Right to Choose for ADHD in England

Page summary

Right to Choose for ADHD gives you a legal right to pick your NHS assessment provider. The NHS funds it for adults and children registered with a GP in England. Your GP refers you to a provider whose NHS contract may cover ADHD, autism or both. After a diagnosis, your GP can take over prescribing under a shared care agreement. AuDHD Psychiatry isn’t a Right to Choose provider and hasn’t applied to be one.

• OVERVIEW
• SYMPTOMS
• ADULTS
• CHILDREN
• WOMEN
• DIAGNOSIS
• TREATMENT
• MEDICATION

If you’ve ended up here after a long wait for NHS ADHD care, you’re far from alone. Long waits are common, and they aren’t your fault. Right to Choose is an NHS route, and its steps run in a set order. Once you know that order, you’ll know what to ask your GP, what to ask a provider, and what comes after.

At a glance

• What it is: your legal right, in England, to pick the NHS provider your GP refers you to.
• Where it applies: England only. Scotland, Wales and Northern Ireland have their own routes.
• Who refers you: your GP.
• Who can take you on: a provider with an NHS contract for ADHD assessment.

What Right to Choose is

Right to Choose is your legal right to pick your NHS provider [1]. You use it when your GP refers you, and it covers mental health as well as physical health. The provider has to hold an NHS contract for the service you need. In mental health, a consultant or a mental health professional must lead that service [1]. You can choose the clinical team as well.

Those contracts are held by integrated care boards, the local NHS bodies that buy care for an area. A private clinic can be on your list if it works for the NHS and costs the NHS no more [2]. GPs are also asked to offer you a shortlist, usually of about five providers, where that’s practical and clinically sensible [1].

Who can use it, and where it does not apply

Anyone registered with a GP in England can ask to use Right to Choose. Your GP decides whether a referral is right for you. Some people don’t have the legal right to choose at all [1]. The groups that matter for an ADHD referral are:

• people already getting care for the condition, where the new referral is an onward one.
• people using urgent, emergency or crisis services.
• prisoners, people on temporary release, and people detained in other prescribed accommodation.
• people held in hospital under the Mental Health Act.
• serving members of the armed forces.

Where you live matters too. Some integrated care boards have set local limits on Right to Choose for ADHD [5]. So what’s open to you can differ from what a friend in another area was offered. The rest of the UK runs its own referral routes, and this table shows where to start in each nation.

Nation	Right to Choose	Where to start
Wales	Doesn’t apply	Your GP, then your local health board. NHS 111 Wales explains the options.
Scotland	Doesn’t apply	Your GP, then your NHS board. NHS inform explains the options.
Northern Ireland	Doesn’t apply	Your GP, then your health and social care trust. nidirect explains the options.

How the referral works, step by step

The referral starts with your GP, and it runs in five steps. If you’ve already found a provider you like, bring its name to the second step. Jot down what each provider tells you, so you can compare the answers.

1. Ask your GP. Book an appointment and ask to be referred for an ADHD assessment through Right to Choose.
2. Talk through the choice. Your GP checks whether a referral suits you, then offers a shortlist, usually about five [1].
3. Check each provider. Ask whether its NHS contract covers ADHD assessment for your age group and your area. Ask whether it sees you online or in person, and what happens after a diagnosis. Each provider sets its own wait, so ask about that too. ADHD UK’s area lookup lists local providers, waits and restrictions [5].
4. Tell your GP which provider you’ve chosen. Your GP then sends the referral. You can use the letter below to ask for it.
5. Hear from the provider. The provider reviews your referral and contacts you.

A letter you can give your GP

Copy it, fill in the gaps and give it to your GP.

Dear Dr (your GP’s name), I’d like a referral for an NHS ADHD assessment, using my legal right to choose my provider. This right is set out in the NHS Choice Framework. The provider I’d like to be referred to is (provider name), which holds an NHS contract for ADHD assessment. Please could you consider this referral and tell me if you need anything else from me. Yours sincerely, (your name and date of birth)

Can AuDHD Psychiatry take a Right to Choose referral?

No. AuDHD Psychiatry isn’t a Right to Choose provider and hasn’t applied to be one. We’re awaiting registration with the Care Quality Commission (CQC), the regulator for health services in England. That registration has to come first, and several NHS steps follow it. We’re working towards becoming a provider, but no date can be given for any step.

That doesn’t stop you using Right to Choose. It just means the provider you name has to be another one. Your GP’s shortlist only includes providers that hold an NHS contract for ADHD, so you won’t be sent to us by mistake. If you’d rather book privately, that’s a separate route, and the comparison below sets the two side by side.

Right to Choose for a combined AuDHD assessment

If you think you’re both ADHD and autistic, often called AuDHD, you can ask for both assessments through Right to Choose. Right to Choose covers ADHD assessment and autism assessment, but it treats them as two separate NHS services. One provider can assess you for both only where its NHS contract covers both.

So ask each provider on your shortlist whether its contract covers ADHD, autism, or both. If it covers only one, you’ll need a second referral for the other, and that could go to a different provider. The autism half works the same way, and Right to Choose for an autism assessment walks through it.

Right to Choose for a child

Right to Choose applies to children in England as well as adults. As a parent, you start by asking your child’s GP. You can ask for an NHS appointment at any clinic that provides ADHD services for the NHS in England [3]. That includes private clinics. The provider’s contract has to cover children, so check that before you name it.

NICE guidance asks for a full picture before anyone diagnoses ADHD in a child [4]. That means a developmental history and reports from people who see your child day to day. It also means looking at symptoms across settings such as home and school. School reports and notes from teachers are worth gathering early. If you’d rather go privately, our child ADHD assessment is booked directly, with no GP referral.

After the assessment: shared care and medication

Shared care lets your GP take over ADHD prescribing from the specialist. It comes after titration, the stage where the specialist adjusts your medication dose until it’s right and steady. NICE guidance says prescribing and monitoring should move to shared care with your GP once the dose is stable [4].

Shared care is always your GP’s decision, so it cannot be guaranteed. Some approve in days, some don’t accept at all. Before you’re referred, ask each provider whether its NHS contract includes titration, and who’ll prescribe if your GP says no. Get both answers in writing, so you’re not left without a prescriber partway through.

Right to Choose or private: how to decide

The two routes differ on cost, on how you get in, and on what happens once you have a diagnosis. You’ll find what each AuDHD Psychiatry option includes on the private ADHD assessment cost page. This table puts the two routes side by side.

	Right to Choose	AuDHD Psychiatry (private)
Cost to you	Nothing, because it’s NHS-funded	£795 for an adult ADHD assessment, £995 for a child
How you get in	Your GP refers you and the provider accepts	You book directly, with no referral
After diagnosis	NHS prescribing, with GP shared care after titration	A private prescription, unless your GP agrees to shared care

Right to Choose is for you if:

• you live in England and you’re registered with a GP there.
• you’d like the NHS to fund the assessment.
• you’re happy for your GP to make the referral.

Right to Choose might not be right today if:

• you live outside England.
• you need urgent or crisis support: call NHS 111 and choose the mental health option [6]. In Northern Ireland, call Lifeline free on 0808 808 8000, any time [7]. In an emergency, call 999 or go to A&E [6].
• you’re already under an NHS service for ADHD.
• you’d rather book an assessment yourself, without a GP referral.

If you’d like to talk the private route through before you choose, AuDHD Psychiatry offers a free 15-minute call. It’s an information call with our team, not an assessment, and we won’t push you either way. Use it to ask about the price, what the report covers, and what happens after a diagnosis.

Questions people ask