Private vs NHS Addiction Treatment

Private vs NHS Addiction Treatment

In the UK, people seeking help for drug or alcohol problems often face a key decision: whether to enter private rehab or access treatment through the NHS. Both options play an important role in supporting recovery, but they differ in terms of access, intensity, cost and availability of services.

• Private rehab: Fast admissions, medically managed detox, residential programmes and a wide range of therapies, but funded through self-payment or private health insurance.
• NHS treatment: Free at the point of use, with most support delivered in community-based services, but often with long waiting times and limited access to residential rehab beds.

At Abbington House, we believe it’s essential for people and families to understand the differences so they can make the decision that best suits their needs, urgency and circumstances. This page explores the key distinctions between private rehab and NHS addiction treatment, helping you weigh up the options with clarity and confidence.

Access and Waiting Times

One of the biggest differences between private and NHS addiction treatment is how quickly you can access support.

Private Rehab

• Immediate admissions are often possible within 24–72 hours.
• Fast access is critical because addiction is progressive and delays can increase health risks, strain relationships, or lead to job loss.
• At Abbington House, admissions can usually be arranged in a matter of days, allowing treatment to begin when motivation is highest.

NHS Treatment

• NHS addiction services are free at the point of use, but demand is high and resources are limited.
• Most people will be directed to community-based support first, such as keyworking, counselling, or substitute prescribing for opioid use.
• Residential rehab placements are rare and typically require going through a lengthy local authority funding process, which can take weeks or months.
• This wait can be especially difficult for people in crisis or at high medical risk.

Private rehab offers fast, direct access to inpatient treatment, while NHS treatment may involve delays before residential care is available.

Eligibility and Referral Routes

The process of entering treatment differs significantly between private and NHS addiction services.

Private Rehab

• Self-referral: You can contact a private rehab directly to begin the admissions process.
• Family referral: Loved ones can make enquiries on your behalf.
• GP involvement: While a GP referral is not required, some clients choose to involve their doctor for medical notes or additional support.
• No eligibility criteria: Private rehab is open to anyone seeking treatment, provided it is clinically safe and appropriate.

NHS Treatment

• Access usually starts with a GP referral or self-referral to a local drug and alcohol service.
• Most treatment is community-based, including counselling, group work, and substitute prescribing.
• Residential rehab is only available in limited cases, usually after community treatment has been tried and if funding is approved by the local authority.
• Eligibility for NHS-funded residential rehab often depends on:
  • Severity of addiction.
  • Evidence of previous attempts at community-based treatment.
  • Local authority funding priorities and budget.

Private rehab is open to anyone and does not require GP or council approval, while NHS residential treatment involves stricter eligibility and referral processes.

Care Settings and Intensity

Another key difference between private rehab and NHS treatment is the setting in which care is delivered and the level of intensity offered.

Private Rehab

• Primarily delivered in a residential (inpatient) setting where clients live at the clinic throughout treatment.
• Structured daily timetable combining therapy, education and wellbeing activities.
• High staff-to-client ratio, ensuring regular one-to-one support.
• Immersive environment that removes clients from daily triggers and enables full focus on recovery.

NHS Treatment

• Most support is delivered in community services, where clients attend appointments while continuing to live at home.
• Treatment usually involves a keyworker model, with varying levels of contact depending on local resources.
• Group sessions and psychosocial interventions are common, but frequency and intensity can be limited.
• Inpatient detox or residential rehab is available in some areas, but places are scarce and typically short-term.

Private rehab offers a fully immersive residential experience with high-intensity therapy and 24/7 support, while NHS treatment is mostly community-based and less intensive.

Detox and Dual Diagnosis

Safe detox and support for co-occurring mental health conditions are crucial parts of addiction treatment and the options available differ between private and NHS care.

Private Rehab

• Medically supervised detox is available on-site, with 24/7 monitoring from clinical staff.
• Medications can be prescribed to reduce withdrawal symptoms and manage risks such as seizures or delirium tremens (DTs).
• Detox is integrated into a broader rehab programme, meaning therapy begins as soon as the client is physically stable.
• Dual diagnosis care: Private rehab often provides integrated treatment for co-occurring conditions like depression, anxiety, PTSD, ADHD or bipolar disorder. At Abbington House, this is a core part of our programme.

NHS Treatment

• Community detox may be offered for people assessed as low risk, often supported with medication and outpatient check-ins.
• Inpatient detox is available but limited, and usually prioritised for those with severe dependence or high medical risk.
• Mental health and addiction services are often delivered separately. For example, a person may receive therapy through NHS mental health services while addiction care is managed by a drug and alcohol service. This can create gaps in support.

Private rehab provides immediate access to medically supervised detox and integrated dual diagnosis treatment, while NHS pathways often separate addiction and mental health care and inpatient detox access is limited.

Therapy and Treatment Approaches

Addiction recovery isn’t just about stopping substance use it’s about addressing the psychological, emotional, and behavioural patterns that drive it. The type and range of therapies offered is one of the clearest differences between private and NHS treatment.

Private Rehab

• Offers a broad range of evidence-based therapies, delivered in both one-to-one and group formats.
• Common approaches at Abbington House include:
  • Cognitive Behavioural Therapy (CBT) – addressing destructive thought patterns.
  • Dialectical Behaviour Therapy (DBT) – emotional regulation and distress tolerance.
  • Trauma-informed therapy – understanding and processing past experiences.
  • Motivational interviewing – strengthening commitment to change.
  • Family therapy – repairing relationships and building healthy support systems.
• Holistic therapies such as mindfulness, nutrition, exercise and creative outlets support physical and emotional wellbeing.

