ADHD Right to Choose: NHS Assessment Guide

What Is ADHD Right to Choose?

NHS Right to Choose is the common name for patient-choice rights in England. If a GP decides that an eligible referral is clinically appropriate, you may have a legal right to choose the provider and team for your first outpatient appointment.

NHS England's current guidance says this applies to physical and mental health services and that some remotely delivered ADHD assessment services may be covered. The chosen service must be clinically appropriate and the provider must hold a qualifying NHS contract for the service you need.

This means an independent organisation can sometimes provide your ADHD assessment as NHS-funded care. It does not mean that any private clinic can be chosen, that a GP must refer regardless of clinical judgement, or that every provider offers medication and follow-up.

Right to Choose as described here applies in England. Scotland, Wales and Northern Ireland have separate systems.

If writing and submitting the request is the barrier, the Right to Choose letter support session provides practical help with organising your own words and documents. It does not decide whether referral is clinically appropriate, select a provider for you, or provide medical or legal advice.

Who Can Use Right to Choose for ADHD?

The relevant choice normally arises when:

• you are registered with a GP in England
• a clinician decides a referral is clinically appropriate
• the referral is for an eligible first outpatient appointment
• the chosen provider and team are clinically appropriate for your needs
• the provider holds a qualifying NHS contract for the service you need

NHS England states that the referrer is responsible for clinical appropriateness. That includes whether referral is in your clinical interests and whether the selected service can meet your needs.

Right to Choose may not apply when you are already receiving care and the request is an onward referral for the same condition, or when you need urgent, emergency or crisis care. The NHS Choice Framework lists other exceptions, including some people detained in prescribed settings.

If you need urgent mental health help, use the appropriate urgent or emergency route rather than waiting for an ADHD assessment referral.

How to Request an ADHD Assessment Through Right to Choose

1. Prepare for the GP Discussion

Write down concise, accurate examples of:

• difficulties that concern you
• how they affect education, work, relationships or daily life
• when you first remember them
• any relevant physical or mental health history
• support or treatment you have already tried

A screening questionnaire can help structure a conversation, but it cannot diagnose ADHD or require a GP to refer. The GP may need to consider other possible explanations and any local clinical referral requirements.

2. Compare the Actual NHS-Funded Services

Do not choose only by an advertised headline wait. Before asking for referral, check:

• Does the provider currently accept NHS Right to Choose referrals?
• Does its qualifying NHS service cover your age and location?
• Is the service assessment-only, or does it include treatment if clinically indicated?
• If medication is offered, who handles titration and prescriptions?
• What happens if your GP does not accept shared care?
• Who provides ongoing specialist reviews?
• Is the service remote, in person or mixed?
• What accessibility adjustments are available?
• What forms must you and the GP complete?
• What is the provider's current NHS-funded waiting information?

The same organisation may offer both NHS-funded and private care. Follow its Right to Choose referral instructions and do not accidentally book or pay for a private appointment.

Provider eligibility and availability can change. Check the provider's own current NHS information and, if needed, ask your GP or integrated care board to confirm the service is available under patient choice.

3. Ask for the Referral

You can say:

I would like to discuss referral for an ADHD assessment. If you agree that referral is clinically appropriate, I would like to exercise my patient choice and be referred to [provider and service]. I have checked that it currently accepts NHS Right to Choose referrals for [adult or child] ADHD assessment.

Bring the provider's current referral instructions and any required forms. A long legal argument is usually unnecessary.

The GP may agree that assessment is appropriate but raise a specific concern about the provider, service scope or suitability. Ask what information is missing and whether another eligible provider would meet the clinical need.

4. Confirm That the Referral Was Received

Ask the practice:

• when the referral was sent
• which provider and service it was sent to
• whether all required forms were included
• how and when to follow up

Then check the provider's stated acknowledgement process. Keep copies of forms and correspondence without sending sensitive personal details through an insecure channel.

5. Complete the Provider's Process

Questionnaires, informant information, appointment format and assessment length vary. Follow the provider's instructions and ask for reasonable adjustments if you need them.

NICE recommends that an ADHD diagnosis is made by an appropriately qualified healthcare professional with training and expertise in ADHD, using a full clinical and psychosocial assessment, developmental and psychiatric history, observer reports and assessment of mental state. Diagnosis should not be made solely from a rating scale.

An assessment can result in an ADHD diagnosis, a different explanation, a request for more information or no diagnosis. Right to Choose funds access to eligible NHS care, not a particular outcome.

Is Right to Choose Free?

Care accepted through the NHS Right to Choose pathway is NHS-funded. You should not be charged a private assessment fee for that NHS service.

