Hello to the Brits!

So, you think you have ADHD? Here's what you can do to go about getting an assessment. There are three main pathways that you can choose:

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1) NHS Pathway

Simply speak to your GP about your suspected ADHD, it may help to write down a list of your symptoms beforehand so that you don't miss anything out. The GP should then refer you to an ADHD specialist and there may be some forms they ask you to do as part of the referral. One of these is likely to be the ASRS (Adult ADHD Self-Report Scale), which you could fill in before the GP appointment as additional evidence, if you would like.

Per NICE guidelines, if you are presenting with ADHD symptoms then you should be referred to a specialist service as a GP does not have the requisite qualifications to assess if someone does or does not have ADHD.

It would be a good idea to ask for an estimate of the waiting list. The charity ADHDUK has a waiting list estimation tool that you can find here, but it is dependent on information released in FOI requests.

NOTE: If you live in North Yorkshire, you may be asked to take a 'Do-It Profiler', which is something campaigners are challenging, as it only allows for referrals if participants meet the criteria of being a direct risk of harm to themselves or others. This is currently only a pilot scheme, and the feedback has been 'largely critical' in the words of the review, so we are hopeful that it will be discontinued.

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Pros of NHS Pathway:

• It's free!
• After assessment and titration, it is easy to transfer prescribing responsibilities to your GP.

Cons of NHS Pathway:

• There are long waiting lists for assessment and titration.

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2) Right To Choose (England only)

This is a piece of legislation that enables patients to choose their own mental healthcare provider and have the NHS pay for their treatment. You can ask your GP to refer you to a provider of your choice, and as long as that provider is above board, it is your legal right to be referred. The charity ADHDUK has a list of providers that accept patients through right to choose.

Here is the NHS page on your legal rights under the Right to Choose legislation, and how to access care through it.

The clinic Psychiatry-UK has a downloadable letter template you can use to request a referral, if you want to go with a different provider, feel free to edit this letter or crib from it.

Some providers will only assess patients and not prescribe medication. Do your research before picking a clinic, there are plenty of trust-pilot reviews out there.

As this process has become more popular these providers now also have long waiting lists; for example, as of March 2024, the waiting list for assessment at Psychiatry-UK is 12 months, with an additional 3 month wait to begin titration.

If you are diagnosed and find a medication that works for you, a shared care agreement should be put in place between your provider and your GP, which means that the GP takes responsibility for prescribing the medication and the NHS will cover these costs. Before being referred, you should ask your GP if they will be okay with accepting any potential shared-care agreement. Please note that the GP does not have to accept the shared-care agreement.

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Pros of Right to Choose:

• It's free!
• Shorter waiting lists than the NHS.

Cons of Right to Choose

• Shared Care Agreements are NOT guaranteed.
• There is still a waiting list for treatment, albeit a shorter one.
• Can be more difficult to get GPs to refer you.
• Sadly, owing to the BBC Panorama documentary, there is a greater stigma around non-NHS diagnoses.

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3) Private Healthcare

If you can afford it, then you can always turn to the private healthcare sector. This requires no input from your GP, and is usually a fairly quick process. However, it can be very expensive.

You will need to pay for the assessment, the titration assessment sessions, the prescription of medication, and the medication itself, which can run to over £100 a month. There are also follow up sessions that incur charges.

There is a possibility that you can transfer over to NHS care via a shared care agreement or by being discharged to your GP, but this is entirely up to your GP's discretion.

The charity ADHDUK has a walkthrough of this process and things to look out for here.

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Pros of private treatment:

• Very fast process.

Cons of private treatment:

• Expensive.
• Reputations of private providers can range wildly and the quality of your care is not guaranteed.
• Greater degree of stigma around private diagnoses (thank you to Rory Carson of the BBC for contributing to that one).
• No guarantee that you'll be able to transfer over to NHS care.

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Additonal option:

If you are a university student, the disabilities service at your uni may be able to pay for your diagnostic assessment, but they usually do not cover titration or medication. It may be worth reaching out to support staff to see what options they offer.