NHS Treatment

• Therapy is usually keyworker-led, with structured conversations focused on harm reduction, relapse prevention, and motivational support.
• Some services offer group therapy or access to talking therapies such as CBT, but availability depends on local resources.
• Family involvement and holistic approaches are less commonly available.
• Intensity of therapy can be limited due to caseloads and time constraints.

Private rehab provides intensive, multi-layered therapy tailored to each person, while NHS treatment focuses on more limited psychosocial support, which may be less comprehensive.

Governance and Safety

Whether treatment is private or NHS-funded, safety and quality of care must be guaranteed. Both sectors are regulated, but there are some differences in how this looks in practice.

Private Rehab

• All private rehabs in England must be registered with the Care Quality Commission (CQC), which carries out inspections and publishes ratings.
• Inspections assess safety, effectiveness, responsiveness, leadership, and quality of care.
• Reputable private clinics are transparent about their CQC reports and inspection outcomes.
• At Abbington House, we follow NICE clinical guidelines and ensure best practice in detox, therapy, safeguarding and aftercare.

NHS Treatment

• NHS addiction services are also regulated by the CQC (or equivalent bodies in Scotland, Wales, and Northern Ireland).
• Governance frameworks are highly robust, and staff are bound by NHS clinical governance, safeguarding, and data protection standards.
• However, service delivery may be constrained by local resources, meaning treatment intensity can vary across regions.

Both NHS and private rehab are regulated and held to strict safety standards. The main difference is that private clinics, like Abbington House, can offer higher staff-to-client ratios and more personalised attention within the same safety framework.

Length of Stay in Treatment

The amount of time a person spends in addiction treatment can have a major impact on outcomes. Private and NHS services offer very different programme lengths and levels of flexibility.

Private Rehab

• 7–14 days: Short stays focused on medically supervised detox and initial stabilisation.
• 28 days: The standard length of stay in private rehab. Provides time for detox, therapy, relapse prevention and rebuilding healthy routines.
• 60–90+ days: Extended programmes for people with long-term addiction, repeated relapses or co-occurring mental health conditions.
• At Abbington House, we recommend a minimum of 28 days to allow meaningful progress in therapy and preparation for life after treatment.

NHS Treatment

• Community services: Typically open-ended, with regular keyworker appointments and group support, but frequency depends on local resources.
• Inpatient detox: Usually lasts 7–14 days, focused on safely managing withdrawal symptoms only within a hospital setting, limited placements.
• Residential rehab placements: Can last 8–12 weeks or longer, but are rare and require local authority approval and funding. Waiting lists are often long.

Private rehab offers flexible, structured stays tailored to individual needs, while NHS inpatient placements are limited and community support may be ongoing but less intensive.

Costs and Funding

The way treatment is funded is one of the biggest differences between private rehab and NHS services.

Private Rehab

• Self-funding: The most common route. Learn more about the cost of rehab. 
• Private health insurance: Some policies cover part or all of the cost of private rehab. Abbington House can help you check whether your policy includes this (not offered at Abbington House currently).

What’s included at Abbington House: 24/7 medical detox (if required), accommodation, all meals, therapy sessions, holistic activities, family involvement and aftercare.

NHS Treatment

• Free at the point of use for all UK residents.
• Includes community-based services such as counselling, group work, and substitute prescribing (for opioid dependence).
• Inpatient detox and residential rehab are also free if funding is approved – but these placements are limited and require strict eligibility.
• Access depends on local authority budgets, which vary widely across the UK.

NHS treatment is free with limited options for detox or funding for residential rehab, while private rehab involves cost but provides immediate, comprehensive treatment and more choice over the setting and therapies.

Which Option Is Right for Me?

Both private rehab and NHS addiction services play a vital role in supporting recovery, but the right choice depends on your needs, circumstances and urgency.

Private Rehab May Be Best If You:

• Need immediate admission without waiting lists.
• Require a medically supervised detox in a safe, residential setting.
• Have experienced repeated relapse after outpatient or community treatment.
• Want intensive, structured therapy with a wide range of evidence-based and holistic approaches.
• Value confidentiality and privacy during treatment.
• Have co-occurring mental health conditions and need integrated dual diagnosis care.

NHS Treatment May Be Best If You:

• Are looking for free, accessible support without financial cost.
• Prefer ongoing community-based care while living at home.
• Are at an early stage of addiction or need harm-reduction strategies rather than residential treatment.
• Want access to substitute prescribing (e.g., methadone or buprenorphine for opioid dependence).
• Are willing and able to wait for inpatient services, if needed.

At Abbington House, we recognise the value of NHS services and often work alongside GPs and community providers to ensure clients receive the best possible support. For those who need urgent, structured and comprehensive care, private rehab offers a way to begin recovery immediately and build a foundation for long-term sobriety.

NHS treatment is accessible and cost-free, but often limited by waiting times and inpatient capacity. Private rehab provides immediate, immersive and highly personalised treatment, which can be life-saving for those in urgent need.

Get Help at Abbington House

Deciding between NHS and private rehab is not easy, but what matters most is taking that first step towards recovery. NHS services provide valuable community support, but for those who need immediate, intensive and personalised treatment, private rehab can make the difference between ongoing struggle and a sustainable recovery.

At Abbington House, we provide:

• Immediate admissions with no waiting lists.
• Medically supervised detox for safe withdrawal.
• Tailored therapy programmes, including CBT, DBT, trauma-informed counselling and holistic care.
• Confidential, supportive accommodation designed for recovery.
• Aftercare, ensuring you are never alone in your journey.

If you’re unsure which option is right for you, our team can talk through your circumstances and guide you to the best solution, whether with us or through NHS pathways.

You don’t have to wait for things to get worse. Call us today or send a confidential enquiry to find out how Abbington House can help you or your loved one begin recovery now.

Private Addiction Rehab vs NHS Treatment FAQs