Private psychiatry · London
Adult ADHD assessment - private in London.
A structured DIVA-5 diagnostic interview with a GMC-registered consultant psychiatrist, optional QbTest, and a titration plan for stimulant or non-stimulant medication. Typical cost £950 to £2,500, from enquiry to written report in two to six weeks.
What it is
A structured diagnostic interview, not a questionnaire.
Delivered by a consultant psychiatrist. Not a coach, not a nurse-led questionnaire, not an online quiz.
A private adult ADHD assessment in London follows the National Institute for Health and Care Excellence (NICE) guideline NG87. The core is a structured clinical interview with a GMC-registered consultant psychiatrist. The standard tool is the DIVA-5, the fifth edition of the Diagnostic Interview for ADHD in Adults, which maps each DSM-5 criterion against a fixed set of examples across childhood and adulthood.
Alongside DIVA-5, most London services use two rating scales (ASRS and WURS), collateral history from a partner or parent where possible, and an optional QbTest. QbTest is a 20 minute computerised task that measures attention, impulsivity and motor activity against age-matched norms. It is supportive evidence, not a diagnosis in itself. A good assessment also screens systematically for the conditions ADHD commonly hides behind: anxiety, depression, autism, bipolar disorder, sleep disorders, and long-term stress.
Symptoms in adults
Adult ADHD rarely looks like the childhood picture.
The visible hyperactivity of childhood shifts inward. What is left is often quieter and harder to name.
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Inattention
Difficulty sustaining focus on non-preferred tasks, frequent switching, unfinished projects and missed detail on paperwork or email.
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Procrastination and task initiation
A gap between knowing what to do and starting. Anxiety piles up around routine admin, deadlines slip even when the work is easy.
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Rejection sensitive dysphoria (RSD)
Sudden, intense emotional pain triggered by real or perceived criticism or exclusion. Common in adult ADHD and often mistaken for anxiety.
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Hyperfocus
Periods of deep, absorbed attention on preferred tasks, sometimes for many hours, at the cost of eating, sleep and other commitments.
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Restlessness
Internal fidget rather than the visible hyperactivity of childhood. Difficulty relaxing, always needing something in the background.
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Emotional dysregulation
Short fuse, quick shifts in mood, difficulty settling after a stressor. Often the symptom that brings adults in, not the attention itself.
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Executive dysfunction
Planning, prioritising, working memory and time perception. Not a lack of intelligence, a lack of the scaffolding that turns intent into action.
The assessment
One or two sessions, two to three hours total.
Some London clinics run this in a single long appointment, others split it across two. Both are valid.
- 01
Pre-assessment screening
Adult ADHD Self-Report Scale (ASRS) and Wender Utah Rating Scale (WURS) sent before the appointment, plus a structured history form covering childhood, work and mental health.
- 02
Clinical interview with a consultant psychiatrist
A 90 to 120 minute structured interview using the DIVA-5 (Diagnostic Interview for ADHD in Adults, fifth edition) against DSM-5 criteria, per NICE guideline NG87.
- 03
Collateral history
Where possible, a short call or written statement from a parent, sibling or partner. Childhood onset before age 12 is a diagnostic requirement and collateral strengthens the record.
- 04
QbTest (optional)
A 20 minute computerised continuous performance test measuring attention, impulsivity and motor activity. Not diagnostic on its own, useful as an objective baseline.
- 05
Differential and comorbidity screen
Anxiety, depression, autism, bipolar, sleep disorders and trauma are common alongside or instead of ADHD. Your psychiatrist will screen these and refer on where needed.
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Written report
A full diagnostic report is issued within one to two weeks, addressed to you and, with consent, copied to your GP. It sets out findings, diagnosis and a treatment plan.
Titration and medication
Finding the right dose, one step at a time.
Titration means starting low and adjusting until benefit outweighs side effects. Monthly reviews for three to six months, then stable prescribing every three months.
NICE recommends stimulant medication as first-line treatment for adult ADHD, with methylphenidate and lisdexamfetamine the two main options. Both are controlled drugs, both require a titration period of monthly appointments while your psychiatrist adjusts the dose against symptom response, blood pressure, heart rate, sleep and appetite. Most adults reach a stable dose within three to six months, after which reviews drop to every three months and prescribing can, in principle, move to shared care with your NHS GP.
Non-stimulants have a place where stimulants are contraindicated (uncontrolled hypertension, certain arrhythmias), where there is a history of substance misuse, or where anxiety is prominent. Atomoxetine is the main non-stimulant option in the UK. It takes six to eight weeks to reach full effect and does not carry the controlled-drug prescribing restrictions of stimulants.
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Methylphenidate (Concerta XL, Ritalin, Equasym, Xaggitin)
First-line stimulant. Long-acting formulations preferred for adults. Titrated in fortnightly steps from 18 mg upwards.
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Lisdexamfetamine (Elvanse)
Second-line stimulant, prodrug of dexamfetamine. Smoother profile for many adults. Titrated from 30 mg to a typical adult range of 50 to 70 mg.
