A private-pay ADHD assessment is a commercial service you (or an insurer) buy from a clinic. Right to Choose is patient-facing shorthand for an England-only legal right: if a GP, dentist or optometrist makes a clinically appropriate elective referral, you may choose a clinically appropriate provider that already holds a qualifying NHS Standard Contract for that service. NHS-funded Right to Choose care is free at the point of use, aside from limited Parliamentary exceptions such as standard prescription charges. The two routes are easy to mix up because some independent clinics sell both.
This is independent information. It is not the NHS, not a clinic, not diagnostic advice and not a referral service. Written by Pete, editor, not a clinician. England only.
Disclosure: we may receive a fee if you ask a listed clinic to contact you. That is not an NHS fee and not a charge for NHS-funded care. See how we make money.
Who this applies to
- People in England comparing an NHS-funded choice referral with paying a clinic directly.
- People in Scotland, Wales or Northern Ireland, for whom English Right to Choose does not apply — private-pay is usually the independent-clinic route. See England, Scotland, Wales and Northern Ireland.
- Anyone who has been told a private invoice is “Right to Choose”. It is not, unless the legal tests below are met and the NHS is funding the episode.
Who this does not apply to
- Treating this page as a recommendation to buy a private assessment, or to name a particular clinic.
- Assuming private care is always faster. We do not invent waits. English RTC waits are snapshots only on waiting times and on each provider page.
- Assuming a private diagnosis automatically converts into NHS-funded titration or shared care. That depends on the clinic, the GP and local pathways — not on this site.
Side by side (commercial comparison)
| NHS-funded Right to Choose | Private-pay assessment | |
|---|---|---|
| Who pays | NHS, if the legal right applies. Free at the point of use except limited Parliamentary exceptions (for example a standard prescription charge if medicine is later prescribed). | You, or an insurer. The clinic’s fee is a private contract. |
| Legal basis | Choice Framework section 3; Standing Rules Part 8 (SI 2012/2996 as amended by SI 2023/1105); NHS England patient-choice guidance. Constitution restates informed choice; it does not create the right. | Ordinary private healthcare contract. Not the Standing Rules right. |
| Qualifying NHS Standard Contract | Required. Signed and in effect before the referral date; for the required service; specified location or access criteria (remote can count); not a one-person spot purchase; held with any ICB or NHS England. | Not required for you to pay them. No contract means it is not Right to Choose, even if the same clinicians work on an NHS contract elsewhere. |
| Referral | GP, dentist or optometrist elective referral. Not self-referral. | Often self-referral or a referral you arrange yourself. That does not become RTC by renaming it. |
| Clinical appropriateness | The referrer’s opinion (regulation 39(6)). They are not required to refer to a provider they do not believe is clinically appropriate. | The clinic’s own acceptance rules. No Standing Rules duty on your GP to refer. |
| Prior ICB approval | Not required when the legal right applies, even if your ICB has no written contract with that provider. | Not an NHS choice process. |
| Geography | England only. | Clinics may accept patients from anywhere they choose, including Scotland, Wales and Northern Ireland, on private terms. |
| What you receive | An NHS service to NHS standards, if the provider is delivering under that contract. Independent-sector organisations can appear on e-Referral alongside NHS providers. | A private assessment. It is not automatically an NHS diagnosis for shared-care or local-trust purposes. |
| This site’s fee | We do not charge an NHS Right to Choose fee. NHS-funded care is not paid through us. | If you ask a listed clinic to contact you, we may receive a lead fee. That is a disclosed introduction, not an NHS referral. |
A clinic without a qualifying contract cannot accept Right to Choose referrals as NHS-funded care. A clinic with a qualifying contract may still also sell a private pathway (for example adult ADHD privately where they do not offer adult ADHD on RTC). Read their page. We have not verified contracts.
What “qualifying contract” actually means
NHS England’s tests, matching Standing Rules regulation 39(8):
- an NHS Standard Contract
- signed and in effect before the referral date
- a commissioning contract for the required service
- the service from a specified location or criteria for how it is accessible (remote delivery can meet this)
- not a spot purchase for a named individual
If your commissioner has no written contract with the chosen provider, the terms of that qualifying contract still apply to the referral (non-contract activity). That is not the same as “the clinic invoices you”.
CQC registration is a separate check. It is not proof that Right to Choose applies.
Money, prescriptions and shared care
The Constitution restates that NHS services are free of charge except for limited exceptions set by Parliament. ProblemShared and Innovate, on their own RTC pages, state that where they prescribe on the NHS a standard NHS prescription charge may apply. That charge is an NHS rule, not a fee to this site and not a private invoice.
