Right to Choose · England
Right to Choose changes and restrictions
Which NHS areas in England are limiting Right to Choose for ADHD and autism assessments, and what that means for you. From our own Freedom of Information requests to every area.
Where things stand
Capping
14 of 36
areas in England are capping Right to Choose. They set a yearly limit on how many assessments each provider is paid to do.
See the capping areasNot capping
19 of 36
areas told us they have no caps in place. Some of these still have other problems, such as very long local waits.
See areas not cappingOther restrictions
8
areas have other limits we know of: extra referral checks, closed local services or no clear local pathway.
3 areas have not given us a clear answer on caps.
See areas with other restrictionsArea by area
What each NHS area in England has told us. Open the quick summary to read their answer, or go to the area page for local waits, providers and letters you can send.
Showing 36 areas
Bath and North East Somerset, Swindon and Wiltshire
Told us: no capsGo to area page › for Bath and North East Somerset, Swindon and WiltshireQuick summary of what they have told us about Bath and North East Somerset, Swindon and Wiltshire
- No caps
This area has no caps on Right to Choose ADHD assessments for adults or children. Source
- No caps
Quick summary of what they have told us about Birmingham and Solihull
- Capping Right to Choose
This area has caps on Right to Choose ADHD and autism providers for adults and children, but would not share the details, saying they were commercially sensitive. Adults wait on average about 2 and a half years for a first assessment with the local NHS service. Source
- Capping Right to Choose
Quick summary of what they have told us about Black Country
- Capping Right to Choose
This area confirmed caps on Right to Choose ADHD providers for adults and children covering April to September 2026. When it replied in June 2026 it had not set any caps beyond September, so we are checking whether they have been renewed. Source
- Capping Right to Choose
Bristol, North Somerset and South Gloucestershire
Capping Right to ChooseGo to area page › for Bristol, North Somerset and South GloucestershireQuick summary of what they have told us about Bristol, North Somerset and South Gloucestershire
- Capping Right to Choose
This area has caps on Right to Choose ADHD assessments for adults and children for 2026/27, covering 12 adult and 7 children's providers. It would not share the details, saying they were commercially sensitive. Source
- Capping Right to Choose
Quick summary of what they have told us about Central East
- No clear local pathway
The local NHS says its adult ADHD service is currently under review, and it could not give a waiting time or describe how the service works. It has no caps on assessments. Source
- No clear local pathway
Cheshire and Merseyside
Told us: no capsLocal service closed to new referralsGo to area page › for Cheshire and MerseysideQuick summary of what they have told us about Cheshire and Merseyside
- Local service closed to new referrals
The adult ADHD assessment service run by Cheshire and Wirral Partnership NHS Foundation Trust is closed to new referrals, except for military veterans and a few others. It only accepts people already under ADHD care who move here, young people leaving children's services, and medication reviews. Source - No caps
This area is still agreeing caps for adult ADHD assessment providers, and there are none for children. This is different from December 2025, when it told us adult caps had been put in place. Source
- Local service closed to new referrals
Cornwall and the Isles of Scilly
Told us: no capsGo to area page › for Cornwall and the Isles of ScillyQuick summary of what they have told us about Cornwall and the Isles of Scilly
- No caps
This area has no caps on Right to Choose ADHD assessments, for adults or children. Source
- No caps
Coventry and Warwickshire
Capping Right to ChooseVery long local waitsGo to area page › for Coventry and WarwickshireQuick summary of what they have told us about Coventry and Warwickshire
- Capping Right to Choose
This area set caps on Right to Choose ADHD assessments for adults and children for 2025/26, as a budget for each of 7 providers, totalling about £2.8 million. Source - Very long local waits
An adult referred to the local NHS service now would wait 3 to 5 years for an ADHD assessment, and a child 5 to 10 years. About 2,400 adults and 9,100 children are waiting. Source
- Capping Right to Choose
Quick summary of what they have told us about Derby and Derbyshire
- Very long local waits
The average wait for an adult ADHD assessment is over 7 years, with 3,768 adults waiting, and adult assessments are provided through Right to Choose. For children the average wait is about 20 months, with 761 waiting. Source - No caps
This area has not introduced caps and does not plan to at the moment. Source
- Very long local waits
Quick summary of what they have told us about Devon
- No caps
This area has not set caps for Right to Choose providers, for adults or children, although it earlier said caps applied from October 2025. Right to Choose waits are kept to between about 3 months and a year. Source
- No caps
Quick summary of what they have told us about Dorset
- No caps
This area has no caps on Right to Choose ADHD assessments for adults or children. This is different from November 2025, when it told us it had caps with 11 independent providers. Source
- No caps
Quick summary of what they have told us about Essex
- No caps
This area has no caps on Right to Choose ADHD assessments for adults or children. Source
- No caps
Quick summary of what they have told us about Gloucestershire
- No caps
