Right to Choose referrals for Attention Deficit Hyperactivity Disorder (ADHD) or Autism Spectrum Condition (ASC)

If your GP agrees that an ADHD or Autism assessment is appropriate for you or your child, with Right To Choose you can access a wider range of provider organisations paid for by the NHS.

As arrangements and care differ across providers, it is important to work with your GP to understand your options to make the best choice for you or your child.

For example, some providers only offer online assessments. Some also have exclusion criteria. Providers also have different treatment options post-diagnosis.

If you ask your GP for a referral to an ADHD or Autism Spectrum Condition (ASC) assessment provider through the NHS Right to Choose scheme, there are some important things you should understand.

• Your GP is responsible for deciding whether a referral is clinically appropriate. The final decision to refer is made by the GP.

• Some Right to Choose providers only offer assessment and diagnosis. If you are diagnosed and medication is recommended, the provider may not be able to prescribe the medication. They may ask your GP to do this, but your GP may not be able to agree.

• Some providers offer assessment, diagnosis, and support to start medication. Once the correct dose has been reached, they may ask your GP to take over prescribing and monitoring through a shared care agreement.

A shared care agreement is optional. GP practices can refuse shared care requests if they believe it is not clinically appropriate or if they do not have the capacity to provide the service.

• The Right to Choose provider may not work closely with local NHS services in the Birmingham, Solihull and Black Country area. If you need further treatment or support, you may need a new referral to another service. This will entail being placed on the waiting list for that service and waiting times differ across services.

• You should talk to your GP about any support you may need after diagnosis. It is also important to check with your chosen provider what treatment and support they offer, and whether it is suitable for your needs.

• Your GP can refer you directly to the provider you choose. They do not need to get funding approval from the Integrated Care Board (ICB) or submit a separate funding request.

Please note: You cannot refer yourself to a provider under the Right to Choose scheme. To use your legal Right to Choose, you must be referred by your GP to a provider that has an NHS contract.

Right to Choose/Patient Choice applies:

• When the Patient has an NHS elective referral for a first outpatient appointment;
• If a GP agrees that an ADHD or Autism assessment is clinically appropriate, the individual has the right to choose a provider that offers this service under NHS funding.
• The provider is NHS-approved – The chosen provider must have a contract with an NHS Integrated Care Board (ICB) or NHS England to deliver Autism/ADHD assessments under Right to Choose/Patient Choice.
• The individual is registered with a GP in England – RTC applies to NHS individuals in England but does not cover Scotland, Wales, or Northern Ireland.
• There are long NHS waiting times - this includes if Right to Choose/ Patient choice has not already been offered and the individual is on a waiting list.

Details of accredited providers

The table lists the details of accredited Right to Choose providers that hold a contract with the Birmingham, Solihull and Black Country Integrated Care Board. to deliver Right To Choose services and some details of the service provision.

There are other RTC providers available however these providers do not hold a contract with the Birmingham, Solihull and Black Country Integrated Care Board.

The list of ADHD and Autism provider organisations for Right To Choose changes regularly, so available options may differ depending on the timing of your referral. When considering a RtC provider, it is worth identifying two to three providers who you think may meet your needs and discuss these with your GP.

The waiting time information shown in the table is an approximation based on the latest information that the ICB receives from providers. Up to date waiting time information may be available by asking your GP  or by contacting or searching the provider’s own website.

If you are diagnosed with ADHD and the provider recommends medication and you wish to explore this as a treatment option, your RTC or NHS provider will arrange to start you on medication, this is called titration. This is the process of finding the right medication and dosage for you.

Once the dose is stabilised by the provider, GPs can prescribe as part of a Shared Care Agreement. This enables the care and treatment you receive for ADHD to be shared between the NHS service and your GP, or between the Right to Choose provider and your GP. This will only occur when your ADHD medication is stable. For more information, please see the General Medical Council (GMC) practice advice Shared care - professional standards – GMC [add link]:

• GPs are not expected to initiate or manage treatment without support from a specialist.
• They retain the clinical right to decline shared care if they feel it is unsafe or inappropriate.
• Shared care agreements are voluntary and require agreement from both the specialist service and the GP.

Right to Choose providers may have a contract that allows prescribing; where this is the case, monitoring and follow-up will be by the Right to Choose provider. It is best to check this before being referred. This is particularly important if your GP decides not to undertake shared care for ongoing prescribing.

If medication is not required, your provider will complete a detailed report outlining your diagnosis. The provider will discharge you back to the care of your GP with recommendations for post diagnostic support and details of any reasonable adjustments

Please note, if you decide you wish to try medication in the future you will need to be referred back to a provider to initiate this. This may incur further waits, wait times vary between teams.

Yes. If you are not happy with your provider and have not yet had an Autism or ADHD assessment, you can ask to change.

Contact your current provider and explain that you want to change your provider. The provider will remove you from their waiting list and discharge you back to your GP.

