Right to Choose ADHD: How to Get an NHS-Funded Assessment Without the Wait

You Have Options, Even If Your GP Hasn't Mentioned Them

If you have been told the NHS waiting list for ADHD assessment is two, three, or even five years long, I want you to know something: there is a legal pathway that could cut that wait dramatically, and it is completely free.

It is called the Right to Choose, and it is one of the most under-discussed options available to people seeking an ADHD assessment in England. When I first learned about it, I was frustrated that nobody had told me sooner. So now I tell everyone.

This guide will walk you through exactly what Right to Choose is, how to use it, and what to do when things do not go smoothly, because sometimes they do not.

What Is Right to Choose?

Right to Choose is not some special ADHD scheme. It is a legal right under the NHS Constitution that allows patients in England to choose which organisation provides their first outpatient appointment. This includes ADHD assessments.

In practical terms, it means you can ask your GP to refer you to an approved private provider, like Psychiatry-UK or Clinical Partners, and the NHS pays for it. You do not pay a penny.

Important: Right to Choose currently applies in England only. Scotland, Wales, and Northern Ireland have separate health systems with different rules. If you are outside England, check with your local health board for alternative pathways.

The legal basis comes from Section 6a of the NHS Act 2006 and the NHS Choice Framework, both of which confirm that patients have the right to choose their provider for elective care, which includes mental health assessments. This is further supported by NICE guideline NG87 (Attention deficit hyperactivity disorder: diagnosis and management), which sets out the clinical standards that all ADHD assessment providers, whether NHS or Right to Choose, must follow.

For your GP, the relevant guidance is clear: if a patient requests a referral for ADHD assessment and the GP agrees that assessment is appropriate, the patient has the right to choose which qualified provider carries out that assessment. The NHS funds it through the patient's local Integrated Care Board (ICB).

The Legal Framework Behind Right to Choose

It helps to understand the specific legislation, especially if your GP is unfamiliar with the pathway. Here are the key references:

You do not need to memorise any of this. But knowing it exists gives you confidence if your GP questions whether Right to Choose applies to ADHD. It does, and there is no ambiguity about it.

Why Does This Exist?

The NHS is overwhelmed. As of early 2026, over 500,000 people are on waiting lists for ADHD assessment in England. Some areas have waits exceeding five years. The system simply cannot keep up with demand, particularly since adult ADHD awareness has exploded in recent years.

Right to Choose was designed to give patients more control over their healthcare. For ADHD specifically, it has become a lifeline, offering a way to access assessment within months rather than years, without going fully private and paying hundreds or thousands of pounds.

Step-by-Step: How to Use Right to Choose

Step 1: Book a GP Appointment

You need to see your GP. This can be in person or over the phone, either works. Some people find it helpful to book a longer appointment slot if available, so you are not rushed.

Before your appointment, write down:

• Your symptoms, be specific. Not "I can't focus" but "I lose track of conversations mid-sentence," "I cannot start tasks even when the deadline is tomorrow," "I have been fired from three jobs because I kept making careless mistakes"
• How long they have been present, ADHD symptoms must have been present since childhood, so think about school, teenage years, and early adulthood
• The impact on your daily life, work, relationships, finances, emotional wellbeing, self-esteem

Step 2: Ask for a Referral Under Right to Choose

Here is the key part. You need to specifically say:

"I would like to be referred for an ADHD assessment under the Right to Choose pathway."

You can also name a specific provider. Psychiatry-UK is the most commonly used for ADHD Right to Choose referrals, as they have an established agreement with the NHS.

If your GP is not familiar with Right to Choose, you can point them to:

• The NHS England patient choice framework
• ADHD UK's guidance at adhduk.co.uk, which includes template letters and GP guidance
• The Psychiatry-UK website, which has a referral section specifically for Right to Choose

Step 3: Your GP Sends the Referral

Once your GP agrees, they send a referral to your chosen provider. This is usually done electronically. The provider will then contact you directly with next steps.

Timeline expectation: Even through Right to Choose, there are waiting times. As the pathway has become more popular, waits with Psychiatry-UK have increased, currently sitting at around 6-12 months in many cases. This is still significantly shorter than most NHS trusts, but it is not instant.

Step 4: Complete Pre-Assessment Questionnaires

Before your assessment, you will typically be asked to complete several questionnaires. These often include:

You may also be asked to have an informant report completed by someone who knew you as a child, a parent, sibling, or other family member. This helps the clinician understand your childhood presentation.

