If you live in Scotland or Northern Ireland, NHS Right to Choose cannot get you an adult ADHD assessment. It is a legal duty placed on NHS commissioners in England by English NHS regulations. It does not reach NHS Scotland or Health and Social Care (HSC) in Northern Ireland, which run their own systems.
In Scotland, each NHS board sets its own adult ADHD pathway. There is no national adult service yet, although the Scottish Government has promised a new national model. In Northern Ireland, the Department of Health says there is no commissioned ADHD service at all. HSC trusts run small services with very long waits.
In both nations, the route still starts with your GP. This guide explains why Right to Choose stops at the border, how referral works, and how shared care works after a private diagnosis. It ends with local notes for Glasgow, Edinburgh and Belfast.
This page is time-sensitive. We checked every figure on 1 November 2026.
Right to Choose is not a general UK entitlement. It comes from regulation 39 of the NHS standing rules regulations for England (S.I. 2012/2996). Regulation 39 says commissioners must offer people who need a non-urgent referral a choice of provider.
For mental health, regulation 39(2)(b) covers services where the first appointment is with a named health professional, not only a consultant. That wording was added from 1 April 2014. It is why ADHD assessment can fall within the right in England.
The duty sits with NHS England and the local NHS commissioners in England, now called integrated care boards. The government's NHS Choice Framework says it applies to people in England. The chosen provider must also hold an NHS England standard contract for the service.
Scotland's health boards and Northern Ireland's HSC trusts are not bodies these regulations cover. So there is no equivalent right to pick an outside ADHD provider and have the NHS pay.
Even in England, the right has limits. It does not apply to urgent care or to people detained under the Mental Health Act. Nor does it cover people in prison or serving armed forces members.
We cover how the right works in England, and its catches, in our guide to NHS Right to Choose and shared care. For what English waits look like, see adult ADHD in the UK: what the wait actually looks like.
Each NHS board in Scotland develops its own ADHD referral and treatment pathway, according to a 2024 Scottish Parliament research briefing (SPICe). The national neurodevelopmental specification covers children and young people, not adults.
Provision varies a lot by area. A June 2025 SPICe briefing summarised board replies from March 2025:
Waiting times are not published nationally. The Scottish Government confirmed this in an August 2025 letter to the Health Committee.
Not yet. In a June 2026 letter, the minister committed to a stepped care approach for adults, as proposed by the Royal College of Psychiatrists. She said the aim is support that does not depend on waiting for a diagnosis.
On 7 October 2026, she told Parliament the adult route map would be published "in the autumn". We had not found it published when we checked. Until it is, your local board's pathway is what applies.
Book a GP appointment and explain how your difficulties affect work, home and relationships. Ask which local pathway the referral will go to and roughly how long it takes. Our page on signs of ADHD in adults may help you prepare.
If you are considering a private clinic, SPICe advises checking it is registered with Healthcare Improvement Scotland, which regulates independent clinics.
In June 2026 the Department of Health answered a freedom of information request plainly. It said: "There is currently no commissioned service for ADHD in Northern Ireland." It added that there is no regionally commissioned ADHD assessment pathway.
What exists is run by individual HSC trusts. Belfast Trust, for example, takes adult referrals from GPs. The trusts do not report ADHD waits to the Department routinely.
The Department published an ADHD needs assessment on 12 February 2026. It makes 19 recommendations. The Health Minister said any commissioned service depends on future budgets and that there are "no cost neutral options". The Department said it was considering next steps.
If you are considering private care in Northern Ireland, ask whether the prescriber is registered with the Regulation and Quality Improvement Authority (RQIA). The Department's June 2026 pharmacy newsletter says medical prescribers serving NI patients may need that registration.
SPICe notes that long waits are pushing more people in Scotland towards private assessment. The catch is ongoing medication. NHS or HSC prescribing after a private diagnosis usually depends on shared care.
