If you think you may have ADHD, the next step is a formal assessment. In Bristol there are a few routes. Always check current details with your GP and the providers, as services and waiting times change.
1. NHS referral via your GP
Start by booking a GP appointment and describing your symptoms and how they affect daily life. Your GP can refer you for assessment through the local NHS pathway for Bristol, North Somerset and South Gloucestershire. Waiting lists can be long.
2. Right to Choose
In England, you may be able to choose an approved provider for an NHS-funded ADHD assessment through Right to Choose. Ask your GP about this and check what the provider offers, including any shared-care arrangements for medication.
3. Private assessment
Private assessments are quicker but cost money, and some GPs have their own policies on shared-care prescribing afterwards. Check that any provider is properly regulated and that the clinicians are qualified.
Tips for your assessment
Keep a list of examples from childhood and adulthood
Ask a family member or partner to share their observations
Bring school reports if you have them
ADHD is often missed in women and girls, so read our guide to ADHD in women.
What happens during an ADHD assessment?
Assessment processes vary between providers, but most include:
A detailed clinical interview about current symptoms, childhood history, school experiences, work, relationships and daily functioning
Questionnaires or rating scales that you (and sometimes someone who knows you well) complete
A review of other factors such as mental health, sleep, medical conditions and substance use that can look similar to ADHD
A discussion of the outcome, including a written report and recommendations if ADHD is diagnosed
Assessments can take anything from an hour or two to several sessions. It is normal to feel nervous. Remember that the clinician’s job is to understand you, not to catch you out.
NHS waiting times: what to expect
Demand for adult ADHD assessment across England has grown significantly in recent years, and waiting lists in many areas are long. Waiting times differ by provider and change over time, so ask your GP what the current expectation is. If you are told the wait is lengthy, ask about Right to Choose and make sure you are on the list.
Right to Choose: how to ask your GP
Right to Choose lets you ask to be referred to an alternative NHS-commissioned provider, which may have shorter waits. A few practical tips:
Raise it at your appointment, and explain that you would like to be referred under Right to Choose for adult ADHD assessment.
Bring a clear summary of your symptoms and how they affect your life.
Ask your GP which providers they will refer to and whether they accept shared-care prescribing from providers outside the NHS pathway, as policies differ.
Check the provider’s own information about waiting times, what is included and what happens after diagnosis.
GPs and providers vary in how they handle this, so be patient and persistent. It may take more than one conversation.
Going private: what to check
If you choose a private assessment, it is worth checking:
That the clinician is appropriately qualified and registered (for example, a psychiatrist registered with the GMC or a suitably qualified psychologist)
What the fee covers: assessment only, report, follow-up appointments, medication titration
Whether your GP will take on prescribing after a private diagnosis (this is called shared care and not all practices agree)
Whether the report will be accepted by your employer or university if you need adjustments
Private costs vary a lot between providers, so compare several before deciding. [Note: avoid quoting specific prices unless you check them.]
Questions to ask any assessment provider
What is the current waiting time to first appointment?
What does the assessment involve and how long does it take?
Who carries out the assessment and what are their qualifications?
What happens after diagnosis, including medication and follow-up?
What are the total costs, if any?
Will you share information with my GP?
After diagnosis: what next?
Receiving an ADHD diagnosis can bring a mixture of relief, sadness and curiosity. Next steps might include:
Discussing treatment options with your clinician, including whether medication is right for you
Telling your employer or university if you want adjustments (see our guides to ADHD at work and ADHD coaching for students)
Learning more about how ADHD affects you personally
Building practical routines and support, with an ADHD coach if you wish
Medication and shared care
If you are prescribed ADHD medication, a specialist usually starts and adjusts it. Your GP may then continue prescribing under a shared-care agreement, with regular reviews. Medication decisions are a medical matter between you and your prescriber, so always follow their advice.
Before your GP appointment: a checklist
Write down your main difficulties with attention, organisation, impulsivity or restlessness, with real-life examples.
Note how long they have been present, including as a child.
Describe the impact: on work, study, relationships, finances, health and wellbeing.
List anything you have already tried, such as apps, planners, therapy or coaching.
Mention other conditions you have, or family history of ADHD, autism or similar.
Say what you want: for example, “I would like to be referred for an ADHD assessment.”
Ask about timescales and what will happen next.
What if my GP is not sure or says no?
Some people have a smooth experience, while others meet hesitation. If your GP is reluctant:
Calmly explain the impact on your daily life, using your written examples
Ask what they would need to see to make a referral
Ask whether another GP in the practice has more experience of adult ADHD
Ask about Right to Choose providers
Consider asking for your reasons to be noted in your records
Contact the practice’s patient liaison service or the local NHS patient advice service if you have concerns about how your request was handled
Be persistent but polite. Being clear and prepared makes a big difference.
Understanding your assessment report
If you are diagnosed, you will usually receive a written report. It may include a summary of your history, the outcome of the assessment, any other conditions considered and recommendations. Keep a copy. You may need it for your GP, employer, university or Access to Work. If anything is unclear, ask the provider to explain.
What to watch out for when choosing a provider
Providers who promise a diagnosis before they have met you
Unclear information about costs, timescales or what happens afterwards
A lack of information about who carries out the assessment and their qualifications
Pressure to buy extra services
No information about how your GP will be involved in future prescribing
Take your time and compare more than one option where you can.
A quick overview of the steps
Recognise the signs and write down examples
Book a GP appointment and ask for an assessment
Discuss NHS and Right to Choose options
Complete the assessment and receive your outcome
Talk through treatment and support, including medication and practical help
Consider coaching, peer support and workplace or university adjustments
Support while you wait
Waiting does not have to mean going without help. An ADHD coach can help you build routines, manage time and reduce overwhelm straight away. Find out about ADHD coaching in Bristol.