Step 5: Attend Your Assessment

The assessment itself is usually conducted via video call with a specialist clinician. It typically lasts 1-2 hours and covers everything I outline in my guide to what actually happens in an ADHD assessment:

• Your current symptoms in detail
• Your childhood history and behaviour
• How symptoms affect your daily functioning
• Other conditions that might explain your symptoms (differential diagnosis)
• Your medical and mental health history

The clinician is looking for evidence that your symptoms meet the DSM-5 criteria for ADHD, have been present since childhood, and cause significant impairment.

Step 6: Receive Your Diagnosis (or Not)

After the assessment, you will receive a report with the outcome. If you are diagnosed, the report will typically recommend next steps, which may include:

• Medication, the clinician may initiate medication and then transfer prescribing to your GP under a shared care agreement
• Psychoeducation, understanding your ADHD and how it affects you
• Support strategies, including mentoring, coaching, or therapy
• Workplace or university accommodations, your diagnosis can be used to access reasonable adjustments

When Right to Choose Does NOT Apply

This is something the competitors and NHS pages cover clearly, and it is important to understand so you do not waste time on the wrong pathway.

Right to Choose does not apply when:

• You are self-referring. You need a GP referral. You cannot contact a Right to Choose provider directly and ask them to assess you without a GP referral. Some providers accept self-referrals for private (paid) assessments, but that is a separate thing entirely
• You need emergency or urgent care. Right to Choose covers planned, elective appointments, not crisis situations
• You are already receiving treatment. If you are already under a specialist for ADHD, Right to Choose does not apply to ongoing follow-up appointments. It covers your first outpatient appointment only
• You are outside England. Scotland, Wales, and Northern Ireland have separate NHS structures. Right to Choose is an England-only policy
• Your local ICB has specific restrictions. Some Integrated Care Boards have introduced activity plans that limit the number of Right to Choose assessments they fund in a given period. This does not remove your legal right, but it can affect waiting times with specific providers in your area

If you are unsure whether Right to Choose applies to your situation, ask your GP directly or contact the provider you are considering. They will be able to tell you whether they can accept a referral from your area.

How ICB Funding Works

Your Right to Choose assessment is funded by your local Integrated Care Board (ICB), which is the regional NHS organisation responsible for commissioning healthcare in your area. When your GP sends a referral to a Right to Choose provider, the provider invoices your ICB for the cost of the assessment.

In recent years, some ICBs have introduced Indicative Activity Plans, which set caps on how many Right to Choose assessments they will fund in a given period. This has caused some providers to pause accepting referrals from certain regions temporarily.

What this means practically:

• Your legal right to choose has not changed. The legislation is clear
• But provider availability may vary by region. A provider might be accepting referrals from one ICB area but not another
• Always check the provider's website for current availability before asking your GP to submit a referral
• If your preferred provider is paused in your area, consider an alternative provider rather than waiting indefinitely

You can find your local ICB by searching your postcode on the NHS England website.

Common GP Pushback (and How to Handle It)

I wish I could tell you that every GP will immediately agree to a Right to Choose referral. But that is not always the case. Here are the most common objections and how to respond.

"We don't do that here"

Right to Choose is a legal right, not a local policy. It does not depend on your GP practice's preferences. You can politely explain this and reference the NHS Choice Framework.

"You need to go through our local pathway first"

This is incorrect. You do not need to be on an NHS waiting list before using Right to Choose. You can request it as your first referral pathway.

"I'm not sure you have ADHD"

Your GP does not need to diagnose you, they only need to agree that assessment is reasonable. If you are experiencing symptoms that affect your daily life, that is sufficient grounds for referral. A GP is a gatekeeper to assessment, not the assessor.

"The private provider won't be accepted"

Providers used through Right to Choose are NHS-approved. Their diagnoses carry the same weight as any NHS assessment. If your GP is concerned about shared care agreements for medication, this is a separate conversation that happens after diagnosis.

If your GP refuses: You have the right to see a different GP at the same practice, register at a different practice, or make a formal complaint through the practice manager. ADHD UK also has template letters you can use. I have written a detailed guide on what to do if your GP refuses Right to Choose, covering every escalation step from practice manager to MP.

After Your Diagnosis: Shared Care Agreements

If you are diagnosed and prescribed medication through a Right to Choose provider, the next step is usually a shared care agreement. This is where your GP takes over routine prescribing of your ADHD medication, with ongoing clinical oversight from the specialist who diagnosed you.

This is one of the areas that causes the most confusion and frustration, so let me break it down clearly.

