NHS Right to Choose for ADHD and Autism Assessments
If you've been stuck on an NHS waiting list for an ADHD or autism assessment (and if you're reading this, there's a good chance you have), you've probably heard people mention "Right to Choose" as a way to skip the queue and get seen for free. It's a genuine, legally backed option, but it's changed quite a bit over the last year, and a lot of what's floating around online hasn't caught up.
What Right to Choose covers
Right to Choose (RTC) is part of the NHS Choice Framework. When your GP refers you for a first assessment, whether that's for ADHD, autism, or something else, you have a legal right to ask for a different provider than whatever the local NHS team happens to be, as long as that provider holds an NHS contract and follows NICE guidelines. The assessment itself is funded at NHS rates, so it doesn't cost you anything.
This isn't a clever workaround someone's found. It's written into the NHS Constitution and the Choice Framework, and it exists because waiting lists for ADHD and autism assessments have got so long in so many parts of the country.
Who can use it:
- You (or your child) need to be registered with a GP in England.
- It has to be for a first assessment. Once you're already being treated for the condition, or you're after a second opinion, RTC generally doesn't apply.
- It's not for urgent or emergency care, and there are some exclusions for people in the armed forces or secure settings.
- It's an England-only scheme. Scotland, Wales and Northern Ireland don't run it in the same way.
What's changed: Indicative Activity Plans
Demand for ADHD and autism assessments through RTC has grown so fast that NHS England asked Integrated Care Boards (ICBs) to agree what are called "Indicative Activity Plans" (IAPs) with independent providers, covering 2025/26 and now 2026/27. An IAP puts a cap on how many assessments a given provider can carry out under NHS funding in a year, along with the budget behind it.
What that means on the ground varies by area and by provider, but the common effects are:
- Some providers pausing or delaying new RTC bookings for a while.
- Waits within RTC creeping up compared to a year or two ago.
- ICBs applying clinical prioritisation, so referrals aren't all treated the same way.
None of this takes away your legal right to ask for a provider of your choice. What it does mean is that Right to Choose isn't the guaranteed shortcut it used to be. It's a genuine choice between providers, some with shorter waits than others, and those waits can shift from month to month. That's why it's worth checking a provider's current wait time before you decide who to name in your referral letter, rather than trusting an older figure you saw somewhere.
How to go about it
- Check you're eligible. Registered with an NHS GP in England, going for a first assessment, not already in treatment for the same thing.
- Pick a provider. Look for one with an NHS contract, ideally one showing a realistic, current wait time rather than a vague "short wait" claim.
- Book an ordinary GP appointment. Nothing urgent needed here, just a routine consultation.
- Take a referral letter with you. GPs deal with a lot of referral requests, so a clear letter that names your chosen provider and points to the right legal basis makes the appointment much easier for everyone involved.
- If your GP seems unsure or reluctant, it's usually not a flat no, more likely that RTC for ADHD and autism is less familiar to them than other referral routes. A letter that spells out the Choice Framework directly is normally enough to get things moving.
Questions people ask
"My GP told me there's no Right to Choose funding round here."
This comes up a lot, and it's usually a misunderstanding rather than an actual rule. An ICB can't block a referral to a provider with a valid NHS contract just because it sits outside the usual local pathway, though that provider might have a capped number of NHS-funded places available under its IAP.
"Does an RTC diagnosis count the same as an NHS one?"
Yes. A diagnosis from an NHS-contracted RTC provider is an NHS diagnosis. NHS guidance to commissioners is clear that titration and shared-care services shouldn't ask for a reassessment based on an independent provider's report unless there's a genuine clinical reason to.
"What if the provider I wanted has paused new referrals?"
This is happening more often under the current IAP setup. Worth checking a provider's current status before your GP appointment rather than finding out after, and having a backup provider in mind just in case.
"Will I get seen faster this way?"
Often, yes, but not always, and not by as much as it once would have been. Treat any published wait time as a starting point rather than a promise, and expect it to move around.
Where to go from here
If you're ready to take the next step, the NHS Right to Choose Hub on NeuroRegistry lets you check current wait times across approved ADHD and autism providers and puts together a GP referral letter, with the correct legal basis included, in a few minutes. If you're not sure which provider suits you, the Clinic Finder can help you narrow it down first.
This article is general information, not clinical, legal or financial advice. Right to Choose rules, provider availability and Indicative Activity Plans change throughout the year, so always confirm current status with your chosen provider and GP before relying on any specific wait time.