Shared care means a specialist starts and adjusts the medicine. Once the dose is stable, your GP takes over prescribing and routine monitoring. NICE's ADHD guideline (NG87, recommendation 1.7.29) describes this model. For how the medicines themselves work, see what ADHD stimulants actually do.
There is no NHS Scotland policy on shared care with private providers. SPICe says it is a matter for the GP's clinical discretion, sometimes decided at practice or local level.
The Scottish Government's August 2025 letter says the same. It states that "a recommendation from a private specialist does not entitle the patient to NHS prescriptions for that medicine". It also says there is no mechanism to reimburse people who pay privately while waiting.
The National Autism Implementation Team (NAIT) published guidance in 2022 on prescribing after a private diagnosis in Scotland. The Scottish Government's 2025 letter refers to it.
In practice, arrangements are patchy. When the Health Committee asked boards in early 2025, several answered "none" on GP practices offering ADHD shared care. If your GP declines, SPICe notes they may refer you to the NHS pathway instead.
Belfast Trust described the regional position in a March 2026 FOI reply. Shared care is "a voluntary agreement". An NHS or private specialist manages diagnosis and titration, and the GP takes over once the dose is stable. The GP must agree, and participation is voluntary.
The regional Interface Pharmacist Network guidance adds a condition. Private providers should not ask GPs for HSC prescriptions without a shared care arrangement that both sides have agreed. If a GP does prescribe, they take clinical responsibility, and ongoing review by the private provider should continue.
Adult ADHD assessment is run by each of the board's six health and social care partnerships, each with its own waiting list. A June 2026 FOI response describes the route. Referrals come from a GP only and are first triaged by the local community mental health team.
The same response gives waits as of 13 May 2026:
SPICe reported in 2024 that the board had developed criteria for accepting private ADHD diagnoses. We could not open the current version, so ask your practice how it applies.
Lothian's adult ADHD services are run by its four health and social care partnerships. An August 2026 FOI reply says the adult pathway is accepting referrals and is not capped. Most adults sit on a general neurodevelopmental assessment list, so ADHD waits cannot be reported separately.
The most recent Edinburgh-specific figure we found is older. A June 2024 FOI reply gave an average wait of 23.5 months for an adult assessment in Edinburgh.
On shared care, a February 2026 FOI reply is detailed:
A July 2026 FOI reply describes the adult pathway. It starts with a detailed GP referral. After triage, the referral joins the waiting list.
The trust said 4,970 people had been referred and were waiting for an assessment appointment. It called the adult provision "a very small, non-commissioned service". It said it could not estimate when a new referral would be seen. A January 2026 reply said the wait then exceeded eight years.
Long waits are hard. If you feel unable to cope, you do not need a diagnosis to get help.
No. The right is a duty on NHS commissioners in England, owed to the people they are responsible for. NHS Scotland and HSC Northern Ireland are not covered by those regulations. If you are registered with a GP in Scotland or Northern Ireland, your local pathway applies.
They might, but they do not have to. In Scotland it is the GP's clinical decision. In Northern Ireland shared care is voluntary. Ask your practice before you pay for a private assessment.
No. Each board runs its own pathway. The Scottish Government has committed to a new stepped care model for adults. In October 2026 it said the route map would follow in the autumn.
There is no commissioned ADHD service, according to the Department of Health. Trusts provide what exists; Belfast Trust calls its adult provision very small and non-commissioned. A February 2026 needs assessment is being considered.
NHS prescriptions are free in Scotland, and prescriptions dispensed in Northern Ireland are free, according to nidirect. Private prescriptions are treated differently. In Scotland, the Scottish Government says the pharmacy charges for the medicine and sets its own dispensing fee.
Proco is preparing clinician-led adult ADHD assessments; you can read about our approach.
This article is general information about how health services work. It is not medical advice and cannot assess your situation. Talk to your GP about your own care.
Reviewed by: Proco Team
Last updated: November 2026