How shared care works in practice

1. Your specialist initiates medication and manages the titration period (typically 4-12 weeks), adjusting the dose until you find what works
2. Once you are stable, the specialist writes to your GP requesting a shared care arrangement
3. Your GP takes over prescribing, issuing repeat prescriptions based on the specialist's recommendations
4. The specialist remains involved for annual reviews, dose changes, or if complications arise

What if your GP refuses shared care?

This is more common than it should be. Your GP is not legally obligated to accept a shared care agreement, though NHS England, NICE guideline NG87, and the BMA all encourage GPs to do so. If your GP refuses:

• Ask them to explain their reasons in writing. This creates accountability
• Escalate to your Integrated Care Board (ICB). ICBs have a responsibility to ensure patients can access prescribed medication
• Contact PALS (Patient Advice and Liaison Service) at your local NHS Trust for advocacy support
• Consider changing GP practice. Some practices are more experienced with ADHD shared care than others
• Your specialist provider may continue prescribing for a limited period, but this is not a long-term solution

I have written a much more detailed guide on shared care agreements for ADHD, which covers the whole process, common problems, and exactly what to do if things go wrong.

Medication is not the end of the story

Getting a diagnosis and starting medication are significant milestones, but they are not the finish line. Many people find that medication helps with focus and impulsivity but does not automatically fix the years of coping mechanisms, avoidance patterns, and organisational chaos that ADHD has created. That is where practical support comes in.

Medication Is Not the Only Option

Diagnosis opens up much more than just medication. Many people benefit enormously from ADHD mentoring and coaching, which focuses on practical strategies for managing executive function challenges, building routines, and developing systems that work with your brain rather than against it.

Medication can be genuinely life-changing for many people. But it is a tool, not a cure. It works best alongside practical support, self-understanding, and a strengths-based approach to how your brain works.

If you are waiting for assessment, you do not need to wait to start building strategies. Mentoring can help right now, whether or not you have a formal diagnosis.

Frequently Asked Questions

Can I use Right to Choose if I already have a referral to my local NHS service? Yes. You can ask your GP to redirect the referral at any point before your NHS assessment takes place. You do not need to come off the NHS waiting list first.

Does Right to Choose work for children? Yes, parents can exercise Right to Choose on behalf of their children for ADHD assessment. Some providers specialise in children and young people, while others only assess adults (18+). Check with the provider before requesting a referral.

What if I live in Scotland, Wales, or Northern Ireland? Right to Choose as described here is an England-only policy. However, each nation has alternative pathways, contact your local health board for options.

Is a Right to Choose diagnosis "less valid" than an NHS one? Absolutely not. Right to Choose providers are NHS-approved and conduct assessments to the same clinical standards set out in NICE guideline NG87. The assessment process, diagnostic criteria, and clinical qualifications are identical. A Right to Choose diagnosis carries the same legal and clinical weight.

How much does it cost? Nothing. The entire assessment is funded by the NHS through your local Integrated Care Board. That is the whole point.

What if I am not diagnosed with ADHD? If the clinician concludes that you do not meet the criteria for ADHD, they will explain their reasoning and may suggest alternative explanations for your difficulties. You have the right to seek a second opinion, either through another Right to Choose provider or through the private ADHD assessment route. A negative result does not necessarily mean you do not have ADHD; it may mean the assessment did not capture your full picture.

Can I choose any provider, or does it have to be from a list? Your chosen provider must meet certain criteria: they must be a qualified provider registered with the Care Quality Commission (CQC), hold an NHS contract or agreement, and deliver services in line with NICE guidelines. In practice, there are a growing number of providers that meet these requirements. Check the provider's website to confirm they accept Right to Choose referrals from your ICB area.

Further Reading

If you are navigating the Right to Choose pathway, these guides may also be helpful:

• How to write a Right to Choose letter to your GP for practical help structuring your request
• What to do if your GP refuses Right to Choose for escalation steps and your rights
• Shared care agreements for ADHD for what happens after diagnosis
• What happens at an ADHD assessment so you know what to expect
• NHS vs private ADHD assessment for a comparison of all pathways
• How to prepare for your ADHD assessment for practical tips
• How to get ADHD medication in the UK for post-diagnosis medication guidance

If you need hands-on support with your Right to Choose letter, I offer a guided letter-writing session as part of my Help With Forms service.

You Deserve Answers

Waiting years for an ADHD assessment while your life feels like it is falling apart is not acceptable. Right to Choose is not a loophole or a shortcut, it is your legal right to timely healthcare. For a broader look at the diagnostic landscape, read my guide to getting an ADHD diagnosis in the UK.

If you are navigating the assessment process and want support along the way, or if you have already been diagnosed and want practical help building strategies that work, I would love to chat. Book a free consultation and let's figure out your next step together.