Going private in Scotland

Why people choose private assessment

NHS waiting times for ADHD assessment in Scotland vary significantly by health board. In some areas, adults wait several years. Many people choose to pay for a private assessment rather than wait, or because their GP has declined to refer them.

A private assessment does not mean a lower quality assessment, but quality does vary considerably, and it is worth knowing what to look for before you book.

Regulation in Scotland

Scotland's independent healthcare regulator is Healthcare Improvement Scotland (HIS). Private providers offering medical services (including ADHD and autism assessments) should be registered with HIS.

Registration means the provider has been inspected against clinical standards and that complaints can be escalated to an independent regulator. Its absence is a significant concern. Some newer providers are in the process of registering. Our Compare providers tool shows current HIS status for each provider.

Look for neurodevelopmental experience

When comparing providers, it is worth checking the assessing clinician's specific area of focus. ADHD and autism assessment sits within a much wider field. Different clinicians will have spent their careers working across very different areas of psychiatry or psychology, and the level of experience in neurodevelopmental conditions specifically will vary.

Reviewing a clinician's background, published work, or stated areas of practice before booking is a reasonable step. You are looking for someone who assesses ADHD and autism regularly, not someone for whom it is an occasional part of a broader caseload.

Understanding how clinics are structured

Private ADHD services vary in how they are set up, and it is worth understanding who is involved in your care at each stage before you commit.

Psychiatrist throughout: Some services use a consultant psychiatrist for the diagnostic assessment and for all subsequent prescribing and reviews. The same clinician oversees your care from assessment onwards.

Psychiatrist for assessment, nurse prescriber for ongoing care: Some clinics use a consultant psychiatrist for the diagnostic assessment, then transfer prescribing and medication reviews to a nurse prescriber. Both roles involve distinct professional training; specialist nurses working in ADHD often have significant experience in titration and ongoing management.

Psychologist-led assessment with nurse prescriber: Some services use a clinical psychologist to lead the diagnostic process, with a nurse prescriber responsible for any subsequent prescribing. This separates the diagnostic and prescribing functions across two clinicians.

There is no single model that is objectively best. Each has different strengths. What matters is understanding the structure of the service you are choosing. Before committing, ask: who carries out the assessment, who will handle prescribing and ongoing reviews, and will you see the same person at each appointment?

What a good assessment includes

A thorough private ADHD assessment should include:

• A clinical interview covering your developmental history, current symptoms, and how they affect your daily life, in your own words rather than just through scales
• Validated diagnostic tools: standardised rating scales such as the Conners Adult ADHD Rating Scales or DIVA (Diagnostic Interview for ADHD in Adults). These are important supporting evidence, but should not be the primary basis for a diagnosis
• Collateral history: information from someone who knew you as a child or who can speak to your current presentation. This is clinically important and should not be skipped or waived
• A written report with a clear diagnostic outcome and the clinical reasoning behind it

What a good assessment report looks like

Written reports vary considerably in length and depth. Length alone is not a reliable indicator of quality. What matters is whether the report reflects a genuine clinical engagement with your history and presentation.

A good report describes your developmental and personal history in meaningful terms, explains how your symptoms manifest across different areas of your life, and uses validated rating scales as supporting evidence alongside clinical reasoning rather than as a substitute for it. Under AQAS (the Academy of Quality Assurance in Psychiatry and related specialties) standards, a good assessment report documents the clinician's reasoning clearly enough that another professional reading it can follow the basis for the diagnosis.

This matters beyond the assessment itself. When your GP reads the report to decide whether to enter a shared care agreement, the clarity and quality of what they receive will influence their response.

Questions to ask before you book

• Is this provider registered with Healthcare Improvement Scotland?
• Who carries out the assessment: a consultant psychiatrist, clinical psychologist, or nurse prescriber? What are their specific qualifications and their background in neurodevelopmental conditions?
• Who will be responsible for my ongoing prescribing and medication reviews after diagnosis? Is it the same clinician who assessed me?
• What validated tools are used, and is collateral history included?
• What does the written report include? How long does it take to receive?
• Do you support shared care with NHS GPs in Scotland? What does your shared care letter include?
• If my GP declines shared care, can you continue to prescribe, and at what cost?

Understanding the full cost

Private ADHD care costs vary considerably and are not always obvious upfront. The assessment fee is usually the most prominently advertised figure, but the total cost of care includes much more:

• Assessment fee: the initial consultation and written report
• Titration appointments: finding the right medication and dose typically requires several follow-up appointments. Ask how many are included in the quoted price and what additional appointments cost
• Ongoing review appointments: once medication is stable, regular reviews are needed (typically every 6–12 months). Clarify who conducts these, how often, and what they cost
• Private prescription fees: if you are not on shared care with your GP, each prescription requires a private prescription charge. Costs vary by provider; some Scottish clinics charge from around £30, with others charging more. Ask upfront what the prescription fee is and how often it applies
• Medication costs: private prescriptions can be dispensed at any pharmacy, including standard high street pharmacies, not only private ones. Medication costs vary between pharmacies and it is worth comparing before settling on one

Some clinics suggest a specific pharmacy. You are not required to use it. A private prescription can be taken to any pharmacy you choose.

Always ask for a written breakdown of what each stage costs before you commit.

After a private diagnosis

Receiving a private diagnosis is a starting point, not an endpoint. What comes next (titration, ongoing prescribing, medication reviews, and potentially shared care) involves decisions and relationships that are worth understanding before you begin.