What Is the Right to Choose?

Right to Choose: Definition

The Right to Choose is a legal right under the NHS Constitution for England that allows patients to choose which NHS-funded provider they are referred to for their first outpatient appointment. This includes ADHD assessments.

In practical terms, it means that instead of waiting on your local NHS ADHD pathway - which can take years - you can ask your GP to refer you to an approved private provider. The NHS pays for the assessment. You pay nothing.

This right is established in Section 3a of the NHS Constitution and is supported by the NHS Choice Framework. It is not a pilot programme, a special arrangement, or a loophole. It is the law.

The Legal Basis

The NHS Constitution for England sets out the rights and responsibilities of patients, the public, and staff. Section 3a states:

"You have the right to choose the organisation that provides your NHS care when you are referred for your first outpatient appointment."

This right was further clarified by NHS England in their 2023 guidance on patient choice, which confirmed that it applies to mental health services, including ADHD assessments.

The legal framework is reinforced by the Health and Social Care Act 2012 and the NHS Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) Regulations 2012.

Who Qualifies for Right to Choose?

To use Right to Choose for an ADHD assessment, you must meet the following criteria:

Right to Choose applies regardless of your age, nationality, immigration status, or which Integrated Care Board (ICB) your GP falls under. If you are registered with an English GP, you have the right.

How Right to Choose Reduces Waiting Times

The reason Right to Choose is so important for ADHD is the scale of NHS waiting times. According to ADHD UK, the average waiting time for an adult ADHD assessment in England exceeds 2 years, with some areas reporting waits of 5 years or more.

Right to Choose providers typically have much shorter waiting times - often 4 to 16 weeks. This is because they have dedicated capacity for assessments and are funded per referral.

The difference is significant. Without Right to Choose, a patient might wait 3 years for diagnosis. With it, they could be assessed within a month.

Step-by-Step: How to Use Right to Choose

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

Common Myths About Right to Choose

Myth: "Right to Choose is only for physical health"

Fact: It applies to all first outpatient appointments, including mental health services.

Myth: "My GP can refuse if they don't know the provider"

Fact: The GP does not need to know the provider. They need to verify the provider is listed on the NHS e-Referral Service.

Myth: "It depends on my postcode"

Fact: It depends on where your GP is registered, not where you live. All GPs in England must honour it.

Myth: "It's a loophole that might close"

Fact: It is a legal right established in the NHS Constitution. It cannot be removed without legislative change.

Myth: "There's a cap on how many patients can use it"

Fact: There is no cap. Every eligible patient has the same right.

Limitations of Right to Choose

While Right to Choose is powerful, there are some limitations to be aware of:

• It only covers the initial assessment - follow-up appointments, medication titration, and ongoing care may not be covered under the same arrangement
• Not all providers accept Right to Choose - check that your preferred provider is listed on the NHS e-Referral Service
• Shared care may not be guaranteed - after diagnosis, your GP may or may not agree to prescribe medication under a shared care agreement
• It does not apply outside England - patients in Scotland, Wales, and Northern Ireland have different systems

Check Your Eligibility

Use our free Right to Choose Eligibility Checker to find out instantly whether you qualify. The checker takes less than 60 seconds and includes a GP referral script.

You can also search and compare ADHD providers across England on Find Care Compare, or learn about the process in London specifically: Can You Use Right to Choose for ADHD in London?