Campaigning to improve accessibility to Right to Choose and Reduce Wait Times

Together we’re campaigning for change. We can only get change if you get involved. Please consider getting involved today.

NHS Payments Scheme (Closes Dec 16th)

Earlier this year the NHS Payment Scheme was used to put in place Indicative Activity Plans – and those plans have now been used to restrict Right to Choose. In essence, a Right to Choose provider is told how many assessments they can do. And in some cases, they are being told zero. It is catastrophic and – in our view – non-compliant with the Right to Choose / Patient Choice legislation. Right now it is a significant minority of NHS areas but it is expanding all the time.

We are building a campaign to fight those changes. But in the meantime, NHS England is at it again. Another bureaucratic sleight of hand to even further restrict access for the Right to Choose. We need your help to stop it.

We think NHS England knows they are likely to lose the challenges to Indicative Activity Plans – so they have got a backup plan. They want to use the NHS Payment Scheme to over-specify and under-cost ADHD Assessments solely for Right to Choose, and NHS outsource suppliers. They are excluding the NHS itself from these rules – in our view, because they know their plans are unworkable.

They want to put in place a national pricing contract. These are used a lot within the NHS. However, they are making it over-specified and under-costed. Requiring a percentage of in-person consultations regardless of whether that is needed or if that provider does that. If these were biscuits, they are specifying a luxury waitrose double chocolate chip butter cookie and pricing it at the price of a Lidl plain digestive. They’re making it impossible to fulfill.

We have been told by multiple providers that they consider the plans to be impossible and some argue unsafe. NHS England is rushing these changes through to save money and exclude people with ADHD from getting their healthcare they are finally getting.

We need your help to protest the changes. To ask them to slow down and make any changes properly. We’ve already seen catastrophic change with our rights circumnavigated. We need to stop this rot.

There is consultation right now. It ends on December 16th. We’ve got a full guide to how to fill in their form and our reccomendations. Alternatively, we have an automation for you and can fill it in for you. The automation takes just 30 seconds of you time. Please click it and protest these changes today.

Step 1 – Open the consultation. Learn all you need to and start filling in your response.

This is the link to the consultation and consultation materials.

This is the link to the consultation form.

Step 2 – Overview

Simply click into the first section “Introduction”

Step 3 – Introduction Section

Fill in:

– Name
– Email Address
– Select Individual 
– Ignore: About your organisation
– Ignore: Responding on behalf of multiple organisations

Step 4 – Accepting or rejecting the proposed NHS Payment Scheme

Section: Do you accept or reject the proposed 2026/27 NHS Payment Scheme?

Select: “REJECT”

In explain the reasons for your answer: “It will reduce the availability and accessibility of ADHD and Autism Assessments across England. It will reduce patient choice. It will lead to greater waiting times”.

Section: If they were implemented, what impact do you feel the policies outlined are likely to have on equality and addressing health inequalities?

Select: Strong negative impact

In “Do you have concerns that there are distinct groups with protected characteristics that our policies may impact negatively?” write:  “People with ADHD, People with Autism”

In: “Please explain the reasons for your answers:” write: Reduction in availability of ADHD and Autism Assessments will (1) Impact all those without a diagnosis, (2) Impact anyone with support (e.g., pharmaceutical support for ADHD) wishing to move NHS location. Presently, they have to be re-assessed and are put to the back of the queue. This will lengthen those queues. 

Step 5 – Section “Proposals applying to all payment mechanisms”

To what extent do you support the proposed one-year NHSPS? Strongly Oppose

The rest : BLANK

Step 6 – Section “Proposals applying to all payment mechanisms”

To what extent do you support the proposed guide prices for ADHD and autism? Strongly Oppose

Please explain reasons for your answer: “The prices and the service structure that underlie them are not fit for purpose”

The rest : BLANK

Step 7 – Section “Mental health and community services currency development”

Section: Attention-Deficit/Hyperactivity Disorder (ADHD) and Autism

To what extent do you agree with the proposed introduction of the following?

        Guide Prices? Strongly Oppose

Initial currency models? Strongly Oppose

Please explain reasons for your answer: “The prices and the service structure that underlie them are not fit for purpose”

What would you like to be covered in future engagement/webinars? “Impact studies”

There is an option to get involved with stakeholder group or joining a task and finish group. If you would like to be involved tick these boxes.

