ADHD & Autism Clinic in Leicester

The NHS waiting list crisis for ADHD and autism

In England, the average waiting time for an adult ADHD assessment on the NHS has crossed 4 years, with many ICBs (Integrated Care Boards) now refusing new referrals altogether. Leicestershire is in the 4–7 year range. For children, NHS waits are 2–3 years. NICE recommends assessment within weeks of GP referral; the system simply does not have the capacity to deliver that.

The problem is structural, not solvable by waiting. Demand for ADHD and autism assessment has grown 5x in the past decade, driven by increased awareness, better recognition that adult ADHD exists (it was historically considered a 'children's condition'), and the impact of remote work / structured environments collapsing during COVID. NHS specialist capacity has not grown in line. Most ICBs are now restricting referrals.

This left tens of thousands of UK adults stuck in a position where they suspected ADHD or autism, their GP confirmed referral was appropriate, but no specialist appointment was likely for years. The government built NHS Right to Choose specifically to address this.

NHS Right to Choose explained

Under the NHS Choice Framework (a statutory entitlement, not a policy), patients have a legal right to choose their provider for elective specialist care. For ADHD and autism assessment, that includes any private provider who holds an NHS contract under the Right to Choose framework.

The mechanics:

1. You ask your GP for a Right to Choose referral letter specifying our clinic as your chosen provider.
2. Your GP issues the referral. They cannot refuse — it's a statutory right, not a discretionary one. (If they push back, point them at the NHS Choice Framework guidance.)
3. The referral arrives with us. We schedule your pre-assessment screening and video assessment.
4. Assessment happens within 8 weeks of referral (typically faster).
5. If diagnosis is given and treatment recommended, we initiate. Long-term care typically transitions to your GP via shared-care agreement.
6. The NHS pays our fee. You pay nothing for the assessment.

For most patients, Right to Choose is the right route. The exceptions: if you want assessment faster than 8 weeks (we can sometimes do 4 weeks fully-private), or if your GP refuses to issue the Right to Choose letter (rare, but it happens — you can pay privately, then dispute the GP's refusal separately).

What's actually involved in an assessment?

Pre-assessment screening (1 hour of your time)

Before the diagnostic interview, you complete validated screening questionnaires:

• DIVA-5 — the Diagnostic Interview for ADHD in Adults, version 5. Walks through every DSM-5 ADHD symptom in detail, asks for current and childhood presentation, real-world examples.
• ASRS — Adult ADHD Self-Report Scale. Short screen used to triage referrals.
• AQ-10 or full AQ-50 — Autism Quotient. Screens for autism traits.
• Parent / partner / school reports — essential for ADHD. The diagnosis requires evidence of symptoms across at least two settings, ideally from someone who's known you a long time.
• ACE+ for adults reporting childhood difficulties — a structured history of developmental milestones, school behaviour, family environment.

The 90-minute video assessment with Dr Sara Patel

Dr Patel reviews your pre-screening questionnaires before the appointment, then runs a structured clinical interview covering:

• Current symptoms and how they affect work, relationships, finances, daily functioning
• Childhood history (ADHD symptoms must have been present before age 12)
• Family history of ADHD, autism, or other neurodevelopmental conditions
• Differential diagnosis — ruling out conditions that mimic ADHD (anxiety disorders, depression, trauma, thyroid dysfunction, sleep disorders)
• Co-occurring conditions — autism, anxiety, depression, dyslexia, dyscalculia are common alongside ADHD
• Medical, medication, and substance history

For autism assessment, the interview also covers social communication patterns, repetitive behaviours and special interests, sensory sensitivities, and life adaptations.

The written report (within 7 days)

The diagnostic report covers:

• Each DSM-5 criterion and whether it was met
• Differential diagnosis considered and ruled out
• Co-occurring conditions noted
• Functional impact assessment
• Treatment recommendations — medication if applicable, therapy referrals, workplace adjustments, university DSA support, DVLA notification if relevant
• Shared-care template for your GP

Medication options after diagnosis

If medication is recommended (always optional, never mandatory):

Stimulants — first-line for adult ADHD

• Methylphenidate (Concerta XL, Medikinet XL, Equasym XL) — the most-prescribed adult ADHD medication globally.
• Lisdexamfetamine (Elvanse) — long-acting amphetamine prodrug. Often used when methylphenidate is ineffective.
• Dexamfetamine — short-acting, used for fine-tuning when long-acting stimulants don't fit.

Non-stimulants — for patients who can't tolerate stimulants

• Atomoxetine (Strattera) — NRI, slower onset, no controlled-drug status.
• Guanfacine (Intuniv) — alpha-2 agonist, useful for ADHD with anxiety.

Mohammed (Independent Prescriber) handles prescribing and dispensing same-day after diagnosis. Titration appointments at week 4 and week 8 to find the right dose; then transition to shared care with your GP for ongoing prescriptions.

For children: differences in the assessment pathway

Children's assessments use age-appropriate screening tools (Conners questionnaires, SDQ) plus essential input from school. The video assessment is typically 60 minutes, with the parent present and the child engaged for part of it. We provide school consent forms so the developmental history component can include teacher observations.

Children with formal ADHD or autism diagnoses are entitled to support under the Children and Families Act 2014 — EHC plans, school adjustments, and (in some cases) educational psychology referrals. Our reports are accepted by schools and Local Authorities for these purposes.

AuDHD: combined ADHD and autism

For decades, ADHD and autism were treated as separate conditions. Research over the past 15 years has shown they co-occur far more often than chance — around 50–70% of autistic adults also meet ADHD criteria, and around 20–40% of ADHD adults also meet autism criteria.

Single-vertical NHS pathways often miss the second diagnosis. If you're referred to an autism service, they may not screen for ADHD, and vice versa. Our default is to screen for both as standard. AuDHD presentation — you can have one diagnosis without the other, but if you have both the treatment approach changes (medication helps the ADHD piece, but the autism piece needs different accommodations).