The Referral Route With Rules: Making Sense of Right to Choose for Autism and ADHD Assessments

Right to Choose gets talked about in family groups like a secret door. It isn’t. It’s a legitimate NHS route with rules, paperwork and limits — and it works best when everyone knows what it is for.

In England, the NHS Choice Framework gives people a right to choose where they receive certain NHS-funded elective care when their GP refers them. For families seeking an autism or ADHD assessment, that can sometimes mean asking for a provider that has an NHS contract and is taking referrals. Sometimes it means being told, politely but firmly, that the local system does not work that way. Both outcomes are possible. The point is to ask from an informed position, not a desperate one.

What Right to Choose can actually do

At its best, Right to Choose can widen the list of NHS-funded providers your GP can refer to. If your local integrated care board (ICB) has a provider with a contract for neurodevelopmental assessment, and that provider is accepting referrals, you may be able to ask for it. The referral still has to be clinically appropriate. The GP still has to make it. The provider still has to accept it. And the wait may be shorter, similar or — this is the bit nobody puts on the poster — longer than the local route.

It is not a diagnosis-for-sale scheme, and it is not a way to skip triage. It is a route through NHS care, not around it.

What it cannot do

Right to Choose is not available across the whole UK in the same way. This guide is about England. It does not force a GP to refer you to a provider that has no NHS contract. It does not guarantee an assessment, a diagnosis or a timescale. It does not usually cover private assessments where you pay upfront and hope to reclaim something later. And it does not replace the clinical judgement of the person doing triage.

Some providers advertise heavily around Right to Choose. Some are excellent and NHS-contracted. Others use the phrase loosely, then ask families to pay. That is why checking the paperwork matters more than checking the slogan.

First, check the ground under your feet

Before you book a GP appointment, do a bit of quiet homework.

Start with your GP practice. Ask whether they accept Right to Choose requests for neurodevelopmental assessment, and whether they have a named person or process for them. Ask for the answer in writing if you can. Next, look at your ICB’s website for its current position on neurodevelopmental referrals and any provider list. Then check the provider directly: do they have an NHS contract for this service, are they accepting referrals from your area, and what is their current wait?

A script you can use: ‘I’m asking about an NHS Right to Choose referral for an autism or ADHD assessment. Can you tell me whether the practice accepts these requests, and what information you need from us?’

That is not a battle. It is a question with a paper trail.

Making the request without turning the appointment into a battle

Bring one page: the young person’s name, date of birth, GP, main concerns, what has already been tried, and the specific provider you are asking about. Keep it factual. ‘We would like to discuss a Right to Choose referral to [provider] for assessment. Here is the information we have about their NHS contract and current referral route.’

Avoid opening with ‘I know my rights.’ You may be right, but the person in front of you may also be the person who has to process the referral. Calm specificity gets further than a courtroom speech in a ten-minute appointment.

If the GP says no, ask: ‘Can you explain the reason in writing, and tell me what would need to change for a referral to be possible?’ That one question gives you something to work with.

Spotting misleading provider claims

Be wary of any provider that promises a diagnosis before assessment, says Right to Choose guarantees NHS funding without checking your GP and ICB, or asks for a large upfront payment while using NHS-sounding language. A legitimate provider should be clear about its NHS contract, its referral criteria, its waitlist and what happens if the referral is rejected. If the website is vaguer than a fortune cookie, slow down.

If the answer is no

A no is not always the end, but it is information. Ask for the reason in writing. Check whether the decision is about your child’s clinical needs, the practice’s policy, the ICB’s commissioning arrangements or the provider’s capacity. Look at the ICB’s published policy. If you think the practice has applied the policy wrongly, contact the practice manager, then the ICB, then NHS PALS or the complaints route. Keep dates and copies.

You can also ask about alternatives: a local NHS referral, a different provider, a review of the referral, or a private assessment if that is accessible and right for you. None of these is a failure. They are different routes with different costs.

A short glossary of referral terms

Right to Choose — an NHS England choice right for certain elective referrals, not a separate assessment service.

ICB — integrated care board; the local NHS body that plans and commissions services.

Provider — the organisation that carries out the assessment, whether NHS, community or independent with an NHS contract.

Triage — the process of reviewing referrals to decide priority and suitability.

PALS — Patient Advice and Liaison Service; local NHS help with concerns and complaints.

The calm version

Right to Choose is worth understanding because it gives families a legitimate question to ask. It is not worth treating as a magic wand. Go in with the provider’s details, the ICB’s position and a written request. Accept that the answer may be yes, no or not yet. And keep the young person at the centre of the paperwork, not buried under it.