In England, ‘patient choice’ applies across NHS funded physical and mental health services for both children and adults. It is often called ‘Right to Choose’. Click here for more information.
Navigate to FAQs and glossary.
Eligibility
If you are eligible for an Autism or ADHD assessment you have the legal right to choose an assessment service. The service must meet NHS England criteria and hold an NHS contract. Click here for more information.
You can choose your service at these points in your referral process;
- When your GP/ referral professional agrees that a referral is clinically appropriate and
- If your wait for an assessment is longer than 18 weeks or
- If you were not offered your choice of provider when the GP/referral professional agreed to refer you for assessment.
There may be some areas that have an interface service that work on behalf of Primary Care and can help with advice, support and pathways. Those interface services may also be a referral route into assessment, for the purpose of this document we have called them ‘referral professional/s’
You have the same rights and choices whether you are referred by a GP, another professional or interface service.
NHS England criteria
The provider must have a current qualifying ‘NHS standard contract’ with an Integrated Care