ADHD and autism assessment across the four UK nations

NHS services are commissioned by integrated care boards. Many adults wait a long time for local assessment. Right to Choose lets you ask your GP to refer you to another qualified provider with an NHS contract, which has been widely used for ADHD and, in some areas, autism. Arrangements for medication after diagnosis vary between areas, and shared-care policies differ.

Assessment is arranged through NHS boards. Right to Choose in the English sense does not apply. Scotland has its own national standards and, for autism, a national strategy. Referral usually goes through a GP to the local board service, and waiting times vary. Private assessment is possible, and prescribing arrangements depend on the health board's policy.

NHS Wales health boards provide assessment, and Wales has run national programmes to improve neurodivergence services, including work on waiting times. Right to Choose does not apply as in England. Patients should ask their GP about local pathways and waiting times, and about private options and prescribing policy.

Health and Social Care Trusts provide assessment. Pathways, waiting times and policies on private diagnoses differ by trust. The Equality Act 2010 does not apply, so disability discrimination is governed by separate legislation, and the Equality Commission for Northern Ireland provides guidance.

• Ask your GP for NHS referral options and expected waiting times.

• Ask whether local services accept private reports for prescribing.

• Keep copies of reports, letters and medication records.

• Check the registration of any private clinician.

• Ask what will happen to prescribing and monitoring if you move area or nation.

If you move, you may need to re-engage with local services and shared-care agreements may not transfer. Ask your current service for a summary letter, and register with a GP in the new area promptly. Where you are on controlled-drug medication, plan ahead to avoid gaps.

Start by asking your GP practice what the local pathway is, how long people are currently waiting and whether private reports are accepted for prescribing. Search the website of your health board, trust or integrated care board for a neurodevelopmental pathway page, because many publish referral criteria. If you are considering private assessment, check whether the NHS in your area will take over prescribing afterwards before you pay. Keep records of everything, including dates of referral, so you can chase progress and show how long you have been waiting.

National charities for autism and ADHD, and local advice services, can explain pathways in your nation and help you prepare for appointments. Citizens Advice can help with rights at work and in education. Many charities run helplines and online forums, which can be useful for hearing how others have navigated local services, although experiences vary and are not a substitute for clinical advice. Check that information is up to date, because pathways and waiting times change frequently.