Right to Choose
Under the NHS Constitution, you have a legal right to choose which provider carries out your ADHD assessment. This means you can get an NHS-funded assessment through an approved private provider — without the long NHS wait. Right to Choose is not a loophole or a shortcut. It is a legal right enshrined in law, and your GP is legally obligated to support it.
What is Right to Choose?
Right to Choose is a legal right established under Section 3a of the NHS Constitution (first introduced in the Health Act 2009, and reinforced by the NHS Mandate). It states that patients have the right to choose the organisation that provides their NHS-funded care, provided that the chosen provider meets NHS standards and contractual requirements.
In practical terms, this means that when your GP agrees you need an ADHD assessment, you can choose to be referred to a qualified provider other than the local NHS mental health team. If the provider you choose has a contract or agreement with the NHS to provide ADHD assessments, the assessment is funded by the NHS — it is free to you. You do not pay for the assessment itself.
Right to Choose applies to the first outpatient appointment for a new condition. Since an ADHD assessment is typically the first outpatient appointment in the diagnostic pathway, it falls squarely within the scope of this right. The right applies in England. Scotland, Wales, and Northern Ireland have separate healthcare arrangements, although similar principles may apply in some cases.
It is important to understand that Right to Choose is not the same as a private assessment. With Right to Choose, the NHS pays the provider. With a private assessment, you pay directly. Both can lead to a valid diagnosis, but the funding route is different.
Who is eligible?
You are eligible to use Right to Choose for an ADHD assessment if you meet the following criteria:
- You are registered with a GP in England
- Your GP agrees that a referral for ADHD assessment is clinically appropriate
- You have not already been seen by a specialist for this particular referral (Right to Choose applies to the first outpatient appointment)
- The provider you choose has a valid agreement with the NHS to provide ADHD assessments
Right to Choose is available to adults (18+) and, in many cases, children and young people, depending on the provider. There are no income criteria, no means testing, and no additional requirements beyond those listed above. If your GP agrees you need an assessment, you can choose who provides it.
How it works: step by step
Research your options
Before seeing your GP, identify an approved Right to Choose provider that accepts referrals in your area. Check their website for specific referral requirements. Not all providers cover all regions, and some have specific forms your GP will need to complete.
Book a GP appointment
Request an appointment with your GP. You can do this in person, by phone, or online depending on your surgery. It helps to specifically mention ADHD when booking so the receptionist allocates enough time. A double appointment (20 minutes) is ideal.
Discuss your symptoms with your GP
Explain your symptoms and why you believe an ADHD assessment is appropriate. It can help to bring a list of specific examples of how symptoms affect your daily life. Your GP does not need to diagnose you — they simply need to agree that a referral for assessment is appropriate.
Request Right to Choose
Tell your GP you would like to exercise your Right to Choose and be referred to your chosen provider. Be clear and specific: 'I'd like to use my Right to Choose under the NHS Constitution to be referred to [provider name] for my ADHD assessment.'
Your GP makes the referral
Your GP completes the referral paperwork and sends it to your chosen provider. This may involve completing a specific referral form provided by the provider, or sending a standard referral letter. Some providers have an online referral portal.
Complete pre-assessment questionnaires
Most providers will send you screening questionnaires and forms to complete before your assessment. These typically include the ASRS (Adult ADHD Self-Report Scale), a developmental history form, and sometimes a request for a collateral report from someone who knew you as a child.
Attend your assessment
The provider carries out your ADHD assessment, usually via video call or in person. This is a comprehensive clinical interview lasting 60–90 minutes, conducted by a specialist psychiatrist or qualified clinician. It covers your current symptoms, childhood history, and functional impact.
Receive your results
After your assessment, you receive a detailed diagnostic report. If you are diagnosed with ADHD, the report will include treatment recommendations. The provider also writes to your GP with the outcome and any prescribing recommendations.
Begin treatment
If medication is recommended and you choose to take it, your treatment may be initiated by the provider under a shared care agreement with your GP. Your GP takes over ongoing prescribing once your medication is stabilised, typically after 3–6 months.
Ongoing care
Your GP provides ongoing monitoring and repeat prescriptions. You may also access follow-up support from the provider, ADHD coaching, or therapy (CBT) depending on your needs and what is available.
GP letter template
If you would like to prepare before your GP appointment, or if you find it easier to communicate in writing, you can use the following template. You can email this to your GP surgery or bring a printed copy to your appointment.
Dear Dr [GP Name],
I am writing to request a referral for an ADHD assessment. I have been experiencing symptoms that I believe are consistent with ADHD, and these symptoms are having a significant impact on my daily life, including [briefly describe 2-3 specific areas of difficulty, e.g. work performance, relationships, managing daily tasks].
I have completed the ASRS-v1.1 self-report screening tool, which indicated that my symptoms are consistent with ADHD and that further assessment is warranted.
I would like to exercise my Right to Choose under Section 3a of the NHS Constitution and request that my referral be directed to [Provider Name], an approved Right to Choose provider for ADHD assessments. Their referral details are as follows: [include provider referral email, fax number, or online portal URL].
Under the NHS Constitution, I have the legal right to choose the provider that carries out my first outpatient appointment. I understand that this referral will be NHS-funded and that [Provider Name] has the appropriate agreements in place with the NHS.
I would be grateful if you could process this referral at your earliest convenience. I am happy to attend an appointment to discuss this further if required.
Thank you for your time and support.
Yours sincerely,
[Your Name]
[Your Date of Birth]
[Your NHS Number if known]
What if your GP refuses?
