If you have been sitting on an NHS or CAMHS list in Bristol for months, you are probably weighing up three things at once: whether to keep waiting, whether NHS Right to Choose is genuinely faster, and whether a self-funded assessment is worth the fee. ADHD Right to Choose waiting times are the pivot point in that decision, and the honest answer is that they now vary enormously by provider and by integrated care board.
This page sets out how the route works, who qualifies, what has changed, and where a private assessment with our ADHD assessment team in Bristol sits alongside the NHS rather than in place of it.
Current ADHD Right to Choose Waiting Times at a Glance
Published ADHD Right to Choose waiting times currently range from a few weeks with providers that have spare capacity to more than 12 months with providers whose lists are full, and the figures move month to month. There is no single national wait for Right to Choose because each independent provider holds its own contract, manages its own caseload, and publishes its own estimate.
Because of that, any number quoted in a blog post ages badly. The reliable approach is to check the provider’s own dated figure on the day you read it. Psychiatry UK, for example, publishes an integrated care board-specific waiting-times update that is revised regularly, so an adult registered with a GP in Bristol may see a very different estimate from someone in Kent. Your local commissioner, NHS Bristol, North Somerset, and South Gloucestershire ICB, publishes the position for the local NHS neurodevelopmental pathways, again with a publication date worth checking.
Three things explain why quoted waits differ so widely:
- Whether the figure covers the assessment only, or assessment plus medication titration. Titration is frequently the longer of the two waits.
- Whether the provider counts from the date the GP referral arrives, or from the date your pre-assessment questionnaires are returned.
- Whether the provider is still accepting new referrals at all. Several have paused or capped intake at various points.
How NHS Right to Choose Works for an ADHD Referral
The right to choose is a legal right in the NHS Constitution to choose which provider conducts your first outpatient appointment when your GP refers you for a physical or mental health condition. If an independent provider holds an NHS contract on the same terms as your local commissioner, you can ask to be referred there instead of the local NHS service, and the care remains free at the point of use. NHS England sets out how this sits within the wider guide to NHS waiting times in England, including where the maximum waiting time standards apply and where they do not.
In practice, the process runs as follows:
- Book a GP appointment and explain your ADHD concerns, ideally with examples of the impact at work, in education, or at home.
- Name the Right to Choose provider you want to be referred to and confirm it is accepting referrals for your age group.
- The GP completes the referral. You cannot self-refer to Right to Choose; the referral must come from a GP.
- The provider acknowledges the referral and sends pre-assessment questionnaires, often including rating scales completed by someone who knew you as a child, or by a school for a child referral.
- Once the paperwork is returned and accepted, the assessment appointment is booked.
| Quick tip: Return pre-assessment questionnaires as soon as they arrive. Several providers only start their waiting time clock once the completed forms are back, so a fortnight of delay at your end can add a fortnight at theirs. |
Right to Choose referrals are made by a GP to a provider holding a qualifying NHS contract with your integrated care board, and the sections below explain that NHS route in general terms. The assessments we describe on this page are self-funded and arranged directly with us.
One point catches people out
Exercising the right to choose usually means leaving the local NHS queue you are already in, because you are choosing where that same referral is delivered. Ask your GP or the local service to confirm what happens to your existing place before the new referral is sent.
Right to Choose Eligibility, Age Limits, and the England-only Rule
Right to Choose applies to patients registered with a GP in England. It does not apply in Wales, Scotland, or Northern Ireland, where patient choice operates under different arrangements. It also does not apply to urgent or emergency care, and in some areas, services commissioned as a single local pathway sit outside the scheme.
A GP can decline a Right to Choose request in defined circumstances, most commonly where the referral is not considered clinically appropriate at that point, or where the provider you have named does not hold a qualifying NHS contract with your commissioner. If that happens, ask which criteria were not met, ask whether a different qualifying provider would be acceptable, and request that the reason be recorded. You can also ask to see another GP in the practice or raise the matter with the practice manager.
Age and pathway limits vary by provider. Some accept adults aged 18+ only, while others run separate pathways for children and young people aged 0 to 19, with different wait times and evidence requirements. Check the age band before you name a provider, because a referral sent to the wrong pathway is usually returned rather than redirected. For clinical details on what a full assessment involves, our ADHD assessment page walks through the structured interview, questionnaires, and the multidisciplinary team review stage.
