The short version
In June 2026, up to 959,662 referrals that may be for an ADHD assessment were open in England, and waits run to years. If you live in England, the law lets you choose who assesses you. Here's how to ask your GP, and what to do when they say no.
In June 2026 there were up to 959,662 open referrals that may be for an ADHD assessment in England, according to NHS England’s own management information. Autism is no better. In the same month, 294,792 people had an open referral for suspected autism, and 86.8% of them had been waiting at least 13 weeks. The government’s independent ADHD Taskforce reported NHS waits of up to 8+ years for adults and 4+ years for children.
If you live in England, you don’t have to join the back of your local queue and hope. You have a legal right to choose who assesses you. It’s called Right to Choose. The law is on your side. Here’s how to use it.
What Right to Choose actually is
Right to Choose isn’t a favour or a local scheme. It comes from regulation 39 of the NHS Standing Rules Regulations 2012, and it sits under the NHS Constitution’s promise that you can “make choices about the services commissioned by NHS bodies”. The government’s NHS Choice Framework spells it out in plain terms.
When you need an elective (non-urgent) referral to mental health services, you can choose any clinically appropriate provider that holds an NHS contract for that service. The service must be led by a consultant or a mental health professional. Adult and child ADHD and autism assessments fall under this. It includes independent providers, many of them online, as long as they hold an NHS Standard Contract with any integrated care board (ICB) or NHS England. It doesn’t have to be your local ICB. It’s free at the point of use, just like any other NHS referral.
When the right doesn’t apply
The Choice Framework lists the exceptions. The right doesn’t apply if you’re already receiving care and treatment for the condition you’re being referred for, or if you need urgent, emergency or crisis care. It also doesn’t apply if you’re in prison, detained under the Mental Health Act, or a serving member of the armed forces. And it only applies at the point of referral, so ask for it before the referral goes off.
How to ask your GP: a step-by-step checklist
- Pick a provider first. Check it holds an NHS contract for ADHD or autism assessment, whether it’s taking new referrals, its current wait, and whether it covers your age group.
- Ask the provider what happens after diagnosis. Can it prescribe for you if your GP won’t agree to shared care? (More on this below.)
- Download the provider’s referral pack. Most have a GP form, and some ask for screening questionnaires. Fill in your part before the appointment.
- Book a GP appointment and say why. Tell reception it’s about a Right to Choose referral, so you get enough time.
- Use clear words. Try: “I’d like a referral for an ADHD [or autism] assessment. I’m choosing [provider] under my legal right to choose a mental health provider, set out in the NHS Choice Framework. They hold an NHS Standard Contract.”
- Get it in writing. If the GP refuses or delays, ask them to note the reason in your record and send it to you.
- Chase it. Check with the provider that the referral has arrived.
If you’re neurodivergent, the GP surgery itself can be a barrier. Phone-only booking and rushed appointments are two examples. You can ask for reasonable adjustments under the Equality Act 2010, such as a longer slot or written communication.
“We don’t do that here”: which GP refusals are lawful
Some refusals are legitimate. Many are not.
| What you’re told | Lawful? | What to say |
|---|---|---|
| “Our practice doesn’t do Right to Choose.” | No | It’s a legal right, not a practice policy. Ask for the refusal in writing. |
| “That provider isn’t commissioned by our ICB.” | Usually no | The provider needs an NHS contract with any ICB or NHS England for the service, not your local one. |
| “I don’t think an assessment is needed.” | Can be | The referral must be clinically appropriate in the referrer’s opinion. Ask for the reasons in writing, and ask to see another GP. |
| “You’re already being treated for this.” | Can be | The right doesn’t apply if you’re already receiving care and treatment for the condition. If you’re only on a waiting list, ask your practice or ICB whether you can switch. |
| “That provider has paused referrals.” | Can be | Providers can hit their funded limit (see below). Ask for another provider, or ask whether your referral can be held. |
| “We won’t do shared care afterwards.” | Yes | Shared care is voluntary. But that isn’t a reason to refuse the referral. |
Shared care: the catch after diagnosis
For ADHD, diagnosis is only half the battle. Once you’re on a stable dose of medication, the provider usually asks your GP to take over prescribing under a shared care agreement. GPs don’t have to agree. Shared care is voluntary, and practices can decline on clinical or capacity grounds. The ADHD Taskforce’s final report (November 2025) warned that shared care protocols “have become more problematic in recent years with many arrangements no longer in place”.
The safety net has improved. NHS England’s 2026/27 payment guidance for ADHD services includes funding for the provider to keep prescribing and reviewing you when a GP refuses shared care, or doesn’t reply within 21 days of the provider’s request. The provider must be willing to do this, so ask before you choose.
A diagnosis you can’t get treatment for is a locked door with a nicer sign on it. Ask about prescribing before you pick a provider.
What changed in 2025 and 2026
The independent ADHD Taskforce published its interim report in June 2025 and its final report in November 2025. It called for waiting times to be reduced urgently and held to the same standards as waits for physical health conditions. It also called for national minimum contracting standards “including when patient choice is applied”.
The bigger practical change is money. NHS England has pointed ICBs to contract tools called Indicative Activity Plans. These set how many assessments each Right to Choose provider will be paid for. South West London ICB, for example, says it put them in place for its ADHD providers from 1 July 2026. Leicester, Leicestershire and Rutland ICB warns that once a provider reaches its allocation, it may “pause or delay” offering new assessment appointments.
As of September 2026, we’ve found no change to the regulation that creates the right itself. What has changed is capacity, which varies by provider and area. Check a provider’s status before you ask for a referral. And if an ICB tells you Right to Choose “no longer exists”, ask it to explain that in writing.
Scotland, Wales and Northern Ireland
Right to Choose is England only. Scotland, Wales and Northern Ireland have no equivalent legal right to choose an NHS-funded assessment provider. If you live there, ask your GP about local pathways and waiting times, and press your MSP, MS or MLA for answers. Your right to reasonable adjustments in healthcare still applies.
How to challenge it when it goes wrong
- Speak to the practice. Ask the practice manager to review the decision, and quote the Choice Framework.
- Make a formal complaint. You can complain to the practice or to your ICB. Since 1 July 2023, complaints about GP services go to the ICB rather than NHS England. Complain within 12 months, in writing, and ask specific questions. Our complaint template helps. Free NHS complaints advocacy is available.
- Go to the Ombudsman. If the local response doesn’t fix it, the Parliamentary and Health Service Ombudsman is the final stage, on 0345 015 4033.
- Get discrimination advice. If the problem is a failure to make adjustments, contact the Equality Advisory and Support Service (EASS) on 0808 800 0082.
Once you have a diagnosis, you can use it. Read our guide to neurodivergent adjustments at work, and check Access to Work for funded support.
A waiting list measured in years isn’t a queue. It’s a wall. Right to Choose is one of the few legal tools that gets you round it. Pick your provider, book your GP appointment, and say the words. If they say no, make them put it in writing, then take it further.