Your GP cannot legally refuse a Right to Choose referral if they agree that you need an ADHD assessment. The right is enshrined in the NHS Constitution. However, some GPs may be unfamiliar with the process, or may raise concerns. Here is how to handle common objections:
“We don't do Right to Choose here”
Right to Choose is a legal right that applies to all GP practices in England. It is not optional or at the discretion of individual practices. Politely remind your GP that Right to Choose is part of the NHS Constitution and applies nationally.
“I've never heard of this provider”
Provide your GP with the provider's details, including their website and NHS contract information. Approved providers will have this information readily available and can often speak directly with GP practices to confirm their status.
“Our CCG/ICB doesn't fund this”
Right to Choose is a national legal right and is not dependent on local CCG or ICB (Integrated Care Board) policy. While funding arrangements may vary, the right itself cannot be overridden by local commissioning decisions.
“I don't think you have ADHD”
Your GP does not need to diagnose you with ADHD — they only need to agree that a referral for assessment is appropriate. If your GP does not feel this is the case, ask them to document their reasons in your medical record, and consider seeking a second opinion from another GP at the practice.
If you continue to experience difficulty, you can raise a formal complaint through the practice's complaints procedure, contact your local Patient Advice and Liaison Service (PALS), or contact NHS England directly.
Right to Choose vs private assessment
Not sure which route is right for you? Here is a comparison of the two main alternatives to the standard NHS waiting list.
| Right to Choose | Private Assessment | |
|---|---|---|
| Cost | Free (NHS-funded) | From £595 |
| GP involvement | Required (GP must make the referral) | Not required (self-referral) |
| Typical wait | 4–12 weeks (varies by provider) | 1–2 weeks |
| Availability | England only | UK-wide |
| Assessment quality | Full clinical assessment by specialist | Full clinical assessment by specialist |
| Medication initiation | Via shared care with GP | Via provider, then shared care with GP |
| Diagnosis validity | Fully recognised by NHS | Fully recognised by NHS |
Regional variations
While Right to Choose is a national right in England, the practical experience can vary by region. Some Integrated Care Boards (ICBs) have well-established relationships with approved providers, making the referral process smooth and straightforward. Others may be less familiar with the process, which can lead to delays.
In some areas, particularly London, the South East, and urban centres in the North West, there are multiple approved providers to choose from, and GP practices are generally well informed about the process. In more rural areas or regions with fewer providers, it may take slightly longer to arrange a referral, and you may need to provide your GP with more information about the provider and process.
Regardless of region, your legal right remains the same. If you experience difficulties, the same escalation routes apply: raise it with the practice manager, contact PALS, or contact NHS England.
Timeline expectations
The full Right to Choose process — from first GP appointment to receiving your diagnosis — typically takes between 6 and 16 weeks, depending on several factors. Here is a realistic breakdown:
GP appointment and referral
Includes booking the appointment, attending, and the GP sending the referral.
Referral processing
The provider receives and processes the referral, confirms eligibility, and sends you pre-assessment forms.
Pre-assessment preparation
Completing and returning questionnaires and any collateral history forms.
Assessment appointment
Wait for an available appointment slot. This varies significantly by provider and demand.
Diagnostic report
After the assessment, the clinician writes and sends your report to you and your GP.
Compare this to the NHS average wait of 3.2 years, and the advantage is clear.
Frequently asked questions
Is Right to Choose really free?
Yes. The assessment is funded by the NHS. You do not pay for the assessment itself. However, some providers may charge for additional services beyond the initial assessment, such as follow-up appointments or medication titration, depending on their NHS contract. Always check with the provider what is covered before proceeding.
Can I use Right to Choose if I'm already on an NHS waiting list?
Yes. If you are currently on an NHS waiting list for an ADHD assessment and have not yet been seen, you can ask your GP to redirect your referral under Right to Choose. You do not need to start the process from scratch.
Does Right to Choose apply in Scotland, Wales, or Northern Ireland?
Right to Choose under the NHS Constitution applies in England only. Scotland, Wales, and Northern Ireland have devolved healthcare systems with their own arrangements. If you are outside England, a private assessment may be the fastest route.
Will my GP accept the diagnosis from a Right to Choose provider?
Yes. A diagnosis from an approved Right to Choose provider is an NHS diagnosis and carries the same weight as a diagnosis from the local NHS mental health team. Your GP should accept the diagnosis and follow the treatment recommendations in the diagnostic report, including entering into a shared care agreement for medication if recommended.
Can I choose any provider, or does it have to be from a specific list?
You can choose any provider that has a valid agreement with the NHS to provide ADHD assessments. Not all private ADHD clinics are approved Right to Choose providers. Check directly with the provider to confirm they accept Right to Choose referrals in your area.
What happens after my Right to Choose assessment?
If you are diagnosed with ADHD, the provider will send a detailed report to both you and your GP. If medication is recommended, the provider will typically initiate and stabilise your medication before transferring ongoing prescribing to your GP under a shared care agreement. You may also receive recommendations for therapy, coaching, or other support.
Important note
Right to Choose is currently available for patients registered with a GP in England. The pathway and approved providers may vary by region. We recommend discussing your options with your GP as a first step. If you are unsure whether Right to Choose is available to you, or if you would prefer to bypass the GP referral process entirely, our private assessment is available from £595 with appointments typically within 2 weeks.
Can't wait for Right to Choose?
The Right to Choose process still involves GP coordination, which can take time — particularly if your GP is unfamiliar with the process or if the provider has a waiting list. If you'd prefer to get assessed quickly without involving your GP, our private assessment is available from £595 with appointments typically within 2 weeks.
Not sure where to start? Take our free ADHD screening questionnaire to see whether a full assessment might be right for you.
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