Do you have any comments on menthal health and community currency development?: 

The proposals for ADHD and Autism assessments will do harm by reducing the assessment availability of people to get assessed and receive support. For ADHD Assessments you have not dealt with serious underlying issue of long waiting lists. Right to Choose has been acting as a safety valve to systemic issues in ADHD Assessment and Support. Your proposals do not do anything to resolve these issues. Including but not limited to (1) A serious plan to reduce the long wait times and to increasing ADHD Assessment capacity to deal with the large number of people waiting. Your actions appear to be aimed to reduce capacity instead of increasing it (2) Failure to put systems in place to identify ADHD in children in schools or in adults when (for example) they present with mental health issues to their GP but aren’t identified as having ADHD and/or Autism. To commonly people have to self-identify as having ADHD and/or Autism after years of failed treatment. This is a medical failure to not identify earlier. (3) Failure to have a bridge between CAMHS and Adult ADHD Care to ensure continued care for pupils turning 18. Too often children are just dropped and put to the end of the adult queue (4) Failure to put in place a process for anyone who moves NHS area to be able to get continued medication and instead go without medication and to the back of the queue [average wait 8 years]. This leads to serious individual ramifications. It also leads to waste in the service as individuals are getting multiple Assessments over years instead of having their NHS ADHD Assessment accepted (5) Failure to provide systems of support beyond medication for ADHD. Too often medication is the only option given despite NICE guidelines. Too often too if medication isn’t opted for at that meeting then returning later to opt for medication can be nigh on impossible and require going to the back of the queue and being reassessed again. (6) This is particularly prevalent for children. Many of whom might want to pause medication to understand its impact on them more. There is a failure to provide support for children with opt not to take medication or who opt to stop medication but when they try to restart/opt for medication they often find they have been discharged and are placed again at the back of the queue often a queue so long they won’t be seen before they leave school (7) Failure to put in systems in place for prisoners going to, or leaving prison, and getting continuity of ADHD medication. This is becoming more significant as the NHS withdraws from providing support in prisons and for prisoners whose prison and home are in different ICB areas. (8) Failure to have a process to resolve the issues of GPs refusing shared care for people with ADHD which is clogging up the diagnosis services with regular care needs (9) Failure to put in place a process around medication shortages and provide a service that is accessible and will provide prescription changes in a timely manner in the event of shortages (10) Failure to ensure good pathways within the NHS for individuals with more complexity than solely having ADHD. (11) Failure to hold the NHS to the same standards/systems/pricing you are setting for the NHS supplier sector.

The rest : BLANK

The rest : BLANK

Step 8 – Any other comments

Do you have any other comments on our proposals for the 2026/27 NHS Payment Scheme?

The proposals for ADHD and Autism assessments will do harm by reducing the assessment availability of people to get assessed and receive support. For ADHD Assessments you have not dealt with serious underlying issue of long waiting lists. Right to Choose has been acting as a safety valve to systemic issues in ADHD Assessment and Support. Your proposals do not do anything to resolve these issues. Including but not limited to (1) A serious plan to reduce the long wait times and to increasing ADHD Assessment capacity to deal with the large number of people waiting. Your actions appear to be aimed to reduce capacity instead of increasing it (2) Failure to put systems in place to identify ADHD in children in schools or in adults when (for example) they present with mental health issues to their GP but aren’t identified as having ADHD and/or Autism. To commonly people have to self-identify as having ADHD and/or Autism after years of failed treatment. This is a medical failure to not identify earlier. (3) Failure to have a bridge between CAMHS and Adult ADHD Care to ensure continued care for pupils turning 18. Too often children are just dropped and put to the end of the adult queue (4) Failure to put in place a process for anyone who moves NHS area to be able to get continued medication and instead go without medication and to the back of the queue [average wait 8 years]. This leads to serious individual ramifications. It also leads to waste in the service as individuals are getting multiple Assessments over years instead of having their NHS ADHD Assessment accepted (5) Failure to provide systems of support beyond medication for ADHD. Too often medication is the only option given despite NICE guidelines. Too often too if medication isn’t opted for at that meeting then returning later to opt for medication can be nigh on impossible and require going to the back of the queue and being reassessed again. (6) This is particularly prevalent for children. Many of whom might want to pause medication to understand its impact on them more. There is a failure to provide support for children with opt not to take medication or who opt to stop medication but when they try to restart/opt for medication they often find they have been discharged and are placed again at the back of the queue often a queue so long they won’t be seen before they leave school (7) Failure to put in systems in place for prisoners going to, or leaving prison, and getting continuity of ADHD medication. This is becoming more significant as the NHS withdraws from providing support in prisons and for prisoners whose prison and home are in different ICB areas. (8) Failure to have a process to resolve the issues of GPs refusing shared care for people with ADHD which is clogging up the diagnosis services with regular care needs (9) Failure to put in place a process around medication shortages and provide a service that is accessible and will provide prescription changes in a timely manner in the event of shortages (10) Failure to ensure good pathways within the NHS for individuals with more complexity than solely having ADHD. (11) Failure to hold the NHS to the same standards/systems/pricing you are setting for the NHS supplier sector.

The rest : BLANK

Step 9 – Click finish

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Step 10 – Click Submit

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