Possible costs or limits still need checking:

• usual NHS prescription charges may apply unless you are exempt
• travel costs are not automatically covered
• optional private extras may not be part of the NHS service
• assessment does not guarantee medication
• provider scope may not include titration or long-term follow-up

Ask the provider to explain what is included in its NHS service before referral. Do not agree to private charges unless you understand that you are choosing a separate private service.

How Long Does ADHD Right to Choose Take?

There is no dependable national figure for all providers. Waiting times change, and an estimate can refer to different stages, such as referral review, assessment, report, medication titration or follow-up.

In 2025, NHS England advised integrated care boards to manage rapidly rising ADHD demand. NHS contract activity plans can affect how quickly a provider offers appointments. A provider may accept a referral but delay appointments to manage its planned NHS activity.

For a useful comparison, ask each service for:

• the date its wait estimate was updated
• which stage the estimate covers
• whether it applies to your age group and pathway
• the separate wait for treatment or titration, if offered

Right to Choose may be faster than a local pathway, but it is not guaranteed.

What Happens After the Assessment?

The answer depends on the clinical outcome and the provider's NHS contract.

If ADHD is diagnosed, possible next steps may include:

• a written report and recommendations
• information about ADHD
• discussion of non-medication support
• medication assessment, if included and clinically appropriate
• titration and monitoring, if included
• a proposed shared-care arrangement after stabilisation
• ongoing specialist review

These are not automatic. Check the pathway before choosing.

Shared care is an agreement between a specialist and GP. A GP can decline if they do not consider it safe or appropriate, or if the required specialist support is unavailable. An NHS-funded provider should explain what prescribing route it offers if shared care is not accepted. Do not assume you will need to pay privately.

If medication access matters to your choice, ask about it before referral, not after diagnosis.

Can a GP Refuse Right to Choose?

Two decisions are often confused:

1. Whether a referral is clinically appropriate. This is a clinical decision for the referrer.
2. Which eligible provider delivers the care. If the referral is in scope, legal patient-choice rights should be respected.

A GP is not required to make a referral they consider clinically inappropriate. They can also question whether a chosen service is suitable or eligible. However, local administrative pathways and prior commissioner approval should not obstruct a legal choice for an eligible referral.

If the answer is no, ask:

• Is the GP declining referral altogether, or only the chosen provider?
• What is the clinical or eligibility reason?
• What information would allow the request to be reconsidered?
• Which eligible alternatives are available?
• Can the reason and next step be recorded in writing?

If you believe a legal choice was not offered after an eligible referral was agreed, follow the careful escalation steps in GP refused Right to Choose for ADHD.

Common Right to Choose Mistakes

Treating Any Private Clinic as Eligible

The provider needs a qualifying NHS contract for the relevant service. CQC registration or a private ADHD service alone does not establish eligibility.

Choosing on Waiting Time Alone

A short assessment wait may be followed by a longer treatment wait, or the provider may offer assessment only. Compare the whole pathway.

Assuming Shared Care Is Guaranteed

It is not. Ask the provider what it does if the GP declines and what ongoing specialist support remains available.

Using Outdated Provider Lists

Provider contracts, age ranges, referral forms and capacity can change. Verify details at the point of referral.

Confusing NHS and Private Pathways

Use the provider's NHS Right to Choose instructions. Paying the same organisation privately is a separate pathway with different costs and arrangements.

Assuming an Assessment Guarantees a Diagnosis

A proper assessment considers ADHD and alternative explanations. No ethical provider can promise the result.

Right to Choose Checklist

Before the GP appointment:

• Confirm the pathway applies in England.
• Check that the provider currently offers the relevant NHS service.
• Compare assessment, treatment, prescribing and review arrangements.
• Download the provider's current referral forms.
• Prepare concise examples and relevant history.

After the appointment:

• Confirm whether referral was agreed.
• If not, ask for the exact reason and next step.
• If agreed, confirm where and when it was sent.
• Follow the provider's acknowledgement instructions.
• Keep a dated record of correspondence.

If the admin is stopping you from acting, practical mentoring can help you organise the task and prepare your own request. The Right to Choose support page explains the session, price and boundaries before you book.

Sources and Review Status

This article was substantively updated on 29 July 2026. It has been checked against official NHS and NICE guidance but has not been reviewed by a clinician or healthcare lawyer.

• GOV.UK: NHS Choice Framework
• NHS England: Patient choice guidance
• NHS England: ADHD service delivery and prioritisation
• NICE guideline NG87: ADHD diagnosis and management
• NHS England: Find your integrated care board