Ask how long the wait is for an autism or ADHD assessment, and the answer depends on who you ask. Your GP might say a year. The letter after referral might say longer. Somewhere in an NHS spreadsheet, the real number can be worse again, and it isn’t your imagination that it keeps getting worse.
Numbers like these are exactly why Right to Choose exists. It’s a legal right, it costs you nothing, and most parents and carers have never heard of it. Right to Choose isn’t about complaining, going private, or jumping a queue. It’s a right written into NHS regulations that lets you ask your GP to send your child’s referral to a different NHS-funded provider instead of the pathway above. The provider still has to accept the referral, and picking the right one takes some homework, but the mechanism is exactly what it sounds like: a choice.
What Right to Choose actually is
The right sits in NHS law, not just NHS goodwill. Section 6E of the National Health Service Act 2006 requires NHS England and integrated care boards to make “standing rules” that let patients make choices about their care, including rights described in the NHS Constitution. Parliament strengthened the choice wording specifically from January 2024.
The working detail sits in secondary legislation. Regulation 39 of the NHS Standing Rules Regulations 2012 gives you a specific choice for an elective referral to mental health services where your first appointment isn’t with a consultant, which is exactly how most ADHD and autism assessment pathways are run. You get to choose any clinically appropriate provider that holds a qualifying NHS contract, and the team that assesses your child.
The NHS Constitution and the NHS Choice Framework translate that legal text into plain language for patients. Every NHS body, and every private or third-sector provider delivering NHS services, is required by law to take account of the Constitution in what it does.
Right to Choose is an England-only right. Scotland, Wales, and Northern Ireland run separate health systems with their own referral routes, so none of this applies if your child’s GP is registered outside England.
Who it covers, and how the referral actually works
Not every family qualifies automatically, and the mechanics matter more than the headline right. To use Right to Choose, your child needs to be registered with a GP in England, and the referral needs to be for an eligible first assessment such as ADHD or autism.
You can’t refer your child yourself. Your GP has to make the referral, which means the conversation with them is the whole ballgame. The provider you choose also has to hold what the regulations call a qualifying contract with an NHS commissioner, and it has to accept referrals for your child’s age group and your part of the country. Providers set their own criteria, and those criteria change often, so check before you ask your GP to act.
None of this is a loophole or a workaround. It’s the same mechanism that lets any NHS patient in England choose a hospital for a hip operation, applied here to a mental health and neurodevelopmental referral instead.
The GP conversation, step by step
Right to Choose lives or dies at one appointment: the one where you ask your GP to make the referral. Most GPs will do this without a fight once they understand what you’re asking for. A small number push back, usually out of unfamiliarity rather than any real objection.
The sequence rarely changes, even when the pace does:
- Research a provider firstCheck the provider’s current age range, area, and waiting time before your appointment, since criteria change often
- Name the provider to your GPAsk directly for a Right to Choose referral to that named provider, not just a shorter wait
- If your GP says they can’tAsk for the refusal in writing and the specific reason. NHS guidance says local teams shouldn’t obstruct your legal right to choice
- Your GP sends the referralUsually through the NHS e-Referral Service or the provider’s own referral route
- The provider triages itThey can accept it, or decline it and tell your GP why
None of this makes you difficult. Right to Choose is used often enough that most practices have a standard process for it, even if the GP in front of you hasn’t hit it before. Keep a written trail from the very first message, since you may need it later.
Choosing a provider, and the caveats nobody puts on the leaflet
Right to Choose only works if you actually pick a provider, and this is where families get stuck. Every provider that accepts Right to Choose referrals has to hold a genuine NHS contract for the service, which rules out anyone offering a purely private assessment with no NHS funding attached. Beyond that legal minimum, providers vary enormously: by age range, by the area they cover, by what evidence they want before they’ll accept a referral, and by how long their own waiting list runs.
That last point matters more than it should. Wait times at Right to Choose providers move fast, sometimes month to month, and can run from a few weeks at the quickest end to well over a year at the busiest. There’s no single number worth trusting without checking the provider’s own current position first.
None of this is because there’s something wrong with asking. Freedom of Information responses compiled in January 2026 show NHS integrated care boards have spent more than £512 million on private ADHD and autism assessments between 2023/24 and January 2026, with boards reporting both years showing a collective 131% rise, because the standard pathway can’t keep pace with demand. That’s also part of why the picture below gets complicated.
