NHS Right to Choose for ADHD and autism assessments

Right to Choose at a glance

A legal right in England

The NHS says: if a GP needs to refer you for a physical or mental health condition, in most cases you have the legal right to choose the hospital or service you’d like to go to.

The NHS pays

If your GP agrees that an ADHD or autism assessment is appropriate for you or your child, with Right to Choose you can access a wider range of provider organisations paid for by the NHS.

Your GP must refer you

You cannot refer yourself. To use your legal Right to Choose, you must be referred by your GP to a provider that has an NHS contract.

A right to choose, not a right to a referral

The GP must agree that an assessment is right for you before a referral can be made, and that the referral is clinically appropriate.

When Right to Choose applies

A first outpatient appointment

It applies when you have an NHS elective referral for a first outpatient appointment.

Your GP agrees

If a GP agrees that an ADHD or autism assessment is clinically appropriate, you have the right to choose a provider that offers this service under NHS funding.

The provider holds an NHS contract

The provider must have a contract with an NHS integrated care board or NHS England to deliver autism or ADHD assessments. A contract with another kind of provider, such as an NHS foundation trust, does not count.

You are registered with a GP in England

Right to Choose applies to NHS patients in England. It does not cover Scotland, Wales or Northern Ireland.

When you cannot choose

The NHS gives emergency care and members of the armed forces as examples. The NHS Choice Framework lists the rest.

How to ask, step by step

1. Talk to your GP

Your GP is responsible for deciding whether a referral is clinically appropriate. The final decision to refer is made by the GP.

2. Shortlist two or three providers

One NHS board advises identifying two to three providers who you think may meet your needs and discussing these with your GP, because the list of providers changes regularly.

3. Check what each provider offers

Some providers only offer online assessments. Some have exclusion criteria. Some only assess and diagnose. Check whether treatment such as medication is included.

4. Your GP refers you directly

Your GP can refer you directly to the provider you choose. They do not need to get funding approval from the integrated care board or submit a separate funding request.

Caps, pauses and long waits

Boards now cap what they fund

Several NHS boards have introduced “Indicative Activity Plans”. These set the level of NHS-funded activity planned with each provider across the financial year.

A cap is not a pause

One board says plainly that an Indicative Activity Plan is not a pause on Right to Choose referrals, and that providers should continue to accept eligible referrals and add people to their waiting lists.

What happens when a provider hits its cap

One board says the provider will be unable to book assessments for new patients during that financial year, but will continue to accept new referrals and place new patients on a waiting list. This may mean a longer wait.

A provider’s website may say “paused”

One board says it is aware of provider websites listing referrals from specific areas as “paused” or “restricted”, and that it cannot mandate the wording providers use.

Advertised waits can be wrong for you

One board says providers it funds are working to an approximately 78-week minimum wait for an initial assessment in 2026/27, even where a provider’s website advertises a much shorter time.

Nobody publishes waiting times nationally

One board says there is no national dashboard for ADHD and autism services, and that it cannot give waiting times for Right to Choose providers.

After a diagnosis: medication and shared care

Some providers only assess and diagnose

If you are diagnosed and medication is recommended, the provider may not be able to prescribe it. They may ask your GP to do this, but your GP may not be able to agree.

Shared care is optional

Some providers start medication and then ask your GP to take over prescribing and monitoring through a shared care agreement. GP practices can refuse if they believe it is not clinically appropriate or they do not have the capacity.

Local approval can matter

One board says that choosing a provider outside its approved network makes it the patient’s responsibility to check whether the provider will enter into shared care agreements with GPs.

You may need a new referral

The provider may not work closely with your local NHS services. If you need further treatment or support, you may need a new referral to another service, and to join its waiting list.

If you are not offered a choice

First

The NHS says you should speak to the person who is referring you.

Then

If you still feel you have not been offered a choice, you could complain to your integrated care board, as they must ensure patients are given choices.

If you are waiting too long

You have the legal right to ask for your appointment to be moved to a different provider if you’re likely to wait longer than the maximum waiting time specified for your treatment.

Docorix is not part of the NHS and cannot make or speed up a referral. This guide does not recommend any provider.