If you've been told the NHS waiting list for ADHD assessment is three, five, or even ten years, Right to Choose might be the most important thing you learn about today. It's a legal right that lets you access assessment through an alternative provider, funded by the NHS, often with a significantly shorter wait. Most people have never heard of it. Many GPs don't fully understand it. Here's everything you need to know.
What Right to Choose Actually Is
Right to Choose is a legal right under the NHS Constitution (specifically, the NHS Choice Framework) that applies in England. It gives you the right to choose your mental healthcare provider, including for ADHD assessment. This means that instead of being placed on your local NHS trust's waiting list, you can ask your GP to refer you to an approved alternative provider. The assessment is still funded by the NHS, so there's no cost to you.
The providers available through Right to Choose are typically private companies that have contracts with the NHS to deliver assessment services. They operate to NHS clinical standards but often have shorter waiting times because they've scaled up specifically to meet the demand the NHS can't absorb.
Right to Choose applies in England only. Scotland, Wales and Northern Ireland have different healthcare systems with separate referral pathways. If you're outside England, check with your local health board about available options.
How to Use Right to Choose: Step by Step
- 1
Choose your provider before the GP appointment. Research which Right to Choose providers are available and accepting referrals. Psychiatry-UK is one of the largest, but there are others. Check their current waiting times (our clinic directory tracks these) and their process for accepting referrals.
- 2
Book a GP appointment and request a referral. Tell your GP you'd like to be referred for an ADHD assessment and that you want to exercise your Right to Choose. Name the specific provider. Bring a printed summary of your symptoms and any screening results.
- 3
Your GP processes the referral. The GP sends a referral to your chosen provider. Some providers have specific referral forms that need to be completed. Check the provider's website beforehand so you can tell the GP exactly what's required.
- 4
The provider contacts you. Once your referral is received, the provider will send you pre-assessment questionnaires and confirm your place on their waiting list. Waiting times through Right to Choose vary but are typically weeks to months rather than years.
- 5
Attend your assessment. The assessment itself follows the same clinical process as an NHS assessment. If you're diagnosed, the provider will send a report to your GP with treatment recommendations.
What Happens After Diagnosis Through Right to Choose
This is where things vary depending on your provider. ADHD UK explains that if your Right to Choose provider offers ongoing care (medication titration, follow-up appointments, post-diagnosis support), you'll receive that care through them, funded by the NHS. If your provider only offers assessment, your GP will discuss next steps, which may include joining the NHS waiting list for treatment or entering a shared care arrangement.
The shared care question is critical and worth understanding before you choose a provider. See our article on the shared care problem for the full picture.
What If Your GP Says No?
Some GPs resist Right to Choose referrals. Common reasons include not being aware of the policy, believing it doesn't apply to mental health services, or having received guidance from their local Integrated Care Board (ICB) to limit referrals. Here's how to handle each scenario.
If they're unaware of the policy, you can reference the NHS England ADHD payment guidance and the NHS Choice Framework. If they've been told by their ICB to restrict referrals, this is a more complex situation. ICBs have been given increasing control over Right to Choose in 2025/26, and some are introducing processes that slow or limit access.
If your GP refuses, ask them to record the refusal in your medical notes (this sometimes prompts a reconsideration). You can also request a second opinion from another GP at the practice, complain to the practice manager, or contact your ICB directly. ADHD UK's Right to Choose hub has template letters you can use.
Important Changes for 2025/26
The Right to Choose landscape is shifting. ADHD UK reports that local ICBs are being given more control over when and how Right to Choose referrals are processed. In some areas, this has introduced additional waiting times or screening steps before a referral is approved. The legal right itself hasn't been removed, but the practical experience of using it varies more than it used to.
Sign up for a free NDPathway account to receive email updates on Right to Choose waiting times and policy changes in your region. We track this so you don't have to.
Right to Choose vs Private Assessment
The key difference is cost. Right to Choose is NHS-funded, so there's nothing to pay. A private ADHD assessment typically costs £500 to £950 out of pocket. However, Right to Choose waiting times have increased as demand has grown, and some providers that were once quick are now reporting longer waits. If speed is your priority and budget allows, private assessment remains the fastest route.
For a detailed comparison, see our article on NHS vs private assessment.
Sources
ADHD UK: Right to Choose (NHS England) · ADHD UK: Right to Choose wait times · ADHD UK: NHS Right to Choose changes · NHS England: ADHD and Autism Payment Guidance 2026/27
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