If you are waiting years for an NHS ADHD assessment in England, you may have come across the phrase Right to Choose and wondered what it actually means. This guide explains it in plain English: what the right is, how to exercise it, who the providers are, and what to expect at each stage. It is written for patients, families, and the GPs supporting them.
For commissioners and providers looking at this from the service side, we have a separate piece: The UK Right to Choose ADHD Provider Landscape in 2026.
What Right to Choose actually is
Right to Choose (sometimes written RTC) is a legal right you already have under the NHS Constitution. If your GP refers you for a non-urgent elective mental health assessment, you can choose any provider in England that holds an NHS contract to carry out that assessment. Your home Integrated Care Board (the ICB, the local NHS body that holds the budget) is legally required to fund the assessment with the provider you choose, under what is called a tariff arrangement.
In short: you do not have to use the NHS service in your local area if another NHS-contracted provider elsewhere in England can see you sooner.
For adult ADHD assessment, Right to Choose has become the main alternative to the NHS core pathway. NHS waiting lists for ADHD assessment routinely run to three, five, or more years in many parts of England. Right to Choose providers usually see patients in weeks or a few months.
What Right to Choose does and does not cover
It covers: adult ADHD assessment and, in most cases, the treatment that follows (medication titration, shared-care arrangements with your GP).
It does not cover: children's services in the same way. Child and adolescent ADHD pathways sit under different rules and are commissioned separately through CAMHS and local authority services. Some Right to Choose providers do see young people but the legal route is not as clear-cut as it is for adults.
It usually covers autism assessment, because adult autism assessment sits under the same part of the NHS Constitution, but fewer providers hold autism contracts than ADHD contracts. Your options may be narrower.
Step by step: how to use Right to Choose
1. Speak to your GP
You need a GP referral to exercise the right. Book an appointment and explain you would like to be assessed for ADHD and that you wish to use your Right to Choose to see a specific provider. GPs are not always familiar with the specifics of Right to Choose, so it helps to come prepared with the provider name and the referral address (most providers publish this on their website).
2. Choose a provider
Several providers hold NHS Right to Choose contracts for adult ADHD in England. The main named providers in 2026 include:
- Psychiatry UK — the longest-established, largest by volume
- ProblemShared — multi-condition platform covering ADHD and autism across the lifespan
- ADHD 360 — ADHD-focused
- Clinical Partners — broad mental health provider with ADHD pathway
- Care ADHD — newer entrant
Provider lists on ICB websites often lag the actual market, so check each provider's website directly for current NHS contract status and waiting times.
3. GP sends the referral
Your GP sends the referral using the provider's standard template or referral address. Some providers have a self-referral option where you fill in the form and your GP only needs to countersign. Ask the provider.
4. Assessment
Most Right to Choose assessments are delivered by video call. You will typically be assessed by a psychiatrist, specialist mental health nurse, or specialist clinical psychologist. The assessment usually includes a structured interview, a review of childhood history, standardised questionnaires, and (where relevant) input from someone who has known you since childhood. Expect it to take 90 minutes to 2 hours.
5. Diagnosis and, if appropriate, treatment
If you are diagnosed with ADHD, the provider will usually offer treatment initiation, most commonly medication titration (gradually finding the right medication and dose for you). Titration typically takes a few months of regular appointments.
6. Shared care with your GP
Once your medication is stable, the provider asks your GP to take over ongoing prescribing under a shared-care agreement. This is where some people hit a problem: not every GP is willing to enter shared care, especially for ADHD medication. If your GP declines, the provider keeps prescribing but your ICB may have to continue funding the private prescription indefinitely, which can complicate things. Discuss this with your GP before you start.
How long does it all take?
Waiting times vary by provider and have changed significantly over the last two years as demand has risen. As of early 2026:
- Initial assessment: typically a few weeks to a few months with a Right to Choose provider, versus two to five years on the NHS core pathway
- Titration: three to six months from diagnosis to stable medication, with regular check-ins
- Shared care transition: variable, depending on GP willingness
Several providers have paused new referrals at different points in 2025 and early 2026 because they ran out of assessor capacity. If one provider has a long wait, another may be shorter — it is worth comparing.
Why waiting lists got so bad
UK ADHD referral rates tripled between July 2020 and January 2023, from roughly eleven to thirty three referrals per one hundred thousand people every month. ADHD medication prescriptions doubled over the same period, from 1.4 million to 3.1 million annually. NHS capacity did not grow to match. The April 2026 government Independent Review into Mental Health, ADHD and Autism named workforce expansion as the single biggest lever to reduce waiting times.
Right to Choose has absorbed a large part of the gap, which is why you are probably reading this piece.
Common questions
Does Right to Choose cost me anything? No. It is NHS-funded via your home ICB. You pay nothing for the assessment or NHS prescriptions, same as any other NHS service. You may pay the standard NHS prescription charge (currently under £10 per item in England) unless you are exempt.
Can my GP refuse to refer me? In principle no, if the assessment is clinically indicated. In practice some GPs are unfamiliar with Right to Choose or cautious about ADHD referrals generally. If you meet resistance, politely cite the NHS Constitution and offer to provide the referral address. If the GP still refuses, you have the option to raise it with the practice manager or change GP.
What if I am diagnosed and medication does not suit me? Providers typically try more than one medication during titration. If none work, or if you prefer non-medication routes, providers should discuss psychological therapy, ADHD coaching, or workplace adjustments.
Can I use Right to Choose for autism assessment too? Usually yes for adults, but fewer providers hold autism contracts and waiting times vary. Ask specific providers about their autism pathway.
What about children? The legal position is different for under-18s. Your local CAMHS or community paediatric service is the usual first route. Some Right to Choose providers accept young people but the funding mechanism varies. Speak to your GP.
Where can I find more detailed guidance? ADHD UK and the ADHD Foundation both publish practical guides and keep their information current. The NHS Constitution itself is on gov.uk.
What happens on the workforce side (why this guide exists)
Right to Choose only works because there are enough qualified assessors to see patients. Vantis Workforce Solutions supplies the clinicians who staff these services: ADHD assessors, ADOS-2 trained autism assessors, clinical psychologists, specialist nurses, and full diagnostic teams. We are the workforce side, not a provider you can refer to directly. But the shorter waits you can see today are partly a function of how quickly the workforce is growing behind the scenes.
If you work in ADHD or autism assessment as a clinician, or you are considering moving into this specialism, our Candidates page is a good starting point.
This guide is general information, not medical advice. For personal decisions about diagnosis or treatment, speak to your GP or a qualified clinician.