Talking to your GP

Booking a GP appointment is one option, not the next step. Some people take a summary straight to their surgery. Some sit with it for a few months. Some never book at all and instead change how they work, rest and ask for help. All of those are reasonable, and none of them is the wrong answer.

If you do decide to go, it helps to know what you're going for. An assessment can:

• give you a formal yes or no from a clinician, after a structured process
• unlock the specific things that ask for a diagnosis, such as certain medications or formal records
• put shared language around patterns you may have noticed for years

An assessment can't:

• happen quickly in most cases. Waits vary a lot by area, and in many places they're long
• guarantee the answer you're expecting
• change your day to day on its own. Support still has to be asked for and set up separately

Knowing that in advance takes some of the sting out of a slow or unexpected outcome.

It's also worth being honest with yourself about which of three wants is driving you, because they pull in different directions:

• Diagnosis. You want the formal outcome, usually because something specific depends on it.
• Support. You want work, home or study to be less exhausting. Some of that needs a diagnosis. A lot of it doesn't.
• Explanation. You want to understand why certain things have always cost you more. That's a real reason to go, and also something reading, community and self-knowledge can partly answer while you wait.

You can want all three. Naming the main one helps you ask for the right thing in a ten-minute appointment.

It's worth keeping a short diary first. Two weeks is plenty. You're not building a case, you're making it easier to be specific at a moment when you're nervous and the clock is running. Concrete beats general every time, and a useful example has three parts: roughly when or how often, what actually happened, and what it cost you.

• Vague: “I can't concentrate.” Useful: “I sat down to do my tax return at 9am, reread the first page around ten times, and closed the laptop at 2pm with nothing filled in.”
• Vague: “I find socialising hard.” Useful: “After my sister's wedding I couldn't speak for the rest of the evening and slept most of the next day.”
• Vague: “I'm disorganised.” Useful: “I've missed three dental appointments this year, all of them in my calendar with two alarms set.”
• Vague: “I'm sensitive to noise.” Useful: “I eat lunch in my car most days because the extractor fan in the office kitchen makes me feel sick.”

Other people notice things you can't see from the inside, and childhood detail matters for most UK pathways. If it feels safe and comfortable, you could ask a partner, friend or flatmate what they quietly work around for you; a parent or older relative what you were like at five, at nine, at fourteen; your school or college for old reports; or a manager or colleague, if you're already open at work. Nobody is under any obligation to help, and you don't have to tell anyone why you're asking.

Then keep what you gather to one page:

• your three to five clearest examples
• any old reports, school records or previous letters
• your free NeuroWeb summary, if you have one
• relevant family history, if you know it
• one sentence on what you want from the appointment

That's enough. You don't have to arrive polished, and a screening summary is a starting point for a conversation, never a diagnosis.

Pick the opener that sounds like you, and say it in the first minute before anything else crowds it out.

After that, describe the impact rather than the label. “I think I have ADHD” invites a debate about whether you're right. What's actually happening to you doesn't. This is the part that tends to make the most difference.

Say what it costs you, where, and how often:

• Work: “I've had two warnings for missed deadlines, and I still work most evenings to keep up.”
• Home and relationships: “My partner handles all the admin because post goes unopened for months.”
• Health: “I'm getting four or five hours' sleep because I can't switch off, and I've been signed off twice this year.”

Dates, numbers and consequences carry further than adjectives. Three concrete examples do more than ten vague ones.

A standard GP appointment is around ten minutes, so assume you'll cover two or three things properly and no more. Before you go in, decide which two you'd be most sorry to leave without saying, and lead with those. You can also ask for a double appointment when you book: “This is a long-standing thing and I'd like a bit more time. Could I have a double slot?” Many practices will, some can't fit it, and that isn't a judgement on your request.

Bring something written and hand it over early rather than at the end. Put your name and the date at the top. “I've written this down because I lose my thread when I'm nervous. Could you read it, or add it to my notes?” If you have a NeuroWeb summary, it can go in the same envelope. It's a screening result rather than a diagnosis, and it's fine to say that yourself.

