in the first year once the assessment, medication titration and private prescriptions are added up. People pay privately for speed, not for a better assessment.
Information only, not medical advice and not a diagnosis. Only a registered clinician can diagnose ADHD or make treatment decisions. Clinic prices are published examples checked on 11 June 2026; always get a current written quote. Waiting times can be long on every route, including Right to Choose.
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Sources: careadhd.co.uk pricing and psychiatry-uk.com fees, checked 11 June 2026.
Sources: careadhd.co.uk pricing and psychiatry-uk.com fees, checked 11 June 2026. Medicine itself is charged separately on both packages.
Titration takes about 3 months, and agreeing shared care with a GP (not guaranteed) takes time on top. If your GP declines shared care, private costs continue beyond the first year.
Source: Psychiatry-UK publishes £25 per private prescription where shared care is declined, checked 11 June 2026.
Default £46 = mean NHS actual cost per ADHD prescription item, NHSBSA English Prescribing Dataset, 2025-06. Private pharmacy prices vary and are often higher.
First-year cost, side by side
| Cost line | Private route | NHS Right to Choose |
|---|---|---|
| Assessment | £0 | £0 (free at the point of use) |
| Medication titration | £0 | £0 (provided on the NHS) |
| Prescriptions and medicine, year 1 | £0 | £0 |
| First-year total | £0 | £0 |
The honest trade-off is time, not quality. Both routes use registered clinicians working to NICE guidance. Before paying anything, read how NHS Right to Choose works and check current waits, then see NHS vs private and how to find a provider if you still want the private route.
What this comparator assumes (methodology)
- NHS prescription charge £9.90 per item in England, and a 12-month prepayment certificate (PPC) at £114.50 (3-month £32.05). Source: NHS and NHSBSA, checked 11 June 2026. The calculator automatically uses whichever is cheaper, and many people qualify for free prescriptions.
- Private clinic figures are published example prices from CARE ADHD and Psychiatry-UK, checked 11 June 2026, not quotes. Other providers charge more or less; you can enter any custom amount.
- One prescription per month is assumed while on medication. After your chosen number of private months, the model assumes a GP shared-care agreement moves prescribing to NHS charges. Shared care is not guaranteed, and if it is declined the private costs continue.
- The first year is counted from the assessment itself. Waiting time before the assessment carries no fee on either route, but it differs and can be long on both.
- This page never estimates a clinical outcome. Whether medication is appropriate at all is a decision for a registered clinician.
Frequently asked questions
Is the NHS Right to Choose route really free?
Yes. In England, an ADHD assessment through the NHS, including via Right to Choose, is free at the point of use. If you are prescribed medication you pay only the standard NHS prescription charge (£9.90 per item) or a prepayment certificate (£114.50 for 12 months), and many people qualify for free prescriptions. The trade-off is usually waiting time, which can be long on every route.
Why do people pay for a private assessment at all?
Almost always to be seen sooner. A private assessment is not a better or more valid assessment, and NICE-aligned providers work to the same diagnostic standards. Before paying, check the realistic wait for Right to Choose providers in your area, as paying does not always save as much time as clinics imply.
What is shared care and why does it matter so much for cost?
Shared care is an agreement where your GP takes over routine ADHD prescribing after a private or Right to Choose provider has stabilised your dose. If your GP accepts, your medication moves to NHS prescription charges. If your GP declines (which they can), you keep paying private prescription and review fees indefinitely, which is the biggest hidden cost of the private route.
Are the clinic prices shown here quotes?
No. They are examples of published price lists from named providers, checked on 11 June 2026, used to make the comparison realistic. Prices change and vary by provider, so always get a current written quote that states exactly what is included before booking.
This is not a diagnosis and not medical advice. ADHD can only be diagnosed by a registered clinician, and treatment decisions belong with them. If cost is a barrier, the NHS route (including Right to Choose) is free at the point of use.
Editor, ADHD Helper
Oliver leads ADHD Helper's editorial coverage of adult ADHD. He researches and writes the plain-English explainers on getting an ADHD assessment through NHS Right to Choose or privately, and on the products and tools people use to manage ADHD, drawing on guidance from the NHS, NICE and the Royal College of Psychiatrists. He is clear that the site is information, not medical advice, and that diagnosis is for a registered clinician.
Last reviewed: 11 June 2026