NHS ‘Right to Choose’ for ADHD & Autism: How to Bypass the Waiting List

NHS ‘Right to Choose’ for ADHD & Autism: How to Bypass the Waiting List

The wait for an NHS ADHD or autism assessment can be incredibly difficult, with local waiting lists across England frequently stretching from two to five years.

Fortunately, an underused legal provision called Right to Choose (RTC) allows patients to bypass these lengthy local queues by choosing an alternative, NHS-approved private provider—funded entirely by the NHS.

Here is a practical, step-by-step guide to understanding, preparing for, and securing an assessment through NHS Right to Choose.

1. Understanding Right to Choose (RTC)

• What it is: A legal right introduced in 2018 in England that permits patients to choose which organization provides their physical or mental health care, provided the clinic has an existing contract with an NHS Integrated Care Board (ICB).

• The financial cost: The assessment and any subsequent treatment (including titration and medication) are 100% free of charge to you; the funding is covered entirely by your local NHS budget.

• Who is eligible: You must be registered with a GP practice in England. Unfortunately, Right to Choose does not currently apply to patients living in Scotland, Wales, or Northern Ireland.

• Key exceptions: You cannot use this pathway if you are already receiving secure psychiatric care, are in prison, or need urgent/crisis mental health support.

2. Choosing an Approved Private Provider

• Identify qualified clinics: You must select an independent provider that has a pre-existing NHS contract in England. Popular options for ADHD and autism include:

  • Psychiatry-UK: One of the largest and most established RTC providers for both ADHD and autism.

  • ADHD 360: A widely used specialist service focusing primarily on adult and pediatric ADHD.

  • Clinical Partners: Often utilized for adult autism and ADHD assessments.

  • Problemshared: Offers assessments for both adults and children, partnering with multiple NHS trusts.

• Check their current wait times: While private providers are much faster than local NHS services, their popularity means they also have waiting lists (typically ranging from 3 to 12 months). Check their websites directly for up-to-date timelines.

• Verify their age range: Make sure the provider you select is registered to assess your specific demographic (e.g., some assess adults only, while others have dedicated pediatric teams).

3. Preparing Your Referral Pack

• Download the provider’s RTC letter template: Almost all approved providers offer a free, downloadable “GP Referral Letter” on their website. Print this out to take to your appointment.

• Complete a self-assessment checklist: GPs require evidence of your symptoms to justify a referral. Complete a standard self-report questionnaire, such as:

  • The ASRS (Adult ADHD Self-Report Scale) for ADHD.

  • The AQ-10 (Autism Spectrum Quotient) for autism.

• Write a personal symptom log: Jot down bullet points explaining how your symptoms affect your daily life, specifically focusing on two or more areas (e.g., employment, relationships, education, or household management).

• Gather historical evidence: If possible, dig out old school reports, performance reviews, or statements from family members that show these traits have been present since childhood.

4. Securing Your GP Referral

• Book a dedicated appointment: Request a specific consultation with your GP to discuss a mental health referral. Do not try to squeeze this into a visit about a physical illness.

• Present your prepared pack: Hand your GP the completed self-assessment form, your symptom log, and the provider-specific RTC referral letter.

• State your legal right clearly: Frame the request around your legal right under the NHS Constitution. You can politely state: “I would like to exercise my NHS Right to Choose to be referred to [Provider Name] for an ADHD/autism assessment.”

• Address potential GP hesitation: Some GPs may not be familiar with Right to Choose. Offer to email them the direct link to your chosen provider’s “GP Info” page, which outlines the legal framework and explains that the funding does not come out of the GP practice’s own budget.

5. Navigating Shared Care and Treatment

• The assessment phase: Once the referral is accepted, the provider will contact you to complete further online questionnaires and schedule your virtual clinical assessment.

• Medication titration: If you receive an ADHD diagnosis and opt for medication, the private provider will manage your “titration”—the process of finding the right dose—which is also funded by the NHS.

• Entering a Shared Care Agreement (SCA): Once your medication dose is stable, the specialist will ask your GP to enter into an SCA. This means your GP takes over writing your monthly prescriptions at standard NHS prescription charges.

• The crucial risk to verify: Before your referral, check if your GP practice routinely accepts SCAs from your chosen private provider. If a GP refuses a Shared Care Agreement, you may have to continue getting your prescriptions directly from the private provider via NHS funding, or pay privately for the medication.