If you’re reading this, you’re probably doing that familiar ADHD thing: you finally decide to sort it out… and then you hit the wall of waiting lists. The choice between an NHS route and a private ADHD assessment often comes down to time, but it’s not only about speed. It’s also about what happens after diagnosis, especially if you want medication, letters for work, or ongoing reviews.
Below is a grounded, Birmingham- and Staffordshire-specific guide to ADHD diagnosis waiting times in the UK, what the ADHD assessment waiting list looks like right now, and what the realistic alternatives are.
The short version (Staffordshire vs Birmingham)
Here’s the “I just need the gist” view, using the most reliable public information available.
Waiting time snapshot table
The national backdrop (why everyone is stuck)
As of the end of December 2025, England had 562,450 open referrals for a possible ADHD diagnosis, and 61.6% of adults waiting had already been waiting over a year.
That is the environment Staffordshire and Birmingham are operating in.
What an ADHD assessment is supposed to involve (not just a quiz)
A decent assessment is not meant to be a “tick-box personality test,” even though it can feel that way online.
NICE (the UK’s clinical guidance body) says ADHD should only be diagnosed by a suitably trained specialist (for example, a specialist psychiatrist or another appropriately qualified professional with training and expertise). And the diagnosis should be based on:
- a full clinical and psychosocial assessment across settings (work, home, education),
- a developmental and psychiatric history,
- and observer reports and mental state assessment, where possible.
That thoroughness is good medicine. It’s also part of why the NHS ADHD assessment pathway can move slowly when services are overwhelmed.
Why waiting lists get so long (the honest version)
A few things stack on top of each other:
1) Demand has exploded faster than capacity
England’s open referrals are now in the hundreds of thousands, and the proportion waiting over a year is huge.
So even if a local team is well-run, they are often trying to empty a bathtub with the tap fully on.
2) ADHD assessments are time-heavy by design
If clinicians follow NICE properly, they’re not just diagnosing. They’re also screening for overlap and lookalikes (anxiety, depression, trauma, sleep problems, substance use, autism traits, and so on). That takes time.
3) “Assessment wait” is not the whole story
Some areas also have a second queue after diagnosis, especially for medication titration and regular monitoring. If your goal is medication, the timeline you care about is often referral → assessment → titration → shared care (maybe).
Birmingham: what the public numbers say (and how to interpret them)
Birmingham adult pathway details that catch people out
BSMHFT’s FOI response notes that they provide adult ADHD diagnoses for the following:
- 18+ in Solihull
- 25+ in Birmingham
That age threshold detail matters if you’re, say, 21 and living in Birmingham. People sometimes assume “adult service starts at 18 everywhere,” and in Birmingham, it is more complicated.
Average waiting time reported for 2023 (completed waits)
For adult ADHD diagnoses, BSMHFT reported:
- 78 weeks average wait from referral to first appointment (completed waits, Jan–Dec 2023)
- 83 weeks average wait from referral to a decision on diagnosis/discharge (same period)
- waiting list snapshot: 3,940 people as of 31 Dec 2023
If you translate 78 weeks into “calendar life,” you’re basically looking at roughly a year and a half.
The “if I joined today” estimate that got attention
In FOI 0272/2023, BSMHFT estimated 5.41 years for a hypothetical adult added to the wait list “today” (at that time), based on their then-current waiting list size and assessments completed over the previous 12 months. They also reported 3,797 adults awaiting assessment in that response.
A fair nuance: this kind of estimate is a moving target. Staffing changes, outsourcing changes, and referral rates change. Still, it’s not a number that a trust publishes lightly, and it explains why people in Birmingham frequently compare NHS vs. private ADHD assessment options.
Staffordshire: what the NHS service itself is telling adults
For South Staffordshire, the most direct statement comes from MPFT’s own service page:
- New joiners are likely to wait “many years” before an assessment can be offered.
That’s blunt, but also refreshingly honest.