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Dexamfetamine (Amfexa)
Alternative stimulant, shorter acting. Used when Elvanse is not tolerated or not funded.
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Atomoxetine (Strattera)
Non-stimulant, noradrenaline reuptake inhibitor. Useful where stimulants are contraindicated, or alongside anxiety.
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Guanfacine (Intuniv)
Non-stimulant alpha-2 agonist. Occasionally used off-label in adults, more common in adolescents.
Shared care with the NHS
You have a right to ask. Your GP has a right to decline.
Shared care is the arrangement most private patients want. It works, but not everywhere and not for everyone.
Once you are stable on medication after private titration, your consultant can write a shared-care agreement to your NHS GP. Under shared care, the GP takes over routine prescribing and monitoring on NHS terms, while the specialist retains responsibility for annual review and any dose changes. This shifts your medication cost from a private prescription (typically £70 to £140 a month) to an NHS prescription (£9.90 per item at 2026 rates).
Whether your GP accepts depends on your Integrated Care Board (ICB) policy and on the individual practice. Several London ICBs actively support shared care for private ADHD diagnoses, others have paused new agreements citing capacity and safety. If shared care is declined, you continue on private prescription at your own cost, or you can join the NHS waiting list for a full re-assessment through a Right to Choose provider.
Cost in London
Honest ranges across the London market.
Total first-year cost, including assessment and titration, typically £2,000 to £4,500 before medication.
| Element | Indicative range | Notes |
|---|---|---|
| Initial assessment (DIVA-5, report) | £950 to £1,800 | One-off. Includes written report. |
| QbTest (optional add-on) | £150 to £300 | Objective attention baseline. |
| Titration review (monthly, 3 to 6 months) | £250 to £450 | Per appointment. 30 to 45 min. |
| Stable review (quarterly) | £250 to £400 | Annual under shared care. |
| Private prescription (per month) | £70 to £140 | £9.90 NHS item under shared care. |
Total first-year outlay for a full private pathway (assessment plus titration plus stable review plus private script) runs roughly £2,500 to £5,500. If shared care succeeds after titration, ongoing cost drops sharply.
Where in London
A short list of established London providers.
All are CQC-registered, all offer adult ADHD assessment and post-diagnostic titration.
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The Priory Wellbeing Centre, Harley Street
Marylebone
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HCA The Wellington Hospital
St John's Wood
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The London Psychiatry Centre
Harley Street
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Nightingale Hospital
Marylebone
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One Welbeck Mental Health
Marylebone
Related guides
Read next
ADHD condition guide
Symptoms, subtypes and treatment overview for adults and children.
Read guideAdult autism assessment
ADOS-2 and ADI-R diagnosis in London, often assessed alongside ADHD.
Read guidePrivate psychiatric assessment
The broader intake used when the presenting problem is not yet clear.
Read guide
Frequently asked
The six questions we hear most.
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How long is the NHS wait for an adult ADHD assessment versus private?
NHS waits for adult ADHD assessment in London currently run from 18 months to 5 years depending on the borough and provider, with some services closed to new referrals. A private assessment through a London consultant psychiatrist is usually completed within 2 to 6 weeks from enquiry to written report.
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Can my NHS GP take over prescribing after a private diagnosis? (Shared care)
Sometimes. A shared-care agreement lets your NHS GP continue prescribing and monitoring once you are stable on medication, at NHS cost. It depends on your Integrated Care Board (ICB) policy and on your individual GP's willingness. Some London ICBs support shared care for private ADHD diagnoses, others decline. If shared care is refused, you continue on private prescription at your own cost.
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Do I have to tell the DVLA?
ADHD itself is not automatically notifiable, but you must tell the DVLA if the condition or the medication affects your ability to drive safely. Stimulant medication at prescribed doses does not usually require disclosure. If you hold a Group 2 (bus, coach, HGV) licence, disclosure rules are stricter. Your psychiatrist will advise in your report.
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Do I have to tell my employer?
No. There is no legal duty to disclose an ADHD diagnosis to an employer. Disclosure can unlock reasonable adjustments under the Equality Act 2010, and Access to Work funding for coaching, software and equipment. Many adults choose to disclose selectively to HR or a line manager, not the wider team.
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What is Right to Choose and does it apply to ADHD?
Right to Choose is an NHS England policy that lets patients in England choose any NHS-contracted provider for a first outpatient appointment, including independent providers with an NHS contract. Several online providers offer NHS-funded adult ADHD assessment through Right to Choose, with waits typically shorter than local NHS services. Your GP has to agree to make the referral, and post-diagnosis shared care still depends on your ICB.
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If I was assessed as a child, do I need a new adult assessment?
Usually yes. A childhood diagnosis is strong supporting evidence, but adult prescribing services almost always require a current adult assessment against DSM-5 criteria and DIVA-5 before starting or restarting medication. Bring your childhood records to the appointment, they shorten the process.
Ready when you are
A consultant psychiatrist, a proper assessment, a written plan.
Tell us what is going on. We come back within one working day with two or three consultant options, indicative fees and the earliest appointment.