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Right to Choose (NHS England)

Introduction

Right to Choose within mental health is a relatively new option (since 2018) and as such, not all patients, GPs or other clinicians are aware of it and how it works. We’ve got an explanation targeted for people going through the ADHD Assessment process below. For how Right to Choose fits into the diagnosis pathway please click here. We’ve also got a downloadable support letter for anyone who finds their GP as initially declined them. 

You will also find significant amounts of information via the NHS link on NHS choices below:

 https://www.nhs.uk/using-the-nhs/about-the-nhs/your-choices-in-the-nhs/

Read the adult diagnosis pathway first

This is a detail page on right to choose and aims to provide additional information for those that need it. To understand the context and use of Right to Choose it is important to read the Adult Diagnosis Pathway page first.

Right to Choose

Patients have the Right to Choose when the following conditions are met:

  • the NHS practice is in England (different rules apply for Scotland, Wales and Northern Ireland)
  • the General Practitioner has agreed to make clinically appropriate outpatient referral (Of note: The decision to make a referral is the GPs responsibility and separate from Right to Choose. Right to Choose is a patient’s right to decide where that referral is to)

Patients have the Right to Choose when the following conditions are met:

  • the NHS practice is in England (different rules apply for Scotland, Wales and Northern Ireland)
  • the General Practitioner has agreed to make clinically appropriate outpatient referral (Of note: The decision to make a referral is the GPs responsibility and separate from Right to Choose. Right to Choose is a patient’s right to decide where that referral is to).

The above is designed to be wide ranging in its application to patient choice. However. there are certain restrictions on a patient’s Right to Choose that you should be aware of. Patients cannot use Right to Choose is they are:

  • already receiving mental health care following an elective referral for the same condition
  • referred to a service that is commissioned by a local authority, for example a drug and alcohol service (unless commissioned under a Section 75 agreement)
  • accessing urgent or emergency (crisis) care
  • accessing services delivered through a primary care contract
  • in high secure psychiatric services
  • detained under the Mental Health Act 1983
  • detained in a secure setting. This includes people in or on temporary release from prisons, courts, secure children’s homes, certain secure training centres, immigration removal centres or young offender institutions
  • serving as a member of the armed forces (family members in England have the same rights as other residents of England.

There are restrictions on who the patient can direct their care to. Patients cannot refer to just any provider. The provider must:

  • have a commissioning contract with any Clinical Commissioning Group (CCG) or NHS England for the required service
  • have the service and team led by a consultant or a mental healthcare professional

Common GP queries include:

  • does an IFR (Individual Funding Request) need to be in place? It does not
  • does the CCG need to be asked permission? It does not

For the avoidance of any doubt: It is our clear understanding, and we know of hundreds who have done so, that an ADHD Assessment generally falls under Right to Choose. It is also our clear understanding that psychiatry-uk.com are a permitted provider.

As a charity we are passionate about helping those with ADHD. We are aware of many long waiting lists within the NHS and therefore will direct people to Right to Choose. If you think it would help, we are also happy to mediate and advocate for those patients where their Right to Choose is being discussed. If you would like to get in touch please contact us.

In the event of a GP intially declining your Right to Choose

The vast majority of GPs understand Right to Choose and appreciate the need for many patients to use it to bypass long NHS waiting lists (we are campaigning against those). Within ADHD UK we’ve heard countless stories of GPs helping their patients with it and are grateful for them doing so. In a very small number of cases we know of GPs intially refusing to allow a patient their Right to Choose. In the majority of these cases it has been due to a slight misunderstanding and not appreciating it was a patient right. To help people in that situation we have a downloadable letter for you to give your GP.

ADHD UK Letter