You think you might have ADHD – so now what? How do you get a diagnosis?

Some of us are ok with self-diagnosing ADHD – the lightbulb moment of finally having a name for your difficulties is enough. However, in the UK, if you want to access reasonable adjustments at medical school like extra time in exams, or you’d like to try medication for your symptoms, you’ll need an official diagnosis of ADHD. This can be quite a complicated process, from diagnosis through to getting medication with a shared care agreement – but I’m going to try and make it a bit clearer here.

First of all, you have two options.

Depending on what support you think you may need after a diagnosis of ADHD, there are two routes you can take to get assessed in the UK.

If you’re a student, you can often get assessed for an ADHD diagnosis by an educational psychologist. Your university should be able to arrange this for you, but you could also find one privately. If you are diagnosed with ADHD, their report should be enough for you to access reasonable adjustments and Disabled Students’ Allowance (DSA). However, they won’t be able to prescribe medication for you, even through a shared care agreement.

If you’d like to try medication, you’ll need to see a psychiatrist. Their clinical diagnosis and report can also help you access reasonable adjustments and DSA. However, accessing a psychiatrist can be a bit complicated.

Step 1: see your GP.

Make an appointment with your GP to discuss your concerns. It can be helpful to take some written notes about why you think you have ADHD. Ask them to refer you to a psychiatrist for an assessment, and potential diagnosis.

Unfortunately, not all doctors are well-educated on ADHD. I wrote about this in my post here, if you’d like to read a bit more. If your GP doesn’t want to refer you for an assessment, make an appointment with another doctor. I promise you’ll get there eventually.

Getting a referral doesn’t mean you’re any closer to a diagnosis just yet, unfortunately. Waiting times for an ADHD assessment and diagnosis in the UK are shockingly long (read more here), and you may have to wait over a year. I was put onto a two year-long waiting list in July 2020, and as of April 2021, I’m still on it.

I promise this isn’t the end of the road though – there’s some shortcuts you can try.

Are you in England? You have a Right to Choose.

If you are registered with a GP in England, and the GP agrees to refer you for an ADHD assessment, you have a legal right to choose the provider that you are referred to. The only condition is that the provider you want needs to be doing NHS assessments in any part of England. Helpfully, this is referred to as Right to Choose (RTC).

These “alternative” providers often have much shorter waiting times. Thanks to COVID-19, they can often do the assessment online over video call too.

How do I get a diagnosis for ADHD through Right To Choose?

Psychiatry-UK, the main provider that patients opt for through RTC in the UK, has a really helpful guide about doing this on their website. It includes template forms and letters you can give your GP to make the referral. Find it here.

Your GP might refuse to refer you for an ADHD assessment – if this is for a clinical reason, see another GP. If the refusal is based on funding concerns, Psychiatry-UK also have some tips on solving this confusion on the link above. If you get the feeling that your GP is not willing to engage at all, it might be worth considering changing GP – especially if you’d like to pursue a Shared Care Agreement for medication further down the line.

Unfortunately, patients registered with a GP in Scotland, Wales and Northern Ireland are not eligible for Right to Choose. You could still try a private assessment for an ADHD diagnosis, if you have the funds.

It’s not too hard to get a private ADHD assessment and diagnosis in the UK… if you have the money.

If you really don’t want to wait for an assessment and diagnosis, and you have some savings, you can see a UK psychiatrist privately.

This is what I did. I faced a two-year wait on the UK’s NHS, and didn’t know about Right to Choose at the time. I wanted a diagnosis ASAP so I could access reasonable adjustments when I returned to medical school in 2 months time.

You don’t often need a GP referral to access a private assessment and diagnosis. Just Googling “ADHD diagnosis UK” will bring up plenty of options.

I personally went with a private psychiatry clinic in London that did online assessments over Zoom. I was based at my parents in the North East of England at the time, and it was cheaper than the local options. All I had to do was ring up and pay a deposit over the phone. I had my assessment, and diagnosis of adult ADHD, a week later. Sorted.

How did I pay for my diagnosis?

I paid for my diagnosis, and the first few months of medication, with my overdraft. It was early June, and my next maintenance loan installment wasn’t due until September. I really wouldn’t recommend doing this if you can – balancing the deficit caused me a lot of stress later on. However, it was worth it for me, because I finally had a diagnosis that allowed me to access the support I needed at university. Eventually, my GP agreed to prescribe my medication through a shared care agreement so I didn’t have to pay for it privately – more about this below…

How much did it cost?

I don’t really like talking about money, but I want to be transparent about this. Hopefully, this can help you assess if the private healthcare options in the UK are a feasible option for you.

My diagnosis, and first prescription, cost £495 in two installments. After this, I had a follow-up appointment once a month while I was titrating my medication – these cost £120 each time. My medication was on a private prescription. Costs for this vary depending on the medication and dosage, but for the first four months, I paid £40 every time I picked it up from the pharmacy. This was every 4-5 weeks or so.

It sounds like a fortune – but it does get cheaper.

If you would like more information about the different types of ADHD medication available in the UK, there is a simple guide here that you can check out!

4 months after my ADHD diagnosis, I switched to a Shared Care Agreement.

Once you’ve got a diagnosis of ADHD and titrated onto your medication (this just means establishing the dose that’s right for you), you can ask your GP to take over the prescribing on a Shared Care Agreement (SCA). Most GPs in the UK are happy to do so. They prescribe the medication, and check your BP and weight occasionally to make sure you’re tolerating the treatment. They might stipulate that you still need a psychiatrist review every few months – I see mine every 9 months (~£200). You can stay private for follow-ups, but you can also make sure you’re still on the NHS waiting list, so eventually you can switch these over too.

GPs aren’t obligated to take on a Shared Care Agreement. There are also some areas of England and the rest of the UK where your medication can’t be prescribed by a GP. In these cases, you can either ask a different GP, or continue the medication privately while you wait for the local NHS service to prescribe it.

The truth is, seeking ADHD diagnosis and treatment in the UK is not an ADHD-friendly process.

The length of this post probably demonstrates that. It’s complicated, and you really have to persevere to get where you need to be. I’ve not even touched on what the assessment entails, but I’ll talk about this in a future post.

When you have ADHD, you have problems with organisation, time management, and persisting with tasks that are difficult or boring.

Guess what you often need to access an ADHD diagnosis in the UK, and organise a Shared Care Agreement for your medication?

Buckets of organisation, time management skills, and persistence.

I am very lucky.

I have supportive parents, an overdraft, and a student loan to help me out. Not everyone has those resources, and it upsets me that people just like me, including other medics, are finding themselves stuck and struggling as a result of an over-complicated system.

I am always happy to talk about getting assessed for an ADHD diagnosis, and arranging a Shared Care Agreement, especially in the UK – please just pop me a message on social media, or anonymously on the About page.

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