NICE NG87 recommends that after titration and dose stabilisation, prescribing and monitoring should be under shared-care protocol arrangements with primary care. Choice law does not force a GP to accept shared care. Some providers claim they will keep prescribing if the GP declines; some do not prescribe at all (Evolve, on their RTC page). Those are their published models. Check the providers index.
Paying privately does not, by itself, create a duty on an NHS GP to continue that medicine.
Lead fees — what we may be paid for
We do not charge you to read this comparison.
We may receive a fee from a partner clinic when you consent to that clinic contacting you — for example on get help. That can happen whether you are exploring NHS-funded RTC (England) or a private-pay conversation. It is a disclosed introduction. Only a GP, dentist or optometrist can make a Right to Choose referral.
We do not:
- charge you an “NHS Right to Choose fee”
- take a cut of NHS treatment funding
- sell your details to a clinic unless you have consented to that clinic contacting you
- lock the providers directory to one clinic
Paying us, or a clinic paying us, does not make a referral clinically appropriate, create the legal right, verify a contract, or guarantee an appointment, a diagnosis, shared care, or a short wait.
Step by step
- If you are in England and the legal tests may apply, read eligibility before you pay anyone.
- If you are comparing clinics that claim a qualifying contract, use the providers index and each organisation’s own URL. Treat contract language as their claim.
- If you intend to pay, get the clinic’s private fee, refund and aftercare terms from them. This site does not set those prices.
- If you intend to use Right to Choose, use the GP script. Do not tell the GP they must refer you to a named independent clinic regardless of clinical judgement.
- If you ask a listed clinic to contact you, read the lead-fee disclosure on that form and on how we make money.
Sources
Primary sources. Retrieved 1 September 2026.
- The NHS Constitution for England — NHS services free of charge except limited Parliamentary exceptions; informed-choice right; does not create new legal rights. HTML
- NHS Choice Framework, DHSC. England; first-outpatient choice is a legal right with listed exceptions, not a paid add-on; independent-sector providers of NHS services can appear on e-Referral. HTML
- Patient choice guidance, NHS England, B1441, 19 December 2023. Qualifying NHS Standard Contract; any ICB or NHS England; no prior approval; legal rights do not apply to self-referrals; remote ADHD assessments may be in scope when other tests are met. Long-read
- NHS Standing Rules, Part 8, SI 2012/2996 as revised, including SI 2023/1105 (qualifying contract; clinically appropriate = referrer’s opinion). Revised Part 8 · SI 2023/1105
- NICE NG87 — clinical standards for ADHD diagnosis, medication and shared care; silent on Right to Choose. NG87
Provider pages (claims about NHS prescription charges and private-versus-RTC offers, not a source of the free-at-point-of-use right):
- ProblemShared, Right to Choose — NHS meets medication cost; standard NHS prescription charge may apply. Page
- Innovate ADHD, NHS patients — NHS prescriptions / standard charges. Page
- Evolve Psychology, Right to Choose — no adult ADHD via RTC (private adult ADHD offered separately); no prescribing on RTC. Page
- Psychiatry UK, Right to Choose — under-18 ADHD not on RTC (they signpost private). Page
Frequently asked questions
Is private ADHD the same as Right to Choose?
No. Private-pay is you buying an assessment. Right to Choose is NHS-funded choice of a qualifying contracted provider in England, after a clinically appropriate elective referral.
Do I pay the independent clinic on Right to Choose?
Not for the NHS-funded episode if the legal right applies. Free at the point of use except limited exceptions such as prescription charges. Payment to this site is never an NHS fee.
Does the clinic need a contract with my ICB?
For Right to Choose: a qualifying contract with any ICB or NHS England, in effect before referral. For private-pay: no NHS contract is required, because it is not the legal right.
Can I self-refer privately and call it Right to Choose?
No. Legal choice does not apply to self-referrals.
Will a private diagnosis get me NHS medication?
Not automatically. Shared care is a local professional and contractual issue. NG87 recommends shared-care arrangements after titration; GPs are not forced by choice law to accept them.
Do you take a cut of NHS funding?
No. We may receive a disclosed lead fee if you ask a listed clinic to contact you.
Is private always faster?
We do not publish that as a fact. We do not invent waits. Some clinics publish private-versus-RTC comparison ranges on their own sites; we quote RTC snapshots only from the URLs listed on waiting times.
Next steps
- NHS-funded path: eligibility · how to ask your GP · providers
- Money: how we make money
- Geography: England, Scotland, Wales and Northern Ireland
Last reviewed: 1 September 2026
Author: Pete, editor, not a clinician
Right to Choose Pathway is an independent England-only information site. It is not the NHS, not affiliated with the NHS, not a clinic, not a diagnostic service and not a referral service.