Right to Choose is an NHS England legal right: when your GP refers you for a first appointment — including ADHD and autism assessment — you can choose any provider in England with an NHS contract for that service. It remains NHS care, free at the point of use, and can cut waits from years to months.
- ✓Right to Choose is a legal right in England — and assessment stays free, as NHS care.
- ✓Choosing an approved independent provider can cut ADHD/autism waits from years to months.
- ✓Ask your GP to name your chosen provider in the referral — that wording matters.
What Right to Choose actually is
The NHS is brilliant. The waiting isn't — and for ADHD and autism assessment, waits at some local NHS services have stretched to years, not months. Right to Choose (sometimes called "patient choice") is the part of the NHS Constitution and NHS England's choice framework that says: when your GP refers you for a first outpatient appointment, you can choose which provider the referral goes to — anywhere in England — as long as that provider holds an NHS contract for the service and the referral is clinically appropriate.
Crucially, several independent providers hold NHS contracts for ADHD and autism assessment, and some have much shorter queues than local NHS services. Choosing one of them is not "going private" — it's NHS care delivered by a contracted provider, free at the point of use, including the assessment itself.
How to use it, step by step
- Do your homework first. Identify one or two providers that hold an NHS contract for ADHD or autism assessment and are accepting Right to Choose referrals — provider websites usually state this clearly and list current indicative waits.
- Book a GP appointment and explain your symptoms as you would for any referral. The GP still needs to agree a referral is clinically appropriate — Right to Choose governs where it goes, not whether one is made.
- Name your chosen provider. Say explicitly: "I'd like to use my legal right to choose, and I'd like this referral sent to [provider]." Some providers publish referral forms and template letters for GPs — bring them; they genuinely help.
- Check the referral wording. The referral should name the provider and the service. Vague referrals to the local pathway are the most common reason people end up on the long list anyway.
- Confirm receipt. Contact the provider after a week or two to confirm your referral has arrived and ask for their current expected wait.
Realistic expectations: waits at popular Right to Choose providers move around as demand shifts — often a few months, sometimes longer as referral volumes surge. Still typically far shorter than local pathways measured in years.
The limits — honest caveats
- England only. Right to Choose is an NHS England framework. Scotland, Wales and Northern Ireland have different systems without an equivalent legal right.
- The provider must qualify. They need an NHS commissioning contract for that exact service. A private clinic without one can't be chosen this way.
- A referral is still required. Your GP must agree an assessment is clinically appropriate; choice doesn't override clinical judgement.
- It applies at first referral. If you're already on a waiting list, switching provider is sometimes possible but less straightforward — ask the new provider how they handle transfers.
- Medication afterwards varies. If you're diagnosed with ADHD, the provider typically starts (titrates) medication, then asks your GP to take over prescribing under a shared care agreement. Some GP practices decline shared care with some providers — see the FAQ below, because it matters.
Want cover for next time?
Right to Choose vs self-pay vs insurance
| Route | Typical cost | Typical wait | Watch-outs |
|---|---|---|---|
| Right to Choose (NHS) | Free at point of use | Months, varies by provider | England only; GP referral needed; shared care varies |
| Local NHS pathway | Free | Often 1–3+ years for ADHD/autism | Longest queue; varies hugely by area |
| Private self-pay | £500–£1,200 for assessment | Days to weeks | Titration and prescriptions cost extra; check provider quality |
| Health insurance | Premiums; cover for ADHD varies | Days to weeks where covered | Many policies exclude or limit ADHD assessment |
If speed matters most and budget allows, our guide to private ADHD assessment costs sets out realistic prices. If you have or are considering health insurance, cover for ADHD assessment varies significantly by insurer — our ADHD assessment cover guide explains who covers what.
Our honest take
We compare private health insurance for a living, but for ADHD and autism assessment specifically, Right to Choose is often the best-value route in England: it's free, it's legitimate NHS care, and it can save you a four-figure sum. Private routes earn their keep when you need speed the NHS can't match, want a specific clinician, or live outside England.
