Is the Right to Choose pathway open to you?
Six questions about the pathway, in the order they actually bite. Work through them before you book the GP appointment, because four of the six have answers you can find out in advance.
This is not a test for ADHD
1. Are you registered with a GP practice in England?
This is the entry condition. Regulation 38 limits an elective referral to a general medical practitioner, a general dental practitioner or an optometrist, and for an ADHD assessment that means your GP. NHS South West London ICB frames the entitlement the same way: anyone registered with a GP in England is legally entitled to access Right To Choose. If you are registered elsewhere in the UK, this pathway is not the one that applies to you, and this site does not describe the Scottish, Welsh or Northern Irish arrangements.
If the answer is not a clear yes: No, or not registered anywhere: registering with a GP practice is the first step, because everything else runs through it.
2. Is your GP willing to refer you for an assessment?
This is the gate that stops most people, and it comes before any choice of provider. Regulation 39(6) treats a provider as clinically appropriate only in the opinion of the person making the referral, and NHS South West London ICB's published step list has the GP deciding whether a referral for an assessment is appropriate at step two. The choice in regulation 39 only opens once that decision has gone your way.
If the answer is not a clear yes: Not yet asked: bring evidence of impairment across more than one setting, with dates, and a named provider with your reason for choosing it.
3. Is this a new referral rather than urgent care or an onward referral?
Regulation 40(2) removes any service where it is necessary to provide urgent care, and the definition of an elective referral excludes treatment identified as immediately required. The NHS also lists onward referrals, where you are already having care and treatment for the condition you have been referred for, among the situations with no legal right to choose.
If the answer is not a clear yes: If you need help now, use urgent and crisis routes rather than waiting on an assessment pathway.
4. Does a statutory exclusion apply to you?
Regulation 41 removes the duty in relation to any person who is detained under the Mental Health Act 1983, detained in or on temporary release from prison or other prescribed accommodation, or serving as a member of the armed forces. The NHS lists the same categories in plainer language, giving a court, secure children's home, secure training centre, immigration removal centre or young offender's institution as examples of other prescribed accommodation.
If the answer is not a clear yes: If one applies, the statutory choice does not, and the route into assessment is a question for the service responsible for your care.
5. Does the provider you want accept referrals for someone like you?
This is a separate question from the law, and it is where a lot of referrals fail. NHS South West London ICB states that although anyone registered with a GP in England is legally entitled to access Right To Choose, each provider will have their own inclusion and exclusion criteria, and that this may mean you are not eligible at a particular provider based on certain pre-existing needs, for example a moderate to severe learning disability or an addiction. Age ranges also differ: ADHD 360 states it can only accept referrals for children aged 8 plus and adults 16 years and older, while Psychiatry-UK describes its scheme service as adults aged 18 and over.
If the answer is not a clear yes: Ask the provider before the referral is sent, and have a second provider in mind.
6. Do you know what that provider does after a diagnosis?
The choice is worth spending on this rather than on an advertised waiting time. NHS South West London ICB warns that not all Right to Choose providers can start medicine or prescribe it and that some only offer an assessment or diagnosis. NHS West and North London ICB adds that where a provider does not offer ongoing care, your GP will discuss next steps, which may include joining the NHS waiting list for treatment or support.
If the answer is not a clear yes: Ask about prescribing, titration and annual reviews, and ask your practice whether it would accept shared care from that provider.
What a yes to all six means
It means the pathway is open to you and you have chosen a provider that will take your referral. It does not mean you will be assessed by any particular date. NHS South West London ICB answers that question directly, and the answer begins with the word no: Right To Choose does not guarantee quicker assessment.
Local rules also differ and move. Integrated care boards now agree Indicative Activity Plans with each provider, capping how much assessment activity they fund, so the current answer for your area comes from your own integrated care board and your GP practice rather than from any national page.
Where to go next
- What the pathway is, in full.
- How to ask your GP.
- What to do if your GP says no.
- Questions to ask a provider.