Thank you for your reply, and I am really sorry to hear how difficult it has been for you and your daughter. Unfortunately, what you describe is very common and many families just like yours are reporting feeling lost, overwhelmed and waiting significant lengths of time. The government is currently conducting a review to investigate exactly this. You are clearly doing everything you can to help her but are not receiving the support you both deserve.

A few points that may help (continued in two posts)

Private assessments and NHS recognition
Private ADHD diagnoses are generally recognised by the NHS, provided they follow NICE guidelines, are conducted by a specialist, and include comprehensive documentation. However, the NHS clinician or team will make the final decision on treatment and may require their own assessment or shared care agreement for NHS-funded medication. A private diagnosis doesn't bypass NHS waiting lists for treatment but can initiate the process, with a private specialist often writing to your GP to establish shared care for prescriptions.

Key Points to consider:
• NICE Compliance: The diagnosis must meet the standards set by the National Institute for Health and Care Excellence (NICE) guidelines. These are CG123 for ADHD and CG170 for autism
• Qualified Clinician and registered with appropriate body: The assessment must be done by a specialist (e.g., psychiatrist, specialist nurse, or psychologist).
• Gold-standard tools must be used (e.g. ADOS-2, ADI-R)
• Detailed Report: A comprehensive report with full clinical history, developmental history, and observer reports is crucial.

For NHS Treatment (e.g. Medication/Therapy):
• Shared Care Agreement: Your private specialist can write to your GP to set up a shared care agreement for NHS prescriptions, this can help cover costs etc.
• GP Discretion: Your GP can refuse to prescribe medication based on a private diagnosis, as the NHS clinician takes clinical responsibility. Therefore if medication is prescribed another assessment may be done by them.
• Reassessment: Some NHS services may still conduct their own reassessment to confirm the diagnosis before starting any treatment but the private report can usually be used if done well.

Right to Choose vs private
• Right to Choose assessments should be fully NHS-recognised, however waiting lists are still be very long, and some services can range to 18 months+ in high demand areas. It might be worth contacting your local area to find out approximate wait times
• You could choose to do a hybrid approach, have a private assessment now for your own clarity and seeking support now, while staying on CAMHS/Right to Choose lists for NHS follow-up and medication if needed.
It is always worth staying on NHS services due to savings and right to care

3.Getting support now
It's clear that school have pushed for a diagnosis, which can be very important and helpful, but you don't need to wait for one to access support. There is help that can be put in place now, pre-diagnosis, which can make a real difference for your daughter.
What will help her most right now is support focused on:

Self-harm behaviours
Any ADHD/ASD related difficulties identified
Any mental health difficulties
Any support needed at school to maintain engagement and wellbeing there

A therapist experienced in neurodivergent adolescents and self-harm (e.g. DBT-skills based, or neuroaffirming therapy) can be hugely helpful even without a diagnosis. Many clinicians and services work with children with queried diagnosis.

Self-harm support
• If she is actively self-harming, CAMHS should be offering some level of support even while awaiting neurodevelopmental assessment. If that hasn’t happened, it’s reasonable to:

Ask for a CAMHS review or escalation based on risk (this make take time depending how busy they are)
Go to your GP and state the duration of self-harm, your concerns and any and current risk. Please note this is a common experience at the moment so there can be a chance you feel invalidated by GP's response, this is not acceptable but can happen.
If things escalate or you’re worried about immediate safety, always go to your A&E or contact the local crisis team. You can see our crisis numbers for more detail. This should never jeopardise future CAMHS input.

S. C.