Key facts
Who can start treatment
A Consultant Psychiatrist or other ADHD specialist
Can a GP start it
No. A GP can continue prescribing later under shared care
Diagnosis needed first
Yes, in every case
Typical titration period
Several weeks, with reviews at each dose change
Private assessment cost
£695 online, £1,095 in person in London or Manchester
Referral needed
Not for a private assessment
The rules that shape the pathway
Two facts explain almost everything about how ADHD medication is obtained in the UK. The first is that a diagnosis has to come before a prescription. The second is that a GP cannot start ADHD medication, whatever the circumstances.
Treatment must be initiated by a specialist, such as a Consultant Psychiatrist, following a full assessment. That is not a local policy or an insurance rule. It reflects how these medicines are licensed and how NICE guideline NG87 sets out the pathway, and it applies equally on the NHS and privately.
Once a dose is stable, prescribing can transfer to a GP under a shared care agreement. That is the one point at which a GP takes over, and it is voluntary on their part.
The four stages
1. Assessment
A specialist assessment establishes whether ADHD is present. It looks at current difficulties, developmental history, how things present in more than one setting, and what else might explain the picture. On the NHS this follows a GP referral. Privately, no referral is needed.
2. Deciding whether to medicate
A diagnosis does not automatically mean medication. It is a decision made together, weighing what medication can and cannot do against coaching, therapy and adjustments. Some people decide against it, and that decision can be revisited later.
3. Titration
If medication is agreed, it starts at a low dose and increases in steps, with a review at each stage and baseline checks on height, weight, pulse and blood pressure. Our guide to titration explains what the appointments involve and how long it usually takes.
4. Ongoing review
Once the dose is stable, treatment moves to periodic review, either with the specialist or with a GP under shared care. Reviews cover whether the medicine is still helping, side effects, and physical monitoring.
The NHS route
The NHS route starts with a GP appointment and a referral to an adult or children's ADHD service. Once assessed and diagnosed, titration is carried out by the specialist service, after which prescribing usually transfers to the GP under shared care.
Assessment and prescriptions are free at the point of use, though the standard NHS prescription charge applies in England to each item once you are established, unless you are exempt.
Waiting times vary widely
Waits for NHS ADHD assessment differ considerably between areas and have been long in many parts of the country. Your GP or local ICB can tell you what the position is where you live. We do not publish waiting-time figures here because they change and vary by area, and an out-of-date number is worse than none.
The private route
A private assessment does not need a GP referral. You book directly, and the assessment is carried out by a GMC-registered Consultant Psychiatrist. If ADHD is diagnosed and medication is agreed, the same specialist can start and titrate it.
At The ADHD Centre, assessments are £695 online and £1,095 in person in London or Manchester. Titration and ongoing prescriptions are charged separately, and our costs guide sets out what to expect beyond the assessment itself.
The practical difference is usually speed rather than the medicine prescribed. The same licensed options are available on both routes, and the same NICE guideline applies.
Clinical context
Private diagnosis and the NHS
A private diagnosis is a clinical diagnosis. Many GPs will accept it and agree shared care once the dose is stable, which moves ongoing prescribing onto the NHS.
That agreement is voluntary, and a practice can decline it. It is worth asking your GP early what their position is, rather than discovering it at the point titration ends.
How to prepare for an assessment
An assessment goes better when you arrive with material rather than trying to recall a lifetime under pressure. None of this is compulsory, and an assessment will proceed without it, but it usually makes the appointment more productive.
- School reports, if you can find them, particularly written comments
- A sense of what was difficult in childhood, not only what is difficult now
- Examples from more than one setting, such as work and home
- Any family history of ADHD or related conditions
- A list of current medicines, including anything bought over the counter
- Notes on sleep, since sleep problems can both mimic and worsen ADHD
It also helps to think in advance about what you want treatment to change. "I want to be able to start work without an hour of circling" is a more useful target than "I want to focus better", and it gives a prescriber something concrete to measure against at review.
What happens after titration
Once a dose is stable, one of two things happens. Either the specialist continues to prescribe and review, which is the usual arrangement in private care where shared care has not been agreed, or the GP takes over under a shared care agreement.
At The ADHD Centre, once shared care is agreed you return for a specialist review every six months, in line with BNF guidance, while your GP issues the routine prescriptions in between.
Shared care is the arrangement most people hope for, because it moves the ongoing cost onto the NHS. It sets out clearly who does what: the specialist remains responsible for the diagnosis and for advice, and the GP handles the routine prescription and monitoring.
Stimulants remain Schedule 2 controlled drugs under either arrangement, so they are treated differently from ordinary medicines rather than issued as repeat prescriptions. Each prescription covers about a month, and identification may be requested at the pharmacy.
- Shared care agreements How prescribing moves to your GP, and what to do if it is declined
- Shared care in detail The full process, and the six-monthly specialist review
- What ADHD medication costs NHS prescription charges and private prices
- Supply and shortages Current status and what to do
Common questions
Can my GP prescribe ADHD medication?
Not to start it. Treatment has to be initiated by a specialist after a full assessment. Once your dose is stable, a GP may agree to continue prescribing under a shared care agreement, though practices can decline.
Do I need a referral for a private assessment?
No. You can book a private ADHD assessment directly without a GP referral.
Will the NHS accept a private diagnosis?
Many GPs will accept a private diagnosis and agree shared care once the dose is stable, which moves ongoing prescribing onto the NHS. That agreement is voluntary and a practice can decline it.
How long does the whole process take?
Assessment can be arranged within weeks privately. Titration then typically takes several weeks, because doses are increased in steps with a review at each stage.
Can I get medication without a diagnosis?
No. A diagnosis from a specialist assessment has to come first, on both the NHS and private routes.
What if I already have a diagnosis from abroad?
A UK specialist will want to see evidence of the diagnosis and treatment history before prescribing. Doses do not transfer directly between countries or products, so treatment is usually titrated afresh.
Important
This information is general and educational. It is not a substitute for medical advice. Decisions about starting, changing or stopping ADHD medication are always made together with a Consultant Psychiatrist following a full assessment.
Considering an ADHD assessment?
Any conversation about medication starts with a diagnosis. Our GMC-registered Consultant Psychiatrists assess adults and children. Assessments are £695 online and £1,095 in person in London or Manchester.
No GP referral needed. Appointments are usually available within weeks.
References
- Attention deficit hyperactivity disorder: diagnosis and management (NG87) National Institute for Health and Care Excellence
- ADHD treatment NHS
- NHS prescription charges NHS
- Controlled drugs: list of drugs and their classification GOV.UK
Last reviewed September 2026. Next review due September 2027.
