Can You Use Right to Choose for ADHD in London?

ADHD Waiting Times in London

London has some of the longest ADHD waiting times in England. Across the capital's Integrated Care Boards (ICBs), waits for an adult ADHD assessment commonly exceed 2 to 4 years. In some boroughs, patients have reported waits of over 5 years.

This is not a temporary backlog. The demand for ADHD assessments has increased significantly since the COVID-19 pandemic, and NHS capacity has not kept pace. According to ADHD UK's 2024 Right to Choose report, London ICBs process thousands of referrals per year, but assessment capacity remains severely limited.

For anyone living in London who suspects they have ADHD, these waiting times are not just inconvenient - they can have serious consequences for work, relationships, mental health, and daily functioning.

Important: The Right to Choose Landscape Has Changed

Please read before continuing. While Right to Choose remains your legal right under the NHS Constitution, the practical landscape has become significantly more complex since late 2025. Integrated Care Boards (ICBs) across London are now using Indicative Activity Plans to restrict or manage the volume of Right to Choose referrals they fund. This means that even where the legal right exists, patients may face new barriers, delays, or limitations that did not exist a year ago.

This does not mean you should not pursue Right to Choose — it remains one of the most effective ways to access an ADHD assessment. But it is important to go in with accurate expectations so you are not caught off guard.

South East London: New Triage Service

From November 2025, the South East London (SEL) ICB introduced a new Adult ADHD Referrals Triage Service affecting patients in Bromley, Bexley, Greenwich, Lewisham, Lambeth and Southwark. This means Right to Choose referrals in these boroughs are now subject to an additional triage step before being processed. Right to Choose is not a straightforward bypass of the local pathway in these areas — if your GP is registered in one of these boroughs, it is worth being aware of this change and discussing it at your appointment.

Provider Capacity and ICB Caps

Some Right to Choose providers have paused or capped new bookings due to ICB-imposed activity limits. Before booking your GP appointment, it is worth checking whether your preferred provider is currently accepting new Right to Choose referrals. You can search and compare ADHD providers on Find Care Compare to check availability.

What Is Right to Choose?

Right to Choose is a legal right under the NHS Constitution (Section 3a) that allows patients in England to choose their healthcare provider for a first outpatient appointment. This includes ADHD assessments.

In practice, this means you can ask your GP to refer you to an approved private provider - and the NHS pays for the assessment. You do not pay anything.

This right applies to all patients registered with a GP in England. It is not dependent on your borough, your ICB, or your postcode. If your GP is in England, you have the right.

For more detail on the legal framework, read our guide: What is the Right to Choose?

How London's ICB Structure Works

London is divided into five Integrated Care Boards (ICBs):

• North Central London (Camden, Islington, Barnet, Enfield, Haringey)
• North East London (Tower Hamlets, Hackney, Newham, Barking & Dagenham, Redbridge, Havering, Waltham Forest)
• North West London (Westminster, Kensington & Chelsea, Hammersmith & Fulham, Brent, Ealing, Harrow, Hillingdon, Hounslow)
• South East London (Southwark, Lambeth, Lewisham, Greenwich, Bexley, Bromley)
• South West London (Wandsworth, Merton, Sutton, Kingston, Richmond, Croydon)

Each ICB commissions its own adult ADHD services. This means waiting times, referral processes, and local policies can vary between boroughs. However, your Right to Choose applies regardless of which ICB you fall under.

Common GP Misconceptions in London

Some GPs in London are unfamiliar with Right to Choose or believe it does not apply in their area. Common misconceptions include:

• "We don't do Right to Choose here" - This is incorrect. Right to Choose is a national policy.
• "You need to go through our local pathway first" - You do not. Right to Choose allows you to bypass local waiting lists — though in some boroughs (such as South East London), additional triage steps may now apply.
• "The CCG/ICB doesn't fund this" - While the legal right exists, some ICBs are actively managing demand through Indicative Activity Plans. Patients may face resistance, but the legal obligation remains.
• "I haven't heard of this provider" - The GP does not need to know the provider personally. They should follow the provider's specific referral instructions, which may involve e-RS or the provider's own referral portal.

If your GP is unsure, you can provide them with the NHS England Right to Choose guidance or use our Right to Choose Eligibility Checker, which includes a script you can take to your appointment.

What to Say If Your GP Says No

If your GP declines to make a Right to Choose referral, you have several options:

In most cases, simply being informed and calm is enough. Many GPs are supportive once they understand the policy.

Step-by-Step: Using Right to Choose in London

A Note on Waiting Times

It is worth being aware that Right to Choose does not automatically guarantee a shorter wait. While it can significantly reduce waiting times compared to local NHS pathways, several factors now affect timelines:

• Some ICBs, including South West London, have explicitly stated that Right to Choose does not mean a shorter wait
• Provider capacity varies — some have long waiting lists of their own
• ICB activity caps may delay referral processing

Always check current estimated waiting times with your chosen provider before requesting a referral from your GP.

London Borough Confusion: Clarified

A common source of confusion is whether Right to Choose depends on your borough or your GP's location. The answer is simple: it depends on where your GP is registered, not where you live.

If you live in one borough but your GP is in another (which is common in London), the ICB associated with your GP determines the funding. But regardless of which ICB funds it, your Right to Choose applies.

Check Your Eligibility Now

Use our free Right to Choose Eligibility Checker to find out in under 60 seconds whether you qualify. The checker includes a GP referral script you can take to your next appointment.

You can also compare ADHD providers and waiting times across London on Find Care Compare.

For a practical guide on what to say at your appointment, read: How to Ask Your GP for an ADHD Referral (Script Included).