NHS Pathway, Right to Choose, and Self-funded Assessment Compared
The three routes differ in more than speed. The table below compares them on the factors that usually decide the choice, using descriptive ranges rather than fixed numbers, because published figures change with each release.
| Route | Typical wait | Cost to you | Who refers | Key limitation |
| Local NHS or CAMHS pathway (BNSSG) | Commonly, the longest of the three; check the current figure published by BNSSG ICB and note its publication date | Free at the point of use | GP, or in some cases, a school or another NHS service | Demand across adult and children’s neurodevelopmental pathways continues to exceed capacity |
| NHS Right to Choose | Highly variable by provider and ICB, from weeks to well over a year; verify the provider’s dated figure before referral | Free at the point of use | GP only, to a provider holding a qualifying NHS contract | England only, some providers pause intake, and you generally leave your existing local queue |
| Self-funded private assessment | Usually the shortest, and driven by clinic availability and how quickly questionnaires are returned | Paid privately; we confirm the fee in full before you commit to anything | Self-referral, no GP referral required | You fund the assessment yourself, and prescribing arrangements need to be agreed separately |
Broadly, the local NHS pathway suits people who can wait and want everything, including any medication, to be provided through a single NHS service. Right to Choose suits people in England whose named provider currently has a shorter list than their local service. A self-funded assessment suits people for whom the wait itself is causing harm at work, in education, or at home. If that is you, our adult ADHD assessment covers adults 18+, and our child ADHD assessment covers children and young people.
Why Right to Choose ADHD Waits Have Grown
Right to Choose was widely described as a fast route, and for a period, it was. It has slowed for a straightforward reason: referral volumes for ADHD and autism have risen sharply across England, while the clinical workforce qualified to assess has not grown at the same rate. Integrated care boards state this openly. NHS Sussex, for example, explains on its Right to Choose framework page that rising demand is lengthening waits for both independent and NHS providers.
Independent Right to Choose providers recruit from the same pool of psychiatrists, psychologists, and specialist nurses as NHS trusts. When a large volume of referrals moves from an NHS list to a Right to Choose list, the demand does not disappear. Add the growth in medication titration and ongoing prescribing caseloads, which many providers now report as their tightest constraint, and the second wait can outlast the first.
National context is published in the NHS England referral-to-treatment statistics, released monthly with a stated publication date. Read it alongside the NHS guide to waiting times, which explains that the headline maximum waiting time standards do not cover every service, as people often assume.
Where a Self-funded ADHD Assessment Fits Alongside the NHS
We are clear about this: a private assessment complements the NHS pathway, it does not replace it. In most cases, you can remain on an NHS or CAMHS list while assessing privately, although you should confirm that with the local service, because policies differ. What a self-funded route removes is the wait, not the standard of assessment.
Our ADHD assessments follow NICE guideline NG87: a structured clinical interview; validated questionnaires mapped against DSM-5 criteria; collateral information from school or a person who knew you in childhood, where appropriate; and a multidisciplinary team review before any conclusion is reached. We do not promise a diagnosis. We promise a thorough assessment and a clear explanation of the outcome, whether or not we can proceed.
Our clinicians are HCPC-registered, hold professional body membership, including with the Royal College of Speech and Language Therapists, and each has more than 10 years of experience across NHS and private settings. Every assessment ends with a full written report suitable for a GP, a school, or a local authority. We see children, young people, and adults 18+ from Bristol, Bath, Gloucester, Weston-super-Mare, and across Avon, Somerset, and Devon, online or in person at our Bristol clinic, starting with a free telephone consultation so you can check suitability before any fee is discussed.
Many people who suspect ADHD also recognise autistic traits in themselves or their child. We run a combined pathway covering both in a single assessment, and if autism is the stronger concern, our adult autism assessment is the better starting point. A private autism assessment in Bristol with us uses the Autism Diagnostic Interview Revised (ADI-R) and the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2).
What Happens After Diagnosis on Each Route
Medication is the biggest difference between the routes. NHS and Right to Choose providers can initiate and titrate ADHD medication, then hand ongoing prescribing to your GP under a shared care agreement. Private clinics vary in what prescribing they offer, and we are an assessment and diagnostic service, so any medication decision would be taken forward with your GP or a prescribing specialist. Raise that on the free consultation, so there are no surprises.
Non-medication support does not depend on the route. NICE NG87 recommends psychoeducation, environmental adjustments, and behavioural support for children and young people regardless of who is diagnosed. Our written report sets out practical recommendations you can take to a school SENCO, use to support a request for an education, health, and care needs assessment, or apply towards exam access arrangements, Disabled Students’ Allowance, or reasonable adjustments at work under the Equality Act 2010.
A private diagnosis carried out to NICE standards by an appropriately registered clinician is clinically valid. Individual NHS services and GP practices do, however, set their own shared care policies, so acceptance for prescribing is a practice-level decision rather than a reflection on the assessment.
| Quick tip: Phone your GP practice and ask two questions before you choose a route. Does the practice accept shared care for ADHD medication, and does it accept it following a private diagnosis? The answers often change, depending on which route makes sense. |