A Staffordshire-specific complication: medication after private or RTC diagnosis
MPFT’s page also states that, “as per ICB guidelines,” they are unable to accept private and Right to Choose ADHD diagnoses to commence treatment in their pathway. They say you would need to be reassessed within MPFT to begin medication through them.
This is the bit that many people only discover after they’ve paid for a private ADHD assessment elsewhere. It doesn’t make private “pointless,” but it changes what private can realistically buy you in Staffordshire if your goal is NHS-led medication.
Can you use Right to Choose while staying on the MPFT waitlist?
MPFT also says, “Yes, you may access the right to choose while waiting for their service.”
So you don’t necessarily have to treat it as an either-or decision.
Right to Choose (England): the “middle option” NHS ADHD assessments
Right to Choose is often described as an NHS ADHD assessment, which is… sort of true and sort of misleading.
- The legal right to choose is described in the NHS Choice Framework. In some situations, you have legal rights to choose, and the NHS does. The UK also points people to the Choice Framework.
- In practice, it means your GP can refer you to an NHS-contracted provider (not just your local trust), as long as the referral qualifies.
Current provider-published RTC waiting times (examples)
Two widely referenced RTC providers publish waiting time information:
- Psychiatry UK (RTC): Adult ADHD initial assessment 32–40 weeks from GP referral; titration 44–52 weeks after assessment (on their waiting time update page).
- ADHD 360 (RTC): shows ICB-specific “projected wait times,” listing NHS Staffordshire and Stoke-on-Trent ICB: 6–8 months (business as usual) and NHS Birmingham and Solihull ICB: exceeded allowance; allowances reset 01/04/2026 (per their page’s own “up-to-date as of 08/01/2026” note).
I wouldn’t treat any of these as a guarantee, but they’re useful for planning.
Birmingham-specific twist: some RTC providers paused new referrals locally
Birmingham and Solihull ICB published an FAQ stating a small number of private Right to Choose providers temporarily paused new referrals until the end of the 2025/26 financial year, naming:
- Clinical Partners
- Psychiatry UK
- ADHD 360
So if you’re in Birmingham, RTC may still be possible, but you might need to pick a provider not on that paused list, depending on what’s current when your GP submits it.
Private ADHD assessment vs NHS: the trade-offs people don’t say out loud
A private ADHD assessment is usually faster. That part is straightforward.
The less straightforward part is what happens next.
Comparison table (practical, not moral)
| Question | NHS route | Right to Choose | Private route |
| Upfront cost | Usually £0 | £0 | Self-funded |
| Wait for the assessment | Often long (can be years in some areas) | Often shorter than the local NHS; varies by provider | Often the shortest, depending on the clinic |
| Medication start and monitoring | Integrated in NHS pathway (still may be slow) | Often included, but can have another wait (titration) | Usually available, but paid; NHS takeover is not automatic |
| Will your GP prescribe under shared care? | More likely | Often possible, still not guaranteed | It can be difficult, depending on local policy and the GP |
The shared care reality (why private can feel messy)
A lot of people do a private ADHD assessment, assuming the NHS will then “continue the care.” Sometimes that happens. Sometimes it doesn’t.
ICB and GP guidance commonly stress that
- GPs are not obliged to enter shared care arrangements and may decline on clinical or capacity grounds.
- Some ICB position statements explicitly say there is no obligation for a GP to prescribe treatment recommended by a private provider.
And in Staffordshire (South Staffordshire / MPFT), the service states directly that they cannot accept private or RTC diagnoses to commence treatment in their pathway.
So, if medication is a big part of why you want an assessment, it’s worth planning the “after” at the same time as the assessment itself.
How to pick a private ADHD assessment that won’t backfire
Not all private assessments are equal. Some are excellent. Some are rushed.
Here’s a checklist that’s both quality-focused and realistically NHS-facing.
