Right to Choose and referrals explained 

Summary: NHS Right to Choose allows people in England to access NHS-funded ADHD or autism assessment and treatment through a choice of providers. The treatment we offer is the same whether you're with us privately or via Right to Choose – the main difference is cost. 

• What is NHS Right to Choose?

• NHS Right to Choose vs private: key differences

• Your GP referral

• If your GP won't refer you

• Transferring to us from another provider

• Switching between private and NHS pathways

NHS Right to Choose is a government scheme. It allows people in England to get an ADHD or autism assessment and treatment funded by the NHS. It lets you choose who provides your treatment, rather than being limited to your local NHS services. 

Many people pick a provider like us based on things like waiting times. To be eligible for Right to Choose, you need to live in England and have a referral from your GP. 

Our assessment and treatment process is the same whichever route you come through. The main differences are around cost and ongoing prescriptions. 

If you've been referred for an autism assessment, the cost comparison below only relates to your assessment – not medication. This is because we don't offer medication for autism. 

• Under Right to Choose, you can access an ADHD or autism assessment fully funded by the NHS.

• Your GP will need to decide whether you’re eligible for an NHS-funded assessment under Right to Choose – rather than you skipping this step as a private patient.

• If the assessment leads to an ADHD diagnosis and we think medication could help, we’ll support you in finding the right medication and dose – with all costs covered by the NHS. You'll only pay the standard NHS prescription rate for medication (currently £9.90 per item, or free depending on eligibility).

• You can also ask your GP to co-manage your treatment with us – this is called “shared care”. Whether your GP agrees to, or refuses, shared care, you can keep receiving prescriptions through us at the NHS rate. We’ll also do a free annual review to make sure your medication is still safe, effective, and working well for you. 

• Your local NHS Integrated Care Board can pause regional funding due to budgetary constraints and pressures on service capacity. This doesn't apply to private patients.

• Instead of using Right to Choose, you can decide to pay for an assessment and treatment privately.

• As a private patient, you don't need to be referred by your GP. This often makes it quicker to kick off the assessment process.

• If you're on the ADHD or dual ADHD-autism pathway and we think medication will help you, you can use our titration service to find the right medication and dose. After this, you can purchase medication through our partner pharmacy, which typically costs between £75–£160 per month.

• You can also ask your GP to co-manage your treatment with us – this is called ‘shared care’. If they agree, you'll be able to access prescriptions at the NHS rate going forward. Any ad hoc or annual review appointments will need to be paid for privately. 

Once your GP submits your referral, here's what happens: 

1. Your GP sends us your referral. Many GPs send referrals in an encrypted format, so we can't confirm we've received it until it's been fully processed. GP surgeries can also take a few weeks to submit the referral after you've made the request.

2. We process your referral. We'll check we have everything we need.

3. You'll receive a welcome email with your next steps. 

If you haven't heard from us within our published waiting times, check in with your surgery to make sure it's been sent. If it has, contact us with your full name, NHS number, and the date your referral was sent – we'll use these to track it down quickly.  

Your GP can carry out a clinical review before referring you, but if they agree a referral is medically appropriate, you have the legal right to choose any eligible provider in England. They can’t refuse your choice of provider.  

If your GP isn't familiar with Right to Choose, that's common. It's a relatively new policy – we've made it easy to get things moving: 

• Download our template letter and referral form to share with your GP.

• Share the NHS Choice Framework if they want to read more.

• Our NHS contract details are included on the referral form on our website, if your GP needs them. 

We get a lot of enquiries from people wanting to transfer to us, often because of long waits elsewhere. Whether that’s possible depends on where you are in the process. 

Scenario 1 – You've been diagnosed privately and want to switch to NHS-funded treatment 

• Having had private care doesn’t affect your right to NHS treatment. If you've been diagnosed privately – either by us or another provider – but haven't yet accessed NHS-funded assessment and treatment under Right to Choose, you can still ask your GP for a referral. They can refer you to us for a full NHS care pathway, including assessment and treatment. 

Scenario 2 – You've been diagnosed under Right to Choose by another provider and want to switch to us for treatment 

• Unfortunately, we can’t accept referrals for patients who’ve already been diagnosed by another NHS Right to Choose provider. This includes referrals for treatment only (such as titration or medication management). It also includes requests for a second assessment after an existing diagnosis. NHS England guidance doesn't allow switching providers mid-treatment under Right to Choose. If this applies to you, NHS England advises that you stay on your original waiting list.

• If you'd like to access medication through us, you’re welcome to do this while paying for our services privately. 

Scenario 3 – You're waiting for an assessment with another provider under Right to Choose and want to switch to us 

• You can ask your GP to re-refer you to us.

• Under Right to Choose rules, your GP can do this if your care hasn't started yet and your original provider can't see you within a reasonable timeframe.

• This is your GP's decision – this may be quicker than continuing under Right to Choose. 

• Our standard NHS Right to Choose policy applies to all Integrated Care Boards (ICBs) across England, unless we have a specific contract in place. Under NHS England rules, we can’t accept medication-only referrals unless a specific ICB agreement exists.

• We currently have agreements with Norfolk and Suffolk ICB, Staffordshire ICB and Stoke-on-Trent ICB that allow us to accept medication-only referrals, including where a diagnosis was made privately or via another NHS provider. Outside of these areas, we can’t accept split referrals.

• Not sure what applies to you? Get in touch with your full name, address, and your GP practice's name, address, and website. We’ll help you figure it out. 

If you've paid for a private assessment with us but also have an active NHS referral, you can switch to the NHS pathway as long as: 

• Your assessment hasn’t happened yet

• Your appointment is more than 48 hours away (if already booked) 

To switch, email appointments@careadhd.co.uk with your full name, NHS number, and date of birth. Let us know which scenario applies to you: 

• Option A – "I'd like to cancel my private appointment and switch to my NHS referral. I understand this will be processed based on my original referral date and may involve a wait."

• Option B – "I'd prefer to keep my private appointment and cancel my NHS referral." 

Once we hear from you, we'll cancel your private appointment and reactivate your NHS referral based on your original referral date. NHS assessments are offered in strict date order and can't be fast-tracked – but we’ll make the process as smooth as we can. 

A £10 admin fee will be deducted from your refund, as outlined in our Terms and Conditions. Please note that if your appointment is less than 48 hours away, we’re unable to process a refund.

The good news is that all your pre-assessment forms remain valid if you switch pathways. However, if your clinical forms (such as the physical health questionnaire) are more than 3 months old, we may ask you to submit updated versions before your NHS appointment. 

Can my GP refuse to refer me to you? 

Your GP must respect your Right to Choose any eligible provider in England. They can only say no if they don't think a referral is medically right for you – they can't refuse your choice of provider. If you're having difficulty, our template letter and referral form can help you explain your rights. 

How will I know when you have received my GP referral? 

Once we've processed your referral, we'll send you a welcome email with your next steps. If you haven't heard from us within our published waiting times, we'd recommend checking in with your surgery – referrals can take a few weeks to process. 

Can I get a refund if I switch from private to NHS before my assessment? 

Yes, as long as your assessment hasn't taken place and your appointment is more than 48 hours away. A £10 admin fee will be deducted. Simply email appointments@careadhd.co.uk and we’ll take it from there.