Right to Choose (NHS England)
If you are based in England under the NHS you now have a legal right to choose your mental healthcare provider and your choice of mental healthcare team. This important right means that, for instance, should you decide the waiting time for your ADHD assessment is too long, then you can choose alternative providers. The provider must supply the service to the NHS somewhere in England. The providers we are aware of are listed below and we update the list regularly.
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.
You will also find significant amounts of information via the NHS link on NHS choices below:
Read the adult diagnosis pathway first
This is a detailed page on Right to Choose which 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.
The Right to Choose System
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.
Psychiatry-uk.com. May be the largest provider of right to choose ADHD assessments in the UK. Their assessments are predominately done by video call, which has become common place since the start of the pandemic. Psychiatry UK provide details on Right To Choose, including a downloadable letter to give your GP, here.
November 2023 Update: They have re-opened for Right to Choose (after pausing from August 2023). We are told the current wait list for diagnosis is around 12 weeks.
Dr J and Colleagues provide both Right to Choose and Private ADHD and Autism Assessments. They are a small provider and tell us that means they can work through the funding provision from the NHS particularly quickly.
November 2023 Update: We are told that they are currently taking Right to Choose bookings for both ADHD and ASD and have a 3 week waiting time for either.
It is important to note that Clinical Partners provide an ADHD Assessment Service but they do not offer a medication titration service.
This is, therefore a great fit for individuals who want an ADHD Assessment but know that medication isn’t something they want to pursue.
To those thinking about the option for an Assessment with Clinical Partners and tirtration/medication elsewhere you need to be aware that we are not aware of any NHS Right to Choose providers, or private providers, who offer a titration only service. We only know of providers who require undertaking their own Assessment prior to offering titration as an option.
October 2023 Update: Wea are told that they are currently taking Right to Choose bookings and have a 12 weeks or less waiting time.
Waiting time is currently 12 weeks or less. However, this is subject to change. For up-to-date waiting time information, please contact 020 3761 7029, or email rtc@clinical–partners.co.uk
We do not currently offer medication titration. However, this is something we’re looking at introducing in the future
Evolve Psychology have two clinics based in Harrogate, North Yorkshire and Huddersfield, West Yorkshire. They offer Right To Choose assessments for ADHD and Autism (or both as a combined neurodevelopmental assessment) for children/ young people up to the age of 19 who are in education. They do not have a Right to choose service for adults (although they do have a private adult service for ADHD and Autism Services). They can accept referrals England-wide. They prefer face to face assessments, but might be able to offer online assessments depending on individual circumstances if the team feel it would be appropriate.
July 2023 Update: Due to high demand, they are only able to take referrals for 0-19 year old.
Psicon offer ADHD face to face appointments only in three areas: Kent and Medway (for adults), Isle of Wight and North East Hampshire (children aged 6-18 only).
November 2023 Update:
Children and Young People (Under 18 years):
Psicon can accept RTC referrals for children for both autism (age 3+) and ADHD assessments (Age 6+).
Assessments for autism are currently only offered face-to-face in Canterbury, Kent.
Assessments for ADHD can be either face-to-face in Canterbury or online (only where clinically appropriate).
ADHD medication/treatment can also be offered face-to-face in Canterbury (from Dec 23) or remotely/online where clinically appropriate (from Feb 24).
Wait times are always subject to change due to demand, but the current wait for an assessment is approximately 6-9 months.
Adults (Aged 18+)
Psicon cannot currently accept RTC referrals for adults for either autism or ADHD assessment.
Visit https://www.psicon.co.uk/ for more information.
Paused or stopped taking new referrals:
Axia ASD are based in Chester and offer local physical and England-wide virtual assessment options under Right to Choose for adults only, and Private for adults and children. For Right To Choose, they provide diagnosis but do not take on medication or titration process, so it’s important to check with your GP or local mental health clinic that they can support the medication process if required.
July 2023 Update: As per their website, ADHD assessments are no longer offered since end of December 2021, only ASD for the time being.
In the event of a GP initially 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 to them for doing so. In a very small number of cases we know of GPs initially 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.