In November 2025 this area told us it had no caps on Right to Choose ADHD or autism providers. In its latest answer it said the questions about caps were 'not applicable', and we have asked them to explain this. Source
- No caps
Quick summary of what they have told us about Greater Manchester
- Capping Right to Choose
This area has caps with all known Right to Choose ADHD providers, for adults and children. It would not share each provider's figures, saying they were commercially sensitive, but the total for 2025/26 was about £19 million across 24 providers. Source
- Capping Right to Choose
Quick summary of what they have told us about Hampshire and Isle of Wight
- Capping Right to Choose
This area has caps on Right to Choose ADHD assessments for adults and children, but would not share the details. The number of Right to Choose providers it pays has grown from 18 when the caps began in July 2025 to 26. Source
- Capping Right to Choose
Herefordshire and Worcestershire
Told us: no capsGo to area page › for Herefordshire and WorcestershireQuick summary of what they have told us about Herefordshire and Worcestershire
- No caps
This area has no caps on Right to Choose ADHD assessments for adults or children. Adult ADHD assessments here are provided only through Right to Choose. Source
- No caps
Quick summary of what they have told us about Humber and North Yorkshire
- No caps
This area has no caps on Right to Choose ADHD assessments for adults or children at present, but says it is finalising caps with its largest Right to Choose providers. Source
- No caps
Quick summary of what they have told us about Kent and Medway
- Capping Right to Choose
This area has caps on Right to Choose ADHD assessments for adults and children. It would not share the details, saying they were commercially sensitive, and said it wants to set a minimum waiting time across all providers within its budget. Source
- Capping Right to Choose
Lancashire and South Cumbria
Capping Right to ChooseGo to area page › for Lancashire and South CumbriaQuick summary of what they have told us about Lancashire and South Cumbria
- Capping Right to Choose
This area has caps on Right to Choose ADHD assessments for adults, allowing about 140 new assessments a month across 16 providers. About 22,000 adults are waiting, and there are no caps for children. Source
- Capping Right to Choose
Leicester, Leicestershire and Rutland
Capping Right to ChooseGo to area page › for Leicester, Leicestershire and RutlandQuick summary of what they have told us about Leicester, Leicestershire and Rutland
- Capping Right to Choose
This area has caps on Right to Choose ADHD assessments for adults and children. New Right to Choose providers starting in 2026 are limited to £50,000 a year, and it would not share each provider's details, saying they were commercially sensitive. Source
- Capping Right to Choose
Quick summary of what they have told us about Lincolnshire
- No caps
When asked, this area had not agreed any caps on Right to Choose ADHD assessments for adults or children for 2026/27, but said negotiations with providers were ongoing. Source
- No caps
Quick summary of what they have told us about Norfolk and Suffolk
- Capping Right to Choose
This area has caps on Right to Choose ADHD assessments for adults and children. It would not share the details, saying they were commercially sensitive while the service is under review, but said it may share them later. Source
- Capping Right to Choose
North East and North Cumbria
No clear answer yetNo clear local pathwayGo to area page › for North East and North CumbriaQuick summary of what they have told us about North East and North Cumbria
- No clear local pathway
In North Cumbria there is no NHS adult ADHD service and a Right to Choose provider is used instead. Elsewhere only health professionals can refer adults, and the local NHS is finalising caps on Right to Choose assessments for 2026/27. Source
- No clear local pathway
Quick summary of what they have told us about North East London
- No caps
This area has not finalised any caps but is exploring them. Adults can use Right to Choose for an assessment, but the local NHS says Right to Choose treatment is not funded until it has contracts with providers in place. Source
- No caps
Quick summary of what they have told us about Northamptonshire
- No caps
This area told us it has no caps on Right to Choose ADHD assessments for adults or children. Source
- No caps
Quick summary of what they have told us about Nottingham and Nottinghamshire
- No caps
This area said it does not directly commission Right to Choose services, so it does not hold any caps on Right to Choose ADHD providers for adults or children. Source
- No caps
Quick summary of what they have told us about Shropshire, Telford and Wrekin
- No caps
This area told us it has no caps on Right to Choose ADHD assessments for adults or children. Source
- No caps
Quick summary of what they have told us about Somerset
- Capping Right to Choose
This area introduced caps on 13 named providers between August and October 2025. It says people can still choose their provider under Right to Choose but should consider waiting times. Source
- Capping Right to Choose
South East London
Told us: no capsExtra referral checks (triage)Go to area page › for South East LondonQuick summary of what they have told us about South East London
- Extra referral checks (triage)
All adult ADHD referrals in this area, including Right to Choose referrals, must go through a central service for extra checks against local criteria before being sent to the patient's chosen provider. Source - No caps
This area has no caps on Right to Choose ADHD assessments for adults or children, but says it is developing them with providers. Source
- Extra referral checks (triage)
South West London
