Right to Choose for
ADHD Assessment

What is Right to Choose?

Right to Choose is a statutory right, established under the NHS Constitution and the National Health Service (Procurement, Patient Choice and Competition) Regulations 2013, that gives NHS patients in England the right to choose any provider on the NHS's approved list for certain services, rather than being automatically allocated to their local service.

For adult ADHD assessment, this means that once a GP has agreed to make a referral, the patient can specify a provider of their choice rather than being referred to the local NHS ADHD service with its associated waiting time. The cost of the assessment is borne by the NHS, paid at the NHS tariff rate to the chosen provider.

Right to Choose applies in England. Equivalent provisions exist in Wales, Scotland, and Northern Ireland but operate under different frameworks, and the specifics vary. This guide focuses on the English system.

Who is eligible?

To exercise Right to Choose for an ADHD assessment, you need to be an NHS patient in England, registered with a GP, and to have your GP agree to make a referral for ADHD assessment. The right applies at the point of referral: your GP cannot simply decline to refer you to a provider of your choice if they have already agreed to make the referral.

You do not need to already be on a waiting list to exercise the right. The right applies at the point of the initial referral, and you can specify a Right to Choose provider at that stage rather than waiting to see how long the local list is.

There is no income threshold and no means test. The right is available to all eligible NHS patients regardless of financial circumstances, which makes it particularly relevant for people who want faster access to assessment but cannot afford private fees.

How to exercise Right to Choose

The process begins with your GP. You need to ask your GP to make a referral for an adult ADHD assessment and to state that you wish to exercise your Right to Choose. Your GP cannot refuse to refer you to a provider on the NHS's approved list if they agree that a referral is clinically appropriate.

You then need to identify a Right to Choose provider. The NHS website's Find a Psychological Therapies Service tool and the websites of individual providers that offer Right to Choose assessments are the most useful starting points. ADHD UK maintains a list of Right to Choose providers and is a helpful resource for people navigating this process.

Once you have identified the provider, give your GP the provider's details so they can make the referral. The provider will then contact you to arrange the assessment.

"Right to Choose does not guarantee immediate access, but it does give you meaningful control over where you are assessed. In a market with very uneven waiting times, that can matter a great deal."

What to expect in practice

In practice, exercising Right to Choose does not always result in immediate access. Providers offering Right to Choose services often have their own waiting lists, and some have been overwhelmed by demand. The wait through Right to Choose may be shorter than through the local NHS service, but it is rarely zero, and some providers have waits of a year or more.

Some GPs are unfamiliar with Right to Choose for mental health services and may initially resist or be uncertain about the process. Being prepared with clear information about the right, including the NHS Constitution's provisions, is helpful. ADHD UK and other advocacy organisations provide template letters that patients have used successfully in these conversations.

The assessment itself, once it takes place, follows the same clinical standards as any NHS ADHD assessment: DSM-5 criteria, validated rating scales, and a structured interview. The quality of the assessment depends on the specific provider chosen.

Limitations of Right to Choose

Right to Choose is a useful right, but it has real limitations. It requires GP cooperation to initiate the referral, and while GPs cannot lawfully refuse to make a referral to an approved provider if the referral is clinically appropriate, navigating a reluctant GP can take time and persistence.

The pool of Right to Choose providers for adult ADHD is not unlimited, and providers in this space have faced significant scrutiny following media coverage of quality issues in the sector. The NHS tariff rate paid to Right to Choose providers is lower than private rates, which affects the staffing model and sometimes the seniority of the clinician available to conduct assessments.

For people who need documentation for an employer, university, or the DVLA quickly, the uncertainty around waiting times through Right to Choose may make private assessment a more reliable option. For people for whom cost is the primary barrier to private assessment, Right to Choose remains an important route worth pursuing.

Right to Choose versus going fully private

The principal advantage of Right to Choose over private assessment is cost: it is NHS-funded and free to the patient. The principal disadvantages are the uncertainty of waiting times, the need for GP cooperation to initiate the process, and the more limited pool of providers and therefore less choice over the seniority of the assessing clinician.

Private assessment offers more immediate control over timing, provider, and clinician grade, but at a financial cost. For people who can afford private assessment and need assessment quickly, it offers a more certain timeline. For people for whom cost is a significant barrier, Right to Choose is a legitimate and valuable alternative worth pursuing properly.

The two routes are not mutually exclusive. Some people pursue a Right to Choose referral while also exploring private options, taking whichever becomes available first. Going private does not remove you from any NHS list you are already on.