How to get an ADHD diagnosis as an adult in England
The three routes to an adult ADHD assessment in England (NHS, Right to Choose and private), what each involves and what to do first.
Lots of adults start wondering about ADHD in their twenties, thirties or later. Sometimes it's a child being assessed, sometimes a friend's diagnosis, sometimes years of feeling behind despite trying hard. Whatever brought you here, the process in England is the same: there are three routes to an assessment, and the first steps are the same for all of them.
Step one: write down what you notice
Before you speak to anyone, spend twenty minutes making notes. You are not trying to prove anything. You're giving the clinician real examples to work with.
- Now. What gets in the way at work, at home, with money, with relationships? Give specific examples rather than general feelings.
- When you were younger. ADHD starts in childhood, so assessors always ask about it. School reports, comments from teachers, and what your parents remember are all useful.
- What you have tried. Apps, planners, routines, therapy. What helped, what did not.
Keep it short. A page of bullet points is plenty.
Step two: talk to your GP
Your GP is the starting point for the two NHS routes, and worth involving in the private route too. Book a longer appointment if your practice offers one and bring your notes.
Your GP will usually ask about your symptoms and how they affect you, check for other things that can look similar (such as low mood, anxiety, sleep problems or a physical health issue), and may ask you to fill in a short questionnaire. If they think a specialist assessment is appropriate, they can refer you.
A GP cannot diagnose adult ADHD themselves. National guidance says the diagnosis should be made by a specialist with training and expertise in ADHD.
Route one: your local NHS adult ADHD service
Your GP refers you to the adult ADHD service that covers your area. It's free. The downside is time: the NHS's own website says waits can be several months or years, and in many areas they're at the long end of that.
If you choose this route, ask your GP how long the local wait is, and whether you can go on the list and look at other options at the same time.
Route two: Right to Choose
If you live in England and are registered with a GP, you can usually choose which provider your GP refers you to, as long as that provider has an NHS contract for adult ADHD assessment. This is called Right to Choose. The assessment is still free, but you may be seen by an independent provider working for the NHS, often by video.
It's a real right, but availability now varies a lot between areas, and some providers have limits on how many people they can assess each year. We explain how it works, and how to ask your GP, in Right to Choose for ADHD.
Route three: a private assessment
You pay a private clinic directly. Many do not need a GP referral, although most will want your GP's details and will write to them with your consent.
Why people choose it. Waiting months or years without knowing can be hard in itself. For many adults, the uncertainty is one of the most draining parts: not knowing whether to keep trying harder, or whether there's a reason things feel the way they do. A private clinic can usually see you much sooner than an NHS waiting list, so you can get answers, and a plan, without putting life on hold. You can also stay on the NHS list while you do it.
Because you're choosing the provider yourself, it's worth knowing what a good one looks like before you pay. Two things matter most:
- What it costs in total, including treatment afterwards if you want it. See how much a private ADHD assessment costs.
- What happens after the diagnosis, especially whether your GP is likely to take over prescribing. See shared care explained.
What a proper assessment includes, whichever route you take
The route changes who pays and how long you wait. It should not change the quality of the assessment. A good one:
- is carried out by a clinician with training and expertise in ADHD
- covers your life now and in childhood, with real examples
- looks at how much the symptoms affect you in more than one area of life
- checks for other conditions that can look similar or sit alongside ADHD
- does not diagnose from a questionnaire alone
- ends with a written report explaining the outcome and the reasoning, whatever the outcome is
We walk through each stage in what happens in an adult ADHD assessment.
After the assessment
If ADHD is diagnosed, there's no single next step. The main options are:
- Medication. This starts with a period called titration, where the dose is adjusted with you over a few weeks.
- Coaching. Practical help with structure, routines and work.
- Everyday changes. Tools, routines and habits that make daily life easier.
- Support at work. Reasonable adjustments, and help through Access to Work.
Many people use a mix, and you can change your mind later.
If ADHD is not diagnosed, a good report should still help. It should explain:
- what else might be going on
- what to do next, including what to take to your GP
Questions to ask, whichever route you choose
- Who will assess me, and what is their experience with adult ADHD?
- Who assesses me, and who confirms the diagnosis?
- What does the written report include?
- What happens after the diagnosis, and who will prescribe if I want medication?
- What is the total cost, if any, for the first year?
This article is general information about ADHD assessment in England. It is not medical advice and does not replace a conversation with your GP or a specialist.