Since 2025-26, several NHS areas have “paused” new Right to Choose referrals for ADHD or capped them with an annual activity plan, and some GPs read that as the right being switched off locally. It isn’t. Ministers have confirmed in parliamentary answers since November 2025 that the legal right itself hasn’t changed: in December 2025 the Government stated flatly that “there has been no change to the existing legal right patients have to choose the provider and team who will provide their elective care.” NHS England’s own Patient Choice Guidance is just as direct about what a pause does and doesn’t mean:
The commissioner’s prior approval for the referral is not required where a patient has exercised their legal right to choice.
If your GP or ICB tells you the right has been paused, ask them to confirm that in writing too. A capped activity plan is a budgeting tool, not a legal block, and at least one NHS area has said so publicly rather than let the confusion stand: “an activity plan does not restrict patient choice.”
What Right to Choose doesn’t change
A faster assessment changes what your child gets a name for. It doesn’t change what your child is entitled to before that name arrives, and it’s worth being clear about that so you don’t wait for a diagnosis before asking for help.
School support, an Education, Health and Care Plan (EHCP) needs assessment, and Disability Living Allowance (DLA) are all needs-based in law, not diagnosis-based. A school has to respond to what it’s observing in your child now, whichever pathway you’ve chosen and however long it takes. Our guide to getting help without a diagnosis covers exactly what you can ask for while any assessment, Right to Choose or otherwise, is still running.
If you’re earlier in the process and still weighing up whether to pursue assessment at all, our wider guide to the diagnosis pathway covers the NHS route, private assessment, and how both compare to Right to Choose.
The medication catch: shared care after an ADHD diagnosis
Autism assessment ends with a diagnosis and, usually, a conversation about support. ADHD assessment can end with a prescription, and that’s where families using Right to Choose sometimes hit a wall nobody warned them about.
Once your child’s ADHD medication dose is stable, typically after 8 to 12 weeks under NICE guideline NG87, the Right to Choose provider will usually ask your child’s GP to take over routine prescribing under what’s called a shared care agreement. Here’s the part that catches parents out: your GP doesn’t have to say yes. The British Medical Association is explicit that shared care prescribing is “non-core voluntary activity that can be declined by the GP practice for any reason.”
It gets more specific for Right to Choose. Many of these providers are independent organisations holding an NHS contract for this one service, not NHS trusts, and in 2025 the UK’s Local Medical Committees passed a policy stating that “any shared care prescribing arrangement with a private provider is unsafe, not enduring, and widens health inequalities.” From 1 July 2026, GPs across England began a fresh round of collective action over exactly this kind of unfunded work transfer between hospitals and practices, which makes an already patchy picture harder to predict.
Before you commit to a Right to Choose provider for ADHD assessment, ask your GP practice directly whether they’ll accept shared care once a diagnosis is confirmed. If they say no, your options are the specialist continuing to prescribe, registering with a different GP practice, or asking your ICB to intervene. None of this affects an autism diagnosis, which doesn’t carry an ongoing prescribing pathway.
None of these options is quick, so it’s worth asking the question before you choose a provider, not after your child’s first prescription arrives.
Common misconceptions
“Right to Choose is queue-jumping.” It isn’t. It’s a legal right written into NHS regulations, available to any eligible patient, not a favour or a loophole.
“My GP has the final say on whether I can use it.” Your GP has to make a clinically appropriate referral, but they don’t get to refuse Right to Choose itself just because they’d rather you used the local pathway.
“If my area has paused Right to Choose, the right is gone.” A pause or an activity cap is a local commissioning decision, not a change to the law. You can still ask, and your GP can still refer.
“A faster diagnosis means faster school support.” School support and an EHCP needs assessment don’t wait for any diagnosis, private, NHS, or Right to Choose. They’re triggered by need.
What to do next
Start by checking which Right to Choose providers currently accept referrals for your child’s age and area, and note their current waiting times. Write down what’s changed recently, what your child struggles with day to day, and why you’re asking now.
Book a GP appointment specifically to discuss the referral, name your chosen provider, and ask for written confirmation of what happens next. If you hit resistance, ask for the refusal in writing and use it to escalate, first through your GP practice, then your ICB, then NHS England if you need to.
Getting help
ADHD UK keeps an up-to-date list of providers currently accepting Right to Choose referrals, along with a template letter for GPs who push back.
National Autistic Society has detailed guidance on the autism diagnostic pathway, written for parents navigating the wait.
Your local SENDIASS can advise on the diagnostic pathway in your area and help with support while you wait, regardless of which route you take.
Our guide to CAMHS waiting times covers what your child is entitled to from children’s mental health services while any assessment, Right to Choose or local, is still in progress.