Right to Choose

What is Right to Choose?

Right to Choose is a legal right that allows NHS patients in England to choose the provider they are referred to for their first outpatient appointment - including ADHD and autism assessments.

If your GP agrees that you need an ADHD assessment, you have the legal right to choose which NHS-approved provider carries out that assessment. This can mean being assessed by a specialist service that your local NHS trust does not provide directly - and it can significantly reduce waiting times.

Right to Choose has been available for physical health services for many years. In 2014, the same legal right was extended to mental health services, including ADHD and autism assessments.¹

Why does this matter for ADHD?

NHS waiting lists for ADHD assessment are long. In many parts of England, the wait for an adult ADHD assessment through the standard pathway is two to five years. For some people, it is even longer.

Right to Choose offers an alternative route. By choosing a provider with shorter waiting times, some people have been able to access assessment within months rather than years - at no cost, because the assessment is NHS-funded.

This matters because untreated ADHD has serious consequences for mental health, relationships, employment, and quality of life. Faster access to assessment means faster access to understanding and support.

Who is eligible?

You can use Right to Choose if:

• You are registered with a GP in England
• Your GP agrees that a referral for ADHD assessment is appropriate
• The provider you choose holds an NHS contract for the relevant service somewhere in England

You cannot use Right to Choose if:

• You are in Scotland, Wales, or Northern Ireland (different systems apply)
• You are currently receiving care for the condition you are being referred for
• You are detained under the Mental Health Act 1983
• You are in a secure setting, prison, or on temporary release
• You are a serving member of the armed forces

How does it work?

Step 1: Speak to your GP

Book an appointment with your GP and explain that you think you may have ADHD. It helps to come prepared:

• Describe how ADHD symptoms affect your daily life
• Bring a completed ADHD self-report questionnaire (such as the ASRS) if you can
• Mention specific areas of difficulty - work, relationships, organisation, emotional regulation

Step 2: Ask for a referral under Right to Choose

If your GP agrees that an ADHD assessment is appropriate, ask to be referred under Right to Choose to a provider of your choosing. Name the specific provider you would like to be referred to.

Step 3: Your GP makes the referral

Your GP sends the referral directly to your chosen provider. You cannot self-refer under Right to Choose - it must come from your GP.

Step 4: The provider contacts you

Once the provider receives the referral, they will ask you to complete screening questionnaires and will arrange an assessment appointment with an ADHD specialist.

Step 5: Assessment and next steps

If you are diagnosed with ADHD, the provider will discuss treatment options with you. If medication is recommended, they will usually initiate treatment and then transfer your ongoing care back to your GP through a Shared Care Agreement.

What is a Shared Care Agreement?

After your assessment and any initial treatment, your chosen provider will typically discharge your care back to your GP. A Shared Care Agreement sets out how your GP and the specialist provider will share responsibility for your ongoing treatment - including prescribing medication.

What if your GP says no?

This is a common problem. Some GPs are not aware of Right to Choose, or they may have misconceptions about how it works.

Common reasons GPs give for refusing - and why they are incorrect

“We do not commission that provider.” Right to Choose means you can choose any provider that holds an NHS contract anywhere in England. It does not need to be a local provider or one commissioned by your local ICB.¹

“We need approval from the ICB first.” No prior approval is needed. The regulations are clear: GPs do not need to seek permission from the ICB before making a Right to Choose referral.¹

“We do not do Right to Choose referrals.” Right to Choose is a legal right. It is not a scheme that practices can opt in or out of.

“The waiting list is the same everywhere.” This is often not the case. Different providers have different waiting times, and some Right to Choose providers have significantly shorter waits.

What you can do

• Ask your GP to read the NHS England patient choice guidance1
• Provide a covering letter explaining Right to Choose (templates are available from ADHD UK)
• If your GP still refuses for non-clinical reasons, you can make a formal complaint through the practice’s complaints procedure
• You can also contact NHS England, which has enforcement powers over patient choice compliance3

Important changes in 2025-2026

Indicative Activity Plans (IAPs)

From 2025-2026, NHS England has asked local Integrated Care Boards (ICBs) to introduce Indicative Activity Plans. These plans set limits on how many Right to Choose assessments can be completed for patients in each ICB area within a financial year.³

This is a significant change. While Right to Choose itself remains a legal right, the practical effect of IAPs is that some providers have been asked to pause new assessments in certain areas until activity plans are refreshed.

What this means for you

• You still have the legal right to choose your provider
• However, your chosen provider may not be able to offer an appointment immediately if your local ICB has reached its activity limit
• Waiting times now vary significantly by area
• It is worth checking the current status of your local ICB before requesting a referral
• ADHD UK maintains updated information on local restrictions

Right to Choose and children

Right to Choose applies to children and young people as well as adults. A parent or guardian can request a Right to Choose referral for their child through the child’s GP. The same eligibility criteria apply.

Providers

Several providers offer ADHD assessments through Right to Choose. These include Psychiatry-UK, Clinical Partners, ADHD 360, and others. Each provider has different waiting times and processes.

Getting support

Useful organisations

• ADHD UK - comprehensive Right to Choose guidance, GP letter templates, and provider tracking
• Psychiatry-UK - one of the largest Right to Choose providers
• ADHD Aware - information on the Right to Choose process

neurobetter resources

• ADHD - understanding ADHD as a whole
• Getting assessed - what to expect from the assessment process
• Shared Care Agreements - how ongoing prescribing works after assessment
• ADHD medication - types of medication and what to expect
• Screening tools - self-report tools to bring to your GP
• Getting a diagnosis - the broader assessment landscape
• Late diagnosis - making sense of a diagnosis later in life
• Our Local Services directory - find ADHD services near you
• Our online community - connect with others who understand
• Ask a Counsellor - private, confidential guidance