You will need to speak to your GP again to make a new referral to a different provider. You can ask your current provider to share your pre-assessment paperwork with your new provider, but please be aware that you may need to complete pre-assessment paperwork for a new provider. You may also need to wait for your assessment with the new provider.

Right to Choose only applies when you are first referred to a consultant led service. If you have already had an assessment under Right to Choose for a condition,  you cannot switch to a new provider for another assessment for the same condition.

You can ask your GP to refer you to a Right to Choose assessment provider, for example if the wait times are shorter.  However, once a patient has had an assessment with a Right to Choose assessment provider, they cannot also have an assessment with the Local NHS provider.

If an individual is also on an NHS Local Provider waiting list, they will not automatically be removed if a referral is then made by the GP to a Right to Choose assessment provider.

When the NHS Local Provider gets in touch with you regarding an appointment or during routine waiting list management, the individual should inform them the appointment is no longer required, or you can let them know sooner by calling directly.

No. RTC does not apply to choice of treatment. However, once a patient has been referred under right to choose to a private provider and accepted as a patient, the patient must be treated in accordance with the specification in the host or original commissioner contract.

If you are unhappy with your treatment or not sure about the result of the Autism and/or ADHD assessment, or if you think something is not right, here’s what you can do:

1. Ask the assessment provider questions: If you do not understand the assessment, or if you think there is a mistake, ask the professionals who did the assessment to explain it to you.
2. Talk about your worries: If you are unhappy with the diagnosis or the recommended follow up plan, talk to your assessment provider. Sometimes, just having a conversation can help you understand things more.
3. Making a complaint: If you still feel something is wrong, you or a parent carer can make a complaint. Complain first to the organisation who did the assessment. They must look into the complaint and reply to you.
4. If you are not happy with the response. Follow the NHS complaints procedure. For Black Country patients, please use the link below to the Black Country ICB webpage where you can find details of how you can complain to us

https://blackcountry.icb.nhs.uk/have-your-say/time-2-talk

For Birmingham and Solihull patients, please use the link below to the Birmingham and Solihull ICB webpage where you can find the Complaints Policy and details of how you can complain to us:

 https://www.birminghamsolihull.icb.nhs.uk/contact-us/compliments-concerns-and-complaints

If you are not happy with the response to your complaint, the next and final stage of the complaints process is the Parliamentary Health Service Ombudsman. This information will be sent to you as part of your response from the provider.

1. Get help with complaints: If you are not sure who to complain to, you can ask the  Birmingham, Black Country and Solihull ICB Patient Experience and Outcomes Team for assistance. You can email bsol.patientexperience@nhs.net or call 0121 203 3313. They will give you advice on what to do and how to do it.

1. What to say in your complaint: Say exactly what you think was wrong or missing in the assessment. Ask for answers to your questions and for them to explain how they followed the Birmingham, Black Country and Solihull ICB service specification for Autism and/or ADHD diagnosis, and ADHD treatment.

1. If you need a second opinion: If you want another doctor to look at your case, talk to your GP. Your GP may request a new NHS assessment if there is clinical evidence that your needs have changed a lot or if there may be a new or different condition. Your GP will need to tell the new provider why this is a new referral and include the clinical reasons for asking for it.

1. Your place in the waiting list: If you get a new referral, you will need to join the waiting list like everyone else who is referred to that provider. Your previous assessment won't affect your position in the queue. 

1. No new evidence: If nothing important has changed, your GP will tell you that you cannot have another assessment through the NHS, as you’ve already had one.

Remember, you can always ask questions and ask for help if you don’t understand something about your assessment or care.

Yes. If you begin treatment privately, you can request to transfer to NHS care at any stage, provided the treatment is commissioned by the NHS. However, you may need to wait and be reassessed by an NHS clinician, and you won’t receive preferential treatment due to having started privately. Please be advised that you cannot remain on two waiting lists.

No. If you choose to pay privately for assessments or treatments that are not commissioned by the NHS, you are responsible for all associated costs—including monitoring, investigations, and management of complications. The NHS will only cover costs of services where the GP has made a referral.

Not within the same episode of care. NHS and private care must be clearly separated. For example, you cannot have a private ADHD assessment and then expect NHS prescriptions or monitoring unless you meet NHS criteria and are reassessed by an NHS clinician.

Only if: The medication is listed on the ICB formulary (a list of medicines, dressings, or other healthcare products that are approved for use within a specific Integrated Care System (ICS). It serves as a guide for prescribers, helping them choose cost-effective and clinically appropriate items for their patients) or normally funded by the NHS. This can only take place if there is an appropriate shared care agreement in place accepted by the GP.

Currently there are no shared care agreements in place between private providers and Birmingham, Black Country and Solihull ICBs, this is under development.

Your GP may seek advice from the ICB about an NHS-funded alternative. You can still choose to purchase the recommended drug privately, but the NHS will not cover any part of the cost.

You can do so if the treatment is commissioned by the NHS. However, the NHS will not reimburse any private costs already incurred. Any change of provider means the patient will usually join the NHS waiting list from the point of referral, which may lengthen the overall waiting time.