NHS, Right to Choose or private?
There is no single “best” pathway. The main differences are funding, provider choice, waiting time, treatment scope and what happens after diagnosis.
Right to Choose is NHS funded for eligible referrals in England. Private assessment is self-funded and may offer earlier appointments, but availability and total costs vary by provider.
Compare the routes
| Local NHS | Right to Choose | Private | |
|---|---|---|---|
| Who pays? | NHS | NHS for eligible services | You / insurer, depending on cover |
| Provider choice | Usually local commissioned pathway | Choice of clinically appropriate eligible provider under the rules | Broad choice of private providers |
| Waiting time | Can be long and varies locally | Varies by provider and local funding/capacity | Often shorter; some providers may have immediate or near-immediate capacity, but this is not guaranteed |
| Referral | Usually GP/local pathway | Eligible referral through the NHS pathway | Often self-referral or direct booking |
| Medication | Depends on local service | Depends on the provider's NHS service scope | Usually a separate paid pathway if offered |
| Shared care | Managed within NHS arrangements | Depends on provider, treatment pathway and GP agreement | Not guaranteed; ask what happens if the GP declines |
| Best reason to consider it | No direct patient charge and local continuity | NHS-funded choice with potentially shorter waits | Speed, flexibility and provider choice |
What Right to Choose actually means
NHS England explains that for eligible mental-health referrals, patients can have a legal right to choose a clinically appropriate provider that holds a qualifying NHS Standard Contract for the service needed. The rules include exceptions and apply at the point of referral.
NHS England – patient choice guidance ↗ · NHS Choice Framework ↗
Check current ADHD RTC provider information →Why people consider private assessment
The main practical advantage is often speed and flexibility. A private provider is not using the same local NHS queue, so appointments may be available much sooner — sometimes with little or no wait when capacity is available. But availability changes, and “no wait” should always be checked at the time of booking.
Private care also means thinking about the whole cost of the pathway: assessment, reports, medication initiation, titration, prescriptions, follow-up and what happens if shared care is not accepted.
Private ADHD assessment explained →