How to use Right to Choose for an ADHD assessment in England

What Right to Choose is

Right to Choose is a legal right in England. When your GP refers you for a first appointment with a mental health specialist, you can choose any provider that holds an NHS contract for that service, and the clinical team you see. It comes from regulation 39 of the NHS Standing Rules Regulations 2012 and is set out in the NHS Choice Framework.

'NHS-contracted' means the provider holds a contract with at least one NHS integrated care board (ICB) in England for adult ADHD assessment. That's enough for any GP in England to refer you there, and for your local ICB to pay. You pay nothing.

Why bother? Local NHS waits can be brutal. A government-commissioned review published in October 2026 found median waits ranging from under two months to more than 1,000 days, depending on where you live. Providers' own figures put the average wait for NHS-funded ADHD assessments at independent providers at 151 days in 2025/26.

Who can use it

• You're registered with a GP in England. Scotland, Wales and Northern Ireland don't have it.
• Your GP agrees a referral is clinically appropriate. If it is, you can pick any suitable provider with an NHS contract, not just the local one.
• You're not already being treated for ADHD by a service. Onward referrals don't count.
• You're not in prison, serving in the armed forces or detained under the Mental Health Act.

What changed in 2026

The legal right hasn't changed, and the government said so again in 2026. The money has. For 2026/27, NHS England asked local NHS areas (ICBs) to agree an 'Indicative Activity Plan' with independent providers: roughly how many NHS-funded assessments each will do in the year. Not every area caps.

In practice, a provider can still accept your referral but may pause or delay appointments once it reaches its plan. ADHD UK's Freedom of Information requests found 14 of 36 NHS areas in England capping Right to Choose in 2026. Switching provider later may not get you seen any faster, so check before you ask for the referral.

More change may come. The October 2026 review recommended that Right to Choose providers meet the same standards and data rules as other NHS services, and that shared care should work to one national standard. Those are recommendations, not law.

Step by step

1. Check your area. Use ADHD UK's NHS area checker and your ICB's website to see which providers take referrals from your area and whether caps apply.
2. Pick a provider and ask it four things. Do you hold an NHS contract for adult ADHD assessment? Are you taking referrals from my area right now? What's the current wait? Do you do titration and prescribing too?
3. Book a GP appointment. Say you'd like an ADHD assessment using Right to Choose, name your provider, and bring its referral form if it has one.
4. Leave a written request with the practice (there's one to copy below), so it doesn't get lost between appointments.
5. Wait for the provider to confirm it has accepted the referral. Keep that email or letter.
6. Do the assessment. Ask beforehand whether it's by video or in person, and what you need to fill in first.

A request you can copy

Dear Dr [name],

I'd like to be referred for an adult ADHD assessment. Under my legal right to choose (NHS Choice Framework), I'd like the referral to go to [provider], which holds an NHS contract for adult ADHD assessment and is accepting referrals from [your ICB area]. Their referral form is attached.

ADHD affects my daily life in these ways: [two or three specific examples, like missed bills, lost jobs or forgotten appointments].

If you don't think a referral is clinically appropriate, could you please tell me why in writing?

Thank you, [your name and date of birth]

After diagnosis: titration and shared care

If you're diagnosed and want to try medication, a provider that offers titration starts it and adjusts it until it's stable. Then it asks your GP to take over the prescriptions under a shared care agreement, while the provider keeps doing your annual review.

GPs don't have to agree, and the October 2026 review found acceptance for medication started by independent providers had fallen to about 62%. If your GP says no, or doesn't reply within 21 days, NHS England's 2026/27 guidance lets an NHS-contracted provider keep prescribing and bill the NHS, if it's willing to. Not every Right to Choose provider prescribes, which is why you ask before you choose.

If your GP refuses or stalls

• Ask for the reason in writing. A GP can decline if they don't think a referral is clinically appropriate.
• Ask to see another GP at the practice, or ask the practice manager to look at it.
• Complain to your ICB. The NHS Choice Framework says ICBs must make sure you're offered choice.
• Still stuck? NHS England can advise on patient choice, and the Parliamentary and Health Service Ombudsman is the last step.
• While you wait, you don't need a diagnosis to ask for reasonable adjustments at work or to apply for Access to Work.