What you want the clinic to be able to say “yes” to
- Who is diagnosing? Ideally, someone clearly meeting NICE expectations (specialist psychiatrist or other appropriately qualified clinician with training and expertise).
- Do they do a full history, not just rating scales? NICE is explicit that diagnosis should be based on a full assessment, developmental and psychiatric history, and observer reports where possible.
- Do you get a detailed written report? This matters for reasonable adjustments at work, university support, and future clinicians.
- Do they offer follow-up and monitoring? If they start medication, you’ll need ongoing review.
- Do they have a clear stance on shared care? Not “yeah, probably,” but a real explanation of how often it works and what happens if it doesn’t.
A realistic example (so it’s not abstract)
If you work in Birmingham city center and you’re already on thin ice at work for missed deadlines, the “value” of a private ADHD assessment is not just the label. It’s the documentation and plan: a proper report, plus a letter with specific adjustments like protected focus time, written instructions after meetings, and permission to use noise-cancelling headphones. Without that, you’ve paid for clarity, but you’re still stuck negotiating your life with vibes.
What to do while you’re waiting (NHS list, RTC queue, or private appointment)
Waiting can be weirdly demoralising, because you’re not “untreated,” exactly, but you also don’t have a framework yet.
A few practical things that tend to help the eventual assessment and your day-to-day life:
1) Build a simple evidence pack (one page is enough)
- 5 to 10 specific adult examples (work, relationships, driving, money, admin).
- 2 to 3 childhood indicators if you can (school reports, “always losing stuff,” “bright but inconsistent,” that kind of thing).
- A list of coping strategies you already use (calendars, alarms, caffeine, last-minute panic sprints).
NICE expects symptoms to have started in childhood and persisted and to cause meaningful impairment. Concrete examples make that discussion easier and less vague.
2) If you’re in South Staffordshire, read MPFT’s rules before paying privately
Because MPFT says private and RTC diagnoses cannot be used to start treatment in their pathway, you want to understand what “success” looks like for you before you spend money
3) If you’re in Birmingham and thinking RTC, check the pause list
Birmingham and Solihull ICB explicitly listed providers that paused new referrals locally until the end of 2025/26. That can affect your plan.
FAQs (People Also Ask style)
What is the ADHD diagnosis waiting time in the UK in 2026?
There isn’t one national waiting time that applies everywhere, but England’s national waiting list data is stark: at the end of December 2025, 61.6% of adults waiting for a possible ADHD diagnosis had already been waiting more than a year.
How long is the NHS ADHD assessment waiting list in Birmingham?
BSMHFT reported an average of 78 weeks from referral to first appointment for completed waits in Jan–Dec 2023 and a waiting list snapshot of 3,940 people at 31 Dec. 2023.
They also produced a modeled estimate of 5.41 years for a hypothetical new joiner at that time in a separate FOI response.
How long is the Staffordshire NHS wait for an adult ADHD assessment?
MPFT’s South Staffordshire Adult ADHD and Autism Service tells patients that people joining the waiting list are likely to wait “many years” before assessment can be offered.
Can I get a private ADHD assessment and then move to NHS medication in Staffordshire?
MPFT states that, as per ICB guidelines, they are unable to accept private and right-to-choose ADHD diagnoses to commence treatment through their pathway, and you would need reassessment within their team to begin medication through MPFT.
Can I use Right to Choose and stay on the MPFT waiting list?
MPFT says yes, you may access the right to choose while waiting for their service.
Conclusion (what I’d do if this were my situation)
If you’re in Birmingham or Staffordshire, the public info makes one thing clear: the ADHD assessment waiting list can be long enough to derail jobs, degrees, and relationships. A private ADHD assessment can be a practical shortcut, but only if you plan the “after” (reports, follow-ups, and how prescribing will work). In Staffordshire specifically, MPFT’s stance on not starting treatment from private or RTC diagnoses is something you genuinely want to read before you spend.
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