If you're told you seem fine: if you've got good at covering things up, that isn't the same as there being nothing to cover. Hiding difficulty has a cost of its own. You can say, calmly:

• “I've had a lot of practice at looking fine. What it costs me is being unable to function at home.”
• “I can hold this together for an hour. I can't hold it for a week, and that's when things fall apart.”
• “People who live with me see a different version of this. Would it help if one of them wrote something?”

You're allowed to disagree politely and keep going.

Don't leave the referral implied. Ask it plainly: “Are you able to refer me for a neurodevelopmental assessment?” Then, before you leave the building, write down:

• yes or no
• if yes, where to, and roughly how long the wait is
• if no, the reason given and what would need to change
• the date, and the name of the person you saw

There isn't one route. What's open to you depends on where you live, and the details change, so treat everything here as a starting point to check locally rather than a promise about what you'll be offered.

Through the NHS, most adult assessments start with your GP. You describe what you're finding hard day to day, and if they agree it's worth exploring, they refer you on to a specialist service. A few areas allow self-referral, but most don't. Your GP practice, or your local NHS service website, will tell you which applies where you are.

Waiting times vary enormously. In some places people are seen within months. In many others the wait runs into years, and some services have paused or closed their waiting lists to new referrals. We won't quote a figure, because any number we gave would be wrong somewhere and out of date quickly. Ask your GP what they're currently seeing, and look up your local integrated care board (ICB) if you're in England. Scotland, Wales and Northern Ireland are organised differently, through health boards and trusts. A long wait isn't a judgement on you.

NHS Right to Choose applies in England only. In England you generally have a legal right to choose which provider you're referred to for a first outpatient appointment for a physical or mental health condition. Three things have to line up: your GP agrees a referral is clinically appropriate, the provider holds an NHS contract for that service, and the provider will accept the referral. It is a right to choose where you're referred, not a right to be referred, and it doesn't guarantee a short wait. Some people use it to be referred to an independent provider with a shorter wait, still NHS-funded, so still free at the point of use.

Worth knowing:

• It doesn't apply in Scotland, Wales or Northern Ireland.
• There are exclusions, including urgent and emergency care, and it only covers providers commissioned to do that assessment.
• GPs vary a lot in how familiar they are with it. Some refer readily, some are unsure, some decline. Naming the provider and bringing their referral form often helps.
• This area keeps moving. Some integrated care boards have capped, paused or added approval steps for these referrals. Check the current NHS patient choice guidance and your own ICB before relying on it.

Going private is the other main route. Costs vary widely, and ADHD and autism are not priced the same. As a rough guide, an adult private ADHD assessment often falls somewhere around £500 to £1,500, while a full adult autism assessment more often starts near £1,000 and can run to £3,000 or more. Treat those as orders of magnitude, not quotes, and ask for the fee in writing. Ask exactly what it includes: the report, any follow-up, and, for ADHD, medication titration and ongoing reviews, which are usually charged separately.

One caveat matters more than the price. Some NHS GPs and services won't take on shared-care prescribing after a private diagnosis. Shared care is voluntary for GPs, and some practices and ICBs have policies against it. If medication is part of why you're seeking assessment, ask your practice in advance what they will and won't accept, in writing if you can. It's also reasonable to check the clinician's registration (GMC, HCPC or NMC) before booking.

Work and study are sometimes a route in as well:

• Some employers fund assessments, often through occupational health. It's worth asking HR or OH what's available. Access to Work supports workplace adjustments rather than diagnosis, and Northern Ireland runs its own version of the scheme.
• Some universities have disability services or hardship funds that may contribute. Disabled Students' Allowances usually supports you once you have evidence, rather than paying for the assessment itself. Ask your disability adviser what your institution actually funds.

Plenty of people are turned down the first time they ask. It's not a verdict on you, and it doesn't mean you were wrong to ask.

If you hear “everyone's a bit like that”, or that you seem to be managing fine, there's one sentence worth having ready.

