Right to Choose for autism in England

Page summary

Right to Choose for an autism assessment means you pick which NHS-contracted provider carries it out. Anyone registered with a GP in England can use it, adult or child, through a GP referral. You choose from providers holding an NHS contract, and the assessment you receive is an NHS one. Support after a diagnosis depends on that provider’s contract and on the services in your area. AuDHD Psychiatry isn’t a Right to Choose provider and hasn’t applied to be one.

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

Many adults and parents arrive here tired, after a long wait for an NHS autism assessment and plenty of self-doubt. Long waits are common, and they aren’t your fault. Right to Choose is an NHS route, and the steps below run in order. You can take them one at a time.

At a glance

• Who can use it: anyone with a GP in England, adult or child.
• Where: England only. Wales, Scotland and Northern Ireland use other routes.
• Who decides: your GP decides whether to refer you, and the provider decides whether to accept.
• What you choose: the provider, from those holding an NHS contract for autism assessment.
• First step: ask your GP for a Right to Choose referral.

What Right to Choose is

Right to Choose is your legal right to pick who provides your NHS care [2]. The right covers autism assessment, and it comes into play when your GP refers you. You can only choose among providers that hold an NHS contract for the service you need [1]. Mental health is included, not just physical health. In mental health, you can choose the clinical team as well as the provider [1]. A consultant or mental health professional has to lead that team.

Integrated care boards are the NHS bodies that plan and pay for care in each part of England. Providers get their NHS contracts through them. When your GP refers you, they’re asked to offer a shortlist of about five providers, where that’s practical and clinically appropriate [1]. Your GP should offer the choice without you having to ask for it [4].

Who can use it for an autism assessment, and where it does not apply

You can use it if you’re registered with a GP in England [4]. The right has limits, though, and the NHS Choice Framework sets them out in one short list [1]. Read it before you book the GP appointment, because a referral in an excluded group won’t go through Right to Choose. You can’t use the route if you’re in any of these groups:

• a patient already receiving care for the condition, being referred onward.
• someone using urgent, emergency or crisis services.
• a prisoner, someone on temporary release, or someone detained elsewhere, such as a young offender institution.
• a patient held in hospital under the Mental Health Act.
• a serving member of the armed forces.

Local arrangements can differ, so ask your GP whether any local rules apply where you live. Wales, Scotland and Northern Ireland each run their own referral routes, and this table shows where each one starts.

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

Your GP makes the referral, and you choose where it goes. The steps run in this order [1]:

1. Book a GP appointment and ask for an autism assessment through Right to Choose. Bring notes on the signs you’ve noticed [4].
2. Your GP considers whether a referral is right for you and should offer a choice of providers. You can also bring a provider you’ve found yourself.
3. Before you choose, check each provider: – its NHS contract covers autism assessment for your age group. – it takes referrals from your area. – whether it sees you online or in person. – what support follows a diagnosis. – its current wait, since each provider sets its own.
4. Tell your GP which provider you’ve chosen, and your GP sends the referral. You can use the letter below to ask for it.
5. The provider reviews the 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 autism 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 autism 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)

Getting past step 1 isn’t always easy. If it’s hard to get a referral, you can ask to see another GP for a second opinion [3]. Take your notes along, since they show the GP what you’ve noticed and for how long.

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 with an NHS contract for autism assessment, so you won’t be sent to us by mistake. Your GP can refer you to one of them in the usual way.

Right to Choose for a child

Right to Choose works for children in England as well [4]. A parent or guardian asks the child’s GP for the referral, and the same steps apply. Some areas route children differently, though. The referral might come through school, or through a health visitor before a child starts school [3]. Elsewhere it goes through CAMHS, the child and adolescent mental health services [4].

Before you pick a provider, check that its NHS contract covers children, because contracts differ. An older child should be part of the conversation, and have a say in the referral [4]. They should also have a chance to understand what being autistic means. If you’d like to compare the private option, you can read how our autism assessment for children works.

What happens after an NHS autism assessment?

The provider tells you the outcome and writes you a report. What follows depends on the provider’s NHS contract and the services near you. Ask about support at step 3, before you pick a provider. Autism itself isn’t treated with medication. Support focuses on what helps day to day, such as adjustments at work, at school or at home.

Local services decide what support your area offers. Your local authority or GP can tell you what’s available near you, so ask them once you have the report. ADHD assessment has a separate path, the Right to Choose route for ADHD.

Right to Choose or private: how to decide

The right route depends on cost, access, where you live and what follows. The table below sets the two routes side by side.

	Right to Choose	AuDHD Psychiatry (private)
Cost to you	Nothing: the NHS funds it [2]	See our fees for the adult and child autism assessment prices
How you get in	Your GP refers you and the provider accepts the referral	You book directly, with no referral
After diagnosis	Support depends on the provider’s NHS contract and local services	A full written report with recommendations for work, study and daily life

Neither route suits everyone, so check yourself against these two lists before you decide.

Right to Choose is for you if:

• you live in England and are 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 [5]. In Northern Ireland, call Lifeline free on 0808 808 8000, any time [6]. In an emergency, call 999 or go to A&E [5].
• you’re already under an NHS service for autism.
• you’d rather book an assessment yourself, without a GP referral.

Without a GP referral, the AuDHD Psychiatry private autism assessment is booked directly and carried out online. Before you book anything, you can have a free 15-minute call to ask us questions. It’s an information call, not an assessment.

Questions people ask