Whichever route you take, the assessment quality question is the same — who conducts it and how thorough it is. A good assessment uses structured diagnostic criteria, takes a proper developmental history, and screens for conditions that mimic or accompany ADHD and autism. That, and the medication question, are covered in the FAQs below.
One more practical note: demand for these assessments has grown enormously, so provider waits published today may lengthen by the time your referral lands. Confirm the current position directly with the provider rather than relying on a months-old forum post — and if one provider's queue has ballooned, remember you're entitled to choose a different qualifying provider instead.
Frequently asked questions
Is Right to Choose really free?
Yes. A Right to Choose referral is NHS care delivered by a provider holding an NHS contract, so the assessment is free at the point of use — no invoice, no top-up fee for the assessment itself. Prescription charges after diagnosis are the standard NHS ones, exactly as if a local NHS clinic had assessed you.
Does Right to Choose apply in Scotland, Wales or Northern Ireland?
No. Right to Choose is part of NHS England's patient choice framework, so the legal right applies to people registered with a GP in England. Scotland, Wales and Northern Ireland run separate systems without an equivalent enforceable right — options there are the local NHS pathway, private self-pay, or insurance where it covers assessment.
What can I do if my GP refuses a Right to Choose referral?
First, clarify the refusal. If the GP doesn't think any assessment is clinically appropriate, choice doesn't override that — ask them to record the decision and consider a second opinion. If they agree assessment is needed but won't use your chosen provider, politely cite your legal right under NHS England's choice framework, bring the provider's GP referral pack, and escalate to the practice manager or your local ICB if needed.
Will my GP prescribe ADHD medication after a Right to Choose diagnosis?
Usually, but not always — and this is the honest caveat. The provider typically starts and stabilises medication, then requests a shared care agreement for your GP to continue prescribing. Most practices accept, but some decline shared care with certain remote providers, leaving ongoing prescribing with the provider. Ask both the provider and your GP practice about shared care before choosing.
How long are Right to Choose waits for ADHD and autism assessment?
It varies by provider and moves with demand — commonly a few months from referral to assessment, though popular providers can stretch longer as volumes surge. That still compares well with local NHS pathways, where ADHD and autism waits of one to three years or more are widely reported. Always ask providers for their current indicative wait before referral.
Which providers can I choose under Right to Choose?
Any provider in England holding an NHS commissioning contract for the service you're referred to — NHS trusts and a number of independent clinics, several of which run dedicated ADHD and autism pathways. Providers accepting Right to Choose referrals usually say so prominently and publish GP referral forms. Check the contract covers your service and, for children, the right age group.
Can I use Right to Choose if I'm already on an NHS waiting list?
Sometimes, but it's cleanest at the point of first referral. If you're already listed, ask your GP to make a fresh referral to your chosen provider and ask that provider how they handle transfers — some accept re-referrals readily, and you'd normally come off the original list once assessed. You don't lose your place until you choose to.
Is a diagnosis from a Right to Choose provider a 'real' NHS diagnosis?
Yes. The assessment is commissioned NHS care, so the diagnosis has the same status as one from a local NHS clinic — it should be recorded in your GP record and support workplace or education adjustments. Quality still varies between providers, as anywhere, so favour those using recognised diagnostic tools and appropriately qualified clinicians.
Can children use Right to Choose for ADHD or autism assessment?
Yes — the choice framework covers children's referrals too, with parents choosing on their child's behalf, and several contracted providers run under-18 pathways. Check the provider's age range and whether your area commissions the specific children's service, as coverage is patchier than for adults. School reports and questionnaires will usually be part of the assessment.
Does using Right to Choose affect my health insurance?
No — it's NHS care, so there's no claim and nothing to declare beyond the medical facts themselves. Bear in mind that any diagnosis, however obtained, becomes part of your medical history, which affects underwriting on policies you take out afterwards. Existing policies aren't affected by choosing an NHS route for assessment.