Asking for the refusal and its reason to be written down is one of the most useful things you can do in that room. It creates a record, and it makes the decision reviewable later. Sometimes it prompts a second look on the spot.

Other options, roughly easiest first:

• See a different GP at the same practice. You don't need a reason, and you don't have to explain the last appointment. Ring reception and book with someone else.
• Take a supporter next time. A partner, friend, relative or advocate can sit in, take notes, and confirm what you've described. You don't have to be the only witness to your own life.
• Use the practice complaints procedure if you were treated dismissively rather than simply told no. Every surgery has one, usually on its website or through the practice manager.
• Go outside the practice. In England, a complaint about GP services can go to your integrated care board, and then to the Parliamentary and Health Service Ombudsman if you're still unhappy. The Patient Advice and Liaison Service (PALS) is free and isn't a complaint in itself, though it sits in hospital trusts rather than surgeries. Scotland, Wales and Northern Ireland run their own advice and advocacy services.

If the appointment took everything you had, put it down for now. The note you asked for will still be there when you come back to it.

Getting referred and being assessed are two different conversations, months or years apart, and they ask different things of you. The GP appointment is about whether it's worth looking. The assessment is the looking.

Formats vary by service, but most adult assessments involve some combination of:

• questionnaires sent in advance, sometimes one for you and one for someone who knew you as a child
• a long conversation, often ninety minutes or more, sometimes split across sessions
• questions about childhood as well as now, because most UK pathways look for a long-standing pattern rather than a recent change
• questions about what you find hard, asked several different ways
• a report afterwards, usually weeks later, and sometimes a follow-up appointment to go through it

Three things are worth knowing before the day.

First, an assessor is not a gatekeeper you have to get past. Their job is to work out what fits. Answering to look more convincing tends to make the picture less accurate, not more, and a good assessor is looking for the shape of your life rather than a score.

Second, you can bring the same page you took to your GP, and it's usually more useful here. Your examples, old school reports, work reviews, any previous letters. If someone who knew you as a child can write a paragraph, that often carries real weight.

Third, masking is the thing most likely to get in the way. A long appointment with a stranger is exactly the situation where people perform being fine, and then leave having described someone else's life. It is completely reasonable to say so out loud:

You can ask for adjustments to the assessment itself, and asking is not evidence against you. A quieter room, the questions in writing beforehand, a video appointment instead of in person, breaks, or bringing someone with you. Services differ in what they can offer, but the request is normal.

Outcomes are not only yes or no. An assessment can end with a diagnosis, without one, with a different explanation than the one you expected, or with a recommendation for something further. Any of those is information you didn't have before, and none of them is a verdict on you.

Waits for adult assessment in the UK are often long, and they vary a lot between areas. It helps to know roughly what usually happens.

Between referral and assessment:

• A confirmation letter or text, sometimes weeks later. If nothing arrives within about a month, ring the practice and check the referral was actually sent.
• Questionnaires, sometimes for you and sometimes for someone who knew you as a child.
• Long quiet stretches. Silence usually means you're on the list, not that you've been forgotten. Checking in every few months is reasonable.
• In England, Right to Choose is normally used at the point of referral rather than once you're already on a list. If you want to use it, that means going back to your GP and asking about a referral to a different provider.

While you wait, keep notes. Jot down examples as they happen: the date, what was going on, what it cost you. Keep older evidence too, such as school reports, work reviews or occupational health letters. Assessments ask for specifics, and memory under pressure isn't a reliable filing system.

Support doesn't have to wait for a diagnosis. Adjustments at work or in study are usually based on how something affects you rather than on a label, and Access to Work doesn't always require a formal diagnosis. Quieter spaces, written instructions instead of spoken ones, flexible hours, shorter meetings: these are things you can ask for now.

You can also re-screen later. Coming back in a few months and comparing gives you something memory can't: a before and after, in your own words. It's still a picture of you right now, not a score to pass or fail, and a picture that has changed is worth having.