NHS Right to Choose – ADHD & Autism Assessments

NHS Right to Choose allows patients in England to choose which provider they are referred to for their care, including ADHD and autism assessments, as long as the provider is commissioned by the NHS.

You can read more about this here:

• NHS England guidance: https://www.england.nhs.uk/long-read/patient-choice-guidance/
• NHS overview: https://www.nhs.uk/using-the-nhs/about-the-nhs/your-choices-in-the-nhs/

Based on NHS England guidance, you cannot use a Right to Choose a provider if:

• You have self-referred.
• You are already receiving care for the same condition.
• The service is funded by a local authority or primary care.
• The care is urgent or an emergency.
• You are in the armed forces.
• You are in a secure hospital under the Mental Health Act.

More information regarding your legal right to choose can be found here

Based on NHS England guidance, you have the legal Right to Choose a provider if:

• The GP refers you for a first outpatient appointment.
• The referral is appropriate for your needs i.e. you are showing significant signs of autism and/or ADHD.
• The service is led by a consultant or mental health professional.
• The provider is funded by the NHS

Right To Choose lets people choose an independent provider through the NHS from anywhere in England. Only a GP can make this type of referral. This route may lead to quicker assessments, but there are some careful considerations to be made about if this is a suitable path for each person.

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

As arrangements and care differ across providers, it is important to work with your GP to understand your options to make the best choice for you.

For example, some providers only offer online assessments. Some also have exclusion criteria. Providers also have different treatment options post-diagnosis.

Because services vary, it’s important to:

• Ask your GP what ongoing support you may need
• Check if providers offer medication (if ADHD is diagnosed) and follow-up care.

Your GP can explain the options and help you choose the provider that best meets your needs.

Right to Choose applies to initial assessments only, and self-referrals are not accepted.

If you ask your GP to refer you to another provider under Right to Choose:

• You will be referred to that provider instead of our service.
• Your referral to our service will be closed.
• You will no longer remain on our waiting list.

The 3 Borough ADHD and Autism Service does not accept referrals under Right To Choose. We are a local NHS diagnostic service and do not accept referrals through Right to Choose. We only accept referrals through our commissioned local pathway.

The National Adult ADHD and Autism Service can accept referrals under Right To Choose, however it is important that you check the service eligibility criteria as the service is for complex cases only.

No. NHS guidance states that service users should only be on one NHS waiting list for the same condition at a time.

If you choose to access another provider for ADHD and/or autism assessment, your referral to our service will be closed.

There are clinical risks of service users being seen by multiple providers simultaneously for the same condition.

In addition, this helps to ensure fairness for all patients by ensuring waiting lists are not artificially inflated and makes efficient use of NHS resources.

For fairness, if your referral to our service has been closed and you later wish to access our service again:

• You will need a new referral from your GP
• If accepted, you will join the waiting list from the beginning

A new assessment may also be required even if one has already been carried out by a private provider.

Different providers have different waiting times. You may wish to:

• Speak to your GP
• Review provider websites
• Consider waiting times and service models before making your decision.

If you are seeking an ADHD assessment, it is important to consider access to medication after diagnosis.

• Some Right to Choose providers offer assessment and diagnosis but do not provide ongoing prescribing
• ADHD medication is usually initiated by a specialist and then continued by your GP.

However:

• Not all GPs will accept shared care agreements from all providers
• Some GPs may decline to prescribe medication recommended by certain Right to Choose providers

This means you could:

• Experience delays in starting medication
• Be required to continue private prescriptions
• Need referral to a local NHS service for prescribing support

You can read more about shared care guidance here:

• National Institute for Health and Care Excellence (NICE) ADHD guidance: https://www.nice.org.uk/guidance/ng87
• NHS England prescribing and shared care guidance: https://www.england.nhs.uk/publication/responsibility-for-prescribing-between-primary-secondary-tertiary-care/

Before deciding, we recommend you think about:

• Waiting times
• Whether the provider offers both assessment and ongoing care
• Medication pathways and shared care arrangements
• Whether your GP is likely to accept prescribing from that provider

• Speak to your GP about your options
• Review the information above carefully
• Contact our service if you are unsure about your current referral

If you have concerns about your provider once your care has started, you should speak with your GP in the first instance. In some cases, it may be possible to seek a second opinion, but this is handled separately from the Right To Choose pathway.

Your GP will decide if an assessment is clinically appropriate. If you are referred again after a previous NHS assessment, there must be new evidence or symptoms that were not looked at before.