Right to Choose (NHS England)
Learn all about NHS Right to Choose and how you can use it for an ADHD Assessment
Learn all about NHS Right to Choose and how you can use it for an ADHD Assessment
Summary
- Right to Choose gives you the option to have your NHS care done by any part of NHS England. If you’ve a long local NHS wait time, you can go elsewhere.
- Right to Choose is an NHS England patient choice right. It does not apply in Wales, Scotland or Northern Ireland.
- Whether a referral is necessary is a decision made by a medical professional (usually your GP). You then have a choice on where that referral goes. “Your GP writes the referral letter, you can write the envelope”
- Several NHS areas have chosen to outsource their ADHD assessment services.
- These are private companies providing NHS services to NHS standards. If you opt for medication, you would receive an NHS prescription.
- You can be referred directly to those NHS outsourced providers. A list of those providers is available from the main right to choose page.
- Once you have chosen your provider, you need to follow their directions (usually on their website) on the exact process to take it forward. Usually it means downloading some forms, filling them in, and then giving them to your GP.
- Some providers cannot provide medication long term without a “shared care” agreement with your GP. You can filter the choice list based on whether your GP is willing to accept shared care.
- This advice is subject to change because there are big changes happening to NHS Right to Choose. You can find out more about those changes from the main right to choose page.
Introduction
For adults and children, there are two main Assessment paths: NHS or Private. However, within the NHS, there are two options for you.
The NHS generally means the default option of your GP sending your referral to join the local service waitlist. However, in England only (Healthcare is devolved; other nations have not chosen this), you have NHS Right to Choose. The right to send your referral somewhere else in NHS England. In summary, Right to Choose is the right to not be caught in your local NHS and instead be seen anywhere in NHS England.
A number of NHS areas outsource their ADHD services. We colloquially call those the “Right to Choose Providers”. You can have your NHS referral sent directly to them. You will receive an NHS service to NHS standards, and, as part of the NHS, if you opt for medication, you will receive an NHS prescription.
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 has 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 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 Framework
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 falls under Right to Choose.
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.
But there are problems | Find out your local situation
Right to Choose for ADHD Assessments has been very successful in reducing ADHD wait times and helping people access this needed medical care.
However, some local NHS areas are putting in restrictions. We do not believe those to be legally correct or morally correct.
We are collating information on the situation and the best options to push back. We will update people via our social media channels and our mailing list. In the meantime, for information on your local situation please navigate to our information via the main Right to Choose page.
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.
