If your local ICB has paused or capped funding for ADHD assessments, it's natural to wonder whether registering elsewhere, or choosing a provider based in another area, could get you around it. Here's why that usually doesn't work, and what your real options are.
The short answer
No. If your ICB has capped or paused funding for ADHD assessments, picking a Right to Choose provider that happens to be based in, or hold a contract with, a different ICB will not get you a funded assessment. Right to Choose gives you the right to pick which provider carries out your assessment. It does not change who pays for it, and the payer is what NHS England calls your "responsible commissioner" - the ICB linked to your GP registration, not the one where your chosen provider is headquartered.
This surprises a lot of patients, because the whole point of Right to Choose is that you're not limited to your local NHS service. That part is still true. What's changed is that a number of ICBs have introduced formal activity limits - known as Indicative Activity Plans (IAPs) - that cap how much they'll fund in Right to Choose referrals for ADHD and autism assessments, regardless of which provider you choose. This is a live and fast-moving area of NHS policy; treat the specifics below as a snapshot rather than a fixed picture, and always check your own ICB's current position before acting.
Why choosing an out-of-area provider doesn't help
Right to Choose works like this: your GP refers you to any provider holding a qualifying NHS Standard Contract, and the cost is met by your responsible commissioner - the ICB covering the area where your GP practice sits. This is confirmed in NHS England's national "Who Pays?" guidance, which sets out that payment responsibility follows GP registration and moves with you if you register with a new practice in a different ICB area. It genuinely doesn't matter where the provider itself is based or which ICB originally contracted with them.
That's exactly why an out-of-area provider doesn't solve a funding restriction. Where an ICB has introduced an Indicative Activity Plan (a formal mechanism under the NHS Standard Contract) for ADHD or autism assessments, it's setting a threshold on referrals it will fund from GPs registered in its own area - sometimes for a given provider, sometimes across the board. A provider based two hundred miles away, in an ICB with no restrictions at all, still gets paid by your ICB - and if your ICB has reached its threshold, that referral can be declined, or your GP may be advised not to send it in the first place.
Right to Choose remains a legal entitlement throughout this, and the NHS Standard Contract itself says that ICBs and providers "must not agree or implement any action" that would restrict a patient's legal right to choice. In practice, though, activity limits create friction: GPs being told by their ICB not to process new Right to Choose referrals for ADHD until a set date, or providers publicly stating that referrals from certain ICBs are currently paused. Neither of these depends on the provider's own location, and neither formally removes your right - it just makes it harder to exercise in the short term.
Restricted in your area? You still have options.
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What about registering with a GP in a different area?
This is the one route that changes which ICB funds your care, because it changes your registered GP practice and therefore your ICB. It's an option, but it's a bigger step than it sounds, and worth being clear-eyed about before you pursue it:
- You'd need to formally register as a patient with a GP practice in the other ICB's area - not just ask them to see you once
- Most practices expect you to live, work, or study within their practice boundary. Since 2015, practices can choose to register patients from outside their boundary on an "online consultation" basis, without offering home visits - some digital-first practices do this - but it's at the practice's discretion, and they can decline if it wouldn't be clinically appropriate or practical
- Deregistering from your current GP means losing continuity of care for everything else they manage, not just ADHD
- There's no guarantee the new ICB has better availability - restrictions vary and change over time, so check the new area's current position before switching
If you're considering this purely to access an ADHD assessment, it's worth weighing it against the other options below first, since it affects your GP relationship for all your healthcare, not just this one referral.
What you can do instead
If your ICB has restricted funding, you still have options:
- Check whether the restriction is total or partial, and whether it applies to you.Some ICBs pause new referrals entirely; others cap numbers or restrict a specific age group (adult pauses, for example, have sometimes exempted younger children). Restrictions also tend to hit new referrals rather than patients already referred, being assessed, or in titration - if you've already started, ask your provider directly whether the restriction affects your case.
- Ask about the local NHS pathway.Restrictions on Right to Choose funding don't usually affect your local NHS ADHD service, so you can still join that waiting list even if Right to Choose is paused.
- Consider a private assessment.This sits outside NHS funding entirely, so ICB restrictions don't apply. Be aware that ongoing NHS prescribing afterwards depends on a shared care agreement, which is voluntary and which your GP isn't obliged to accept - ask about this before you commit to a provider, not after.
- Keep an eye on the timeline.Many restrictions are described as temporary, often tied to a financial year or a stated review date, though some have no fixed end date. There's no single official tracker of which ICBs currently restrict Right to Choose, so check directly with your ICB or your chosen provider rather than relying on any list, including ours, as definitive.
- Escalate if you think the restriction is unlawful.Right to Choose is a legal entitlement, and ICBs cannot lawfully abolish it outright by policy. Start with your GP practice or your ICB's PALS service. For a formal patient choice complaint, NHS England's national team can be contacted at england.choice@nhs.net. If you're not satisfied with the response, the Parliamentary and Health Service Ombudsman is the next stage, and contacting your local MP can also help.
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