ADHD Right to Choose lets patients in England request an NHS ADHD assessment with a provider of their choosing — often with much shorter waiting times than the local NHS service.
This guide explains how the pathway works in 2026, including the ICB activity caps that are now restricting access in several areas, what to say to your GP, and how to plan ahead for shared care.
What is Right to Choose for ADHD?
ADHD Right to Choose is the legal entitlement that allows patients registered with a GP in England to choose which NHS-contracted provider carries out their first outpatient ADHD assessment.
It sits under the NHS Constitution and the Health and Social Care Act. In practice it means you can ask your GP to refer you to any qualifying provider in England — not just your local NHS service — for an ADHD assessment funded by the NHS.
Right to Choose is a legal entitlement, but your GP must still agree that a specialist referral is clinically appropriate. They act as the clinical gatekeeper; the choice of provider is yours.
Who is eligible?
You may be eligible if:
- You are registered with a GP in England
- You are being referred for your first outpatient appointment
- Your chosen provider holds a qualifying NHS contract for ADHD assessment
Right to Choose does not typically apply to:
- Emergency care
- Services where you are already under active treatment
- Some highly specialised commissioned services
Eligibility can also vary by ICB. Recent local restrictions (covered in section 4) may affect whether your referral is accepted, even where the underlying legal right applies.
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How much faster is Right to Choose for ADHD?
Waiting times vary enormously by provider and ICB area. The table below sets out broad ranges reported across England in early 2026.
| Pathway | Typical assessment wait |
|---|---|
| Local NHS referral | 2–7 years |
| Right to Choose — shorter-wait providers | No wait once referral is processed - 8 weeks |
| Right to Choose — mid-range | 3-5 months (12-20 weeks) |
| Right to Choose — longer | 6-18 months (26-78 weeks) |
| Right to Choose — longest / most restricted | Up to 24 months |
| ICB-restricted areas | Paused / not accepting |
| Private clinic | 2–8 weeks |
Right to Choose waiting times have grown since early 2025 due to a major surge in referrals. While RTC remains a faster route than local NHS in most cases, it is no longer the guaranteed fast-track it once was. Check provider-level waiting times before requesting a referral.
ICB activity caps in 2026 — check before you start
Since mid-2025, several Integrated Care Boards have issued revised activity plans that pause or cap new ADHD assessments under Right to Choose. The 2026/27 NHS Payment Scheme introduced practical caps on Right to Choose ADHD spend per ICB area, around £100k in many regions. Before requesting a referral, check whether your local ICB is currently accepting RTC referrals for ADHD.
- At least nine NHS areas were affected as of early 2026, with some pauses running until at least April 2026.
- ICBs cite budget pressures and a surge in referrals as the reasons for capping or pausing activity.
- In affected areas, GPs may decline to process new Right to Choose referrals, even when the patient is otherwise eligible.
- The legal status of these caps is actively disputed — they may sit uncomfortably alongside the underlying legal right to choose.
- ADHD UK has publicly challenged Coventry and Warwickshire ICB's suspension of adult ADHD referrals for over-25s as one example of this dispute.
If your ICB has paused RTC referrals
- Request written confirmation of the pause from your GP practice or ICB.
- Ask whether the pause applies to all age groups or only certain cohorts.
- Submit a formal complaint via your ICB's complaints process.
- Contact ADHD UK for advocacy and current information on legal challenges.
- Consider a private assessment as a fallback — but ask your GP about shared care in advance, as it is not guaranteed.
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Step-by-step: requesting an ADHD Right to Choose referral
- Check your ICB's current Right to Choose positionConfirm that your local ICB is currently accepting RTC ADHD referrals before you do anything else.
- Identify an eligible provider with current capacityChoose a provider that holds a qualifying NHS contract and is open to new RTC referrals.
- Confirm waiting time and RTC acceptanceContact the provider directly to confirm their current waiting time and that they accept Right to Choose referrals for ADHD.
- Book a GP appointmentA standard appointment is usually enough. Mention you'd like to discuss an ADHD referral when booking.
- Request a Right to Choose referralAsk for a referral for ADHD assessment under NHS Right to Choose, naming your chosen provider.
- Provide provider details and any required formsSome GPs will ask for the provider's contact details or referral form. Bring them with you.
- Follow up to confirm the referralCheck that the referral has been sent and acknowledged by the provider. Keep written records.
What to say to your GP (ADHD-specific script)
A simple, calm script tends to work best. You can use or adapt the following:
"I'd like to request a referral for an ADHD assessment under NHS Right to Choose. I understand that as a patient registered with a GP in England, I have a legal right to choose my provider for a first outpatient appointment. I've been experiencing symptoms that are affecting my daily life, and I would appreciate being referred to [provider name] for a formal assessment."
Key tip
GPs are particularly focused on functional impairment — how symptoms affect your ability to work, study, manage daily responsibilities, or maintain relationships. Lead with specific real-life examples of impact rather than only listing symptoms.
If your GP is unfamiliar or refuses
If your GP is unsure about Right to Choose
Some GPs are not fully familiar with the framework. You can calmly say:
"I understand that Right to Choose applies to first outpatient appointments in England. Could we look at whether this referral can be made under that pathway? It's set out in the NHS Choice Framework."
If the GP still isn't sure, you can ask them to check the NHS Choice Framework or speak with the practice manager.
If your GP refuses to refer
- Ask for the specific reason for the refusal.
- Request written confirmation of the decision.
- Discuss with the practice manager.
- Submit a formal complaint via the practice's complaints process.
- Contact your local Integrated Care Board (ICB).
- Contact the Patient Advice and Liaison Service (PALS).
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Choosing a provider
When comparing providers, check:
- That the provider is currently accepting Right to Choose referrals for ADHD.
- CQC registration and current rating where available.
- Their current waiting time — this can change quickly.
- Assessment format — remote video or in-person.
- What happens after diagnosis (titration, follow-up, shared care).
Shared care: what to check before committing
Receiving a diagnosis is not the end of the journey. To transfer medication prescribing from your specialist to your NHS GP, you need a shared care agreement. In 2025–2026, shared care refusals have become widespread — including for patients diagnosed via Right to Choose providers. Ask about your GP practice's shared care policy before committing to a provider, not only after diagnosis.
For a deeper look at how shared care works and what to do if your GP refuses, read our guide to shared care agreements for ADHD.
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- Check your GP practice's shared care track record
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- Choose a provider with this in mind, not after
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Right to Choose vs private ADHD assessment
| Pathway | Cost | Typical wait | Shared care likelihood | Best for |
|---|---|---|---|---|
| Right to Choose | Free | 0–24 months | Moderate but declining | Most patients eligible in England |
| Private | £800–£1,500+ | 2–8 weeks | Low and variable | If RTC is paused in your area or you want fastest access |
For a fuller comparison including medication, ongoing prescribing, and follow-up, read NHS ADHD diagnosis vs private.