What Right to Choose is
If you live in England and your GP refers you for an adult ADHD assessment, you have a legal right to choose where you're referred. You can pick any provider that holds an NHS contract for the service, as long as the service is led by a consultant or a mental health professional. The rules are set out in the NHS Choice Framework.
The NHS pays the provider, so this isn't going private. Many Right to Choose providers are independent companies that do NHS work alongside their private services.
Good to know: the choice is made when your GP refers you. It doesn't cover urgent or crisis care, people held in hospital under the Mental Health Act, people in prison or serving members of the armed forces. And it only applies in England.
The NHS website is honest about why people use it: waits for ADHD services can be "several months or years", and you may be able to find a clinic with a shorter wait through your GP using Right to Choose.
Is it actually faster?
Often, but not always, and less reliably than it was a few years ago.
Demand is huge. NHS England estimates there were up to 959,662 open referrals that may be for an ADHD assessment in June 2026, and up to 37,105 new referrals that month alone, 46.7% more than a year earlier. These are estimates: they may include some referrals for other conditions and miss some independent providers.
The independent review published in October 2026 found that independent providers delivered more than half of NHS-funded ADHD assessments in 2025/26, mostly through Right to Choose. At the providers that shared figures, NHS-funded patients waited an average of 151 days for an ADHD assessment, while people paying privately at the same providers waited 21.5 days. Only around 10 of roughly 120 providers sent data, so treat these numbers as a rough guide.
Providers also publish their own estimates. One large provider said in September 2026 that adult assessments were taking 14 to 24 weeks from referral, more than a year in areas where the local NHS had capped its numbers, and that the wait to start medication afterwards could be up to 60 to 65 weeks.
| Local NHS service | Right to Choose | Paying privately | |
|---|---|---|---|
| Who pays | The NHS | The NHS | You |
| Where | Your local area | England only | Anywhere |
| Wait | Depends on your area, and can be years | Often shorter, but caps can add months | Usually the shortest |
| Medication afterwards | Started by the specialist service, then your GP if they agree to shared care | Started by the provider, then your GP if they agree to shared care | Private prescriptions, unless your GP agrees to shared care |
How to ask, step by step
- Check it applies to youYou need to live in England and be registered with an NHS GP. If you live in Scotland, Wales or Northern Ireland, see the section below.
- Choose a providerLook for providers with an NHS contract for adult ADHD assessments. Ask each one whether it takes Right to Choose referrals from your area, what its current wait is, and whether your local NHS has capped its numbers. The charity ADHD UK has a guide to checking your area.
- Do the provider's paperwork firstSome providers ask you to fill in a form before your GP refers you, or send a form for your GP to complete. Doing your part early saves a round trip.
- Book a GP appointmentSay at the start that you want to talk about an ADHD referral using Right to Choose, and take the provider's name and details with you. The script below helps.
- Check the referral arrivedAsk how and when the referral will be sent. A week or two later, check with the provider that they have it.
- If you're not offered a choiceAsk for the reason in writing. If that doesn't resolve it, complain to your integrated care board (ICB), the local NHS body that must make sure choice is offered. After that, you can go to NHS England and then the Parliamentary and Health Service Ombudsman.
What to say to your GP
GPs are busy, and not all of them know the details. NHS England's 2026/27 guidance says GPs should explain which providers are available and what each one offers, so you can make an informed choice. You don't need to argue. Just be clear about what you're asking for.
A script you can use
"I'd like to be referred for an adult ADHD assessment. I'd like to use my right to choose under the NHS Choice Framework, and I've chosen [provider name], which holds an NHS contract for adult ADHD assessments. Could you make the referral, please?"
Your GP will want to understand why you're asking. Bring a few short, specific examples of how things affect you now and how they affected you as a child. Our guide on preparing for an adult ADHD assessment shows how to write them.
Caps, and what can slow things down
Integrated care boards pay for Right to Choose assessments in their area, and many set yearly budgets, sometimes called Indicative Activity Plans. These limit how many assessments each provider is paid to do. A cap doesn't take away your right to choose, but it can make the wait much longer. Another provider may have more space, so it's worth asking before you pick.
Caps are common. ADHD UK, a campaigning charity, asked every NHS area in England through freedom of information requests. In its 2026 tracker, 14 of the 36 areas listed said they were capping Right to Choose assessments.
In 2025, NHS England dropped a wider proposal that would have required commissioners to set payment limits for elective services, after a public consultation. Local caps have carried on.
After diagnosis: medication and shared care
A diagnosis doesn't always lead straight to treatment. Under NICE guidance, ADHD medication can only be started by a specialist, after health checks. Once your dose is stable, your GP may take over prescribing through a "shared care" agreement.
That handover isn't guaranteed. The British Medical Association says all shared care arrangements are voluntary. GPs taking part in the BMA's collective action have been turning down new shared care agreements they consider "unsafe" or "underfunded" since 1 July 2026. The October 2026 review found that GP acceptance of shared care for medication started by independent providers had fallen to around 62% on average.
There is a safety net. NHS England's 2026/27 payment guidance lets a provider be paid to keep prescribing if your GP refuses shared care, or doesn't reply within 21 days, as long as the provider is willing to keep you on.
Ask before you choose: "If I'm diagnosed, how long is the wait to start treatment, and what happens if my GP says no to shared care?"
What the October 2026 review means for you
On 9 October 2026, the government published Professor Peter Fonagy's independent review of mental health conditions, ADHD and autism. It recommends making all ADHD and autism diagnostic assessments an activity regulated by the Care Quality Commission (CQC), banning direct-to-public advertising of NHS-funded assessments, and holding Right to Choose providers to the same standards as services the NHS commissions directly.
The government's response, published the same day, says it will work towards CQC regulation of all diagnostic assessments and write to the Advertising Standards Authority about ADHD and autism adverts. NHS England will also consult on a national set of prices, with new payment arrangements planned from April 2027.
Neither the review nor the government's response proposes ending Right to Choose. As of 13 October 2026, it works as described on this page. We'll update this guide as things change.
If you live in Scotland, Wales or Northern Ireland
Right to Choose is part of the NHS in England, so it doesn't apply in the rest of the UK. You'll usually go through your GP to local services, and waits can be very long.
- Scotland: NHS Greater Glasgow and Clyde had 8,681 adults waiting for an ADHD assessment in May 2026, with a median wait of 106 weeks. NHS Lothian, which counts ADHD and autism together, had 12,769 adults waiting in July 2026, with a median wait of 177 weeks.
- Wales: the Senedd's research service says there's no consistent offer for adults across Wales, and no waiting time policy for adults. The Welsh Government set up an adult ADHD task and finish group in 2026.
- Northern Ireland: the Department of Health said in June 2026 that there is currently no commissioned ADHD service, and that it doesn't hold waiting list figures.
Making the wait count
Whichever route you take, there's usually a wait. It helps to keep a running note of examples as they happen, look out any old school reports, and ask someone who knew you as a child whether they'd be willing to talk to the assessor.
Questions people ask
Can my GP refuse a Right to Choose referral?
Your GP still decides whether a referral is clinically appropriate. Once you're being referred, you have a legal right to choose any provider with an NHS contract for the service. If you aren't offered a choice, ask why, then complain to your integrated care board, which must make sure choice is offered.
Is Right to Choose being scrapped?
No. As of 13 October 2026 it still applies in England. The October 2026 independent review recommends tighter standards and CQC regulation for providers, not ending the right, and the government's response doesn't propose ending it. NHS England is due to consult on national prices, with new payment arrangements planned from April 2027.
Does a cap in my area mean I can't use Right to Choose?
No. A cap limits how many assessments a provider is paid to do in your area, so waits get longer. You can still choose, and another provider may have more space. Ask providers about your area before you pick one.
Will my GP prescribe medication after a Right to Choose diagnosis?
Not necessarily. Shared care is voluntary, and the October 2026 review found GP acceptance averaged around 62%. If your GP refuses or doesn't reply within 21 days, NHS England's guidance lets the provider be paid to keep prescribing, if it's willing to.
Does Right to Choose cost anything?
No. The NHS pays the provider for the assessment. If a provider asks you to pay for the assessment itself, that's a private service, not Right to Choose. Normal NHS prescription charges still apply to any medication.
Can I use Right to Choose in Scotland, Wales or Northern Ireland?
No. It's part of the NHS in England only. Elsewhere, your GP refers you to local services, where waits are often long and published figures are patchy.
Sources
- Department of Health and Social Care. The NHS Choice Framework: what choices are available to you in your NHS care. 23 October 2024.
- NHS. ADHD in adults. Reviewed 19 March 2025.
- NHS England. 2026/27 NHS Payment Scheme: ADHD and autism payment guidance. March 2026.
- NHS England Digital. ADHD Management Information, August 2026. 27 August 2026.
- Department of Health and Social Care. Independent review into mental health conditions, ADHD and autism: final report. 9 October 2026.
- Department of Health and Social Care. Government pledges earlier support to tackle mental health crises. 9 October 2026.
- Psychiatry UK. Initial assessment and titration waiting times. Updated 9 September 2026.
- ADHD UK. Right to Choose changes 2026: ADHD caps and restrictions by area. 2026.
- NHS England. 2025/26 NHS Payment Scheme: changes following consultation. 4 April 2025.
- British Medical Association. General practice responsibility in responding to private healthcare. 31 August 2023.
- British Medical Association. GPs in England urge practices and patients to back campaign to save the profession and improve patient care. 31 July 2026.
- NICE. Attention deficit hyperactivity disorder: diagnosis and management (NG87), recommendations. 2018, updated 2019.
- Senedd Research. Neurodevelopmental services in Wales. July 2026.
- NHS Greater Glasgow and Clyde. Freedom of information response on adult ADHD waiting lists (published by ADHD UK). 22 June 2026.
- NHS Lothian. Freedom of information response 11646: ADHD and autism waiting times. July 2026.
- Department of Health (Northern Ireland). ADHD assessments in Northern Ireland: freedom of information response. 30 June 2026.
This article is general information, not medical advice, and it doesn't diagnose ADHD. Talk to your GP about your own situation. In crisis? Call Samaritans on 116 123.