No clear answer yetWaiting for a clear answerGo to area page › for South West LondonQuick summary of what they have told us about South West London
- Waiting for a clear answer
This area told us it does not hold any information on caps for Right to Choose ADHD assessments, but said it is currently contacting providers about them. Source
- Waiting for a clear answer
Quick summary of what they have told us about South Yorkshire
- No caps
This area told us it does not currently have any caps on Right to Choose ADHD assessments for adults or children. Source
- No caps
Staffordshire and Stoke-on-Trent
Told us: no capsGo to area page › for Staffordshire and Stoke-on-TrentQuick summary of what they have told us about Staffordshire and Stoke-on-Trent
- No caps
This area told us it has not introduced, and is not planning to introduce, caps on Right to Choose providers. Source
- No caps
Quick summary of what they have told us about Surrey and Sussex
- No caps
This area told us it has not issued caps to any ADHD providers in Sussex, for adults or children. The Right to Choose providers it works with are listed on its website. Source
- No caps
Thames Valley
Capping Right to ChooseExtra referral checks (triage)Go to area page › for Thames ValleyQuick summary of what they have told us about Thames Valley
- Capping Right to Choose
This area has caps with 26 adult and 11 child Right to Choose ADHD providers, allowing 5,035 adult and 540 child assessments in 2026/27. It would not share how many each provider is given, saying this was commercially sensitive. Source - Extra referral checks (triage)
Since April 2026, adults must have clear written evidence of significant daily difficulties, and be likely to benefit from treatment such as medication, to be referred for ADHD or autism assessment, including through Right to Choose. People seeking a diagnosis mainly for understanding or reassurance are excluded. Source
- Capping Right to Choose
Quick summary of what they have told us about West and North London
- Capping Right to Choose
This area has caps on Right to Choose ADHD assessments for adults and children. It would not share the details, saying they were commercially sensitive. Source
- Capping Right to Choose
Quick summary of what they have told us about West Yorkshire
- Capping Right to Choose
This area has had caps on autism and ADHD assessments with several Right to Choose providers since August 2025. It told us it is negotiating caps with all Right to Choose providers for 2026/27. Source
- Capping Right to Choose
Right to Choose applies in England only. Scotland, Wales and Northern Ireland: see all NHS areas.
What a cap means for you
The caps are called Indicative Activity Plans. They are agreements between your local NHS area and each provider about how many assessments the NHS will pay for in a financial year (April to March).
You still have the right to choose
A cap does not remove your legal right. Your GP can still refer you to a Right to Choose provider. What changes is how quickly that provider can see you.
Waits can jump when a cap is reached
Once a provider has done its allowed number of assessments for your area, new assessments may wait until the next financial year. A wait quoted as weeks can become months.
Each provider has its own cap
Caps differ between providers, so another provider may still have space this year. Our provider waiting times show who reports short waits.
Ask before you are referred
Ask the provider whether they can see someone from your area this year, and how long you would actually wait. If you are already under a provider's care, ask how the plan affects your follow-up appointments.
What has changed nationally
2026/27
New national payment guidance
NHS England's ADHD and autism payment guidance for 2026/27 sets guide prices for assessments (for example £850 for a face-to-face adult ADHD assessment and £700 online). It says ADHD and autism diagnoses from independent providers, including Right to Choose providers, should be accepted by NHS services that start medication, and that GPs should explain which providers are available.
Since summer 2025
Local areas started capping
From mid-2025 many local NHS areas began setting Indicative Activity Plans for Right to Choose providers, citing the NHS Standard Contract. Our Freedom of Information requests track which areas have done this and what they told us.
Early 2025
Our campaign against the national change
NHS England consulted on changing the NHS Payment Scheme so local areas could control Right to Choose activity. More than 12,000 people emailed their MP through our campaign, and NHS England changed its plans after the consultation. The fight for proper NHS ADHD care continues.
Read more about the 2025 campaign
The proposal would have let local NHS areas use payment rules to decide when Right to Choose patients are seen. We argued it removed a right given by Parliament without debate, was consulted on in a way the public could not easily take part in, and would push waits from months to years. Thank you to everyone who wrote to their MP.
NHS England: 2025/26 Payment Scheme changes following consultation
What you can do
1
Check your area
See local waits, Right to Choose providers and any restrictions where you live.
Find your NHS area2
Write to your ICB and MP
Each area page has letter templates where they are ready. A short personal letter carries weight.
Go to your area page3
Get updates
We email when caps, waits or national rules change.
Join our mailing list4
Tell us about a cap
Been told a provider has hit its limit for your area? Use the "Share information" form on your area page so we can check it.
Go to your area pageHow we work: we send Freedom of Information requests to every NHS area and to the NHS services they use, and record what they tell us. Dates show when each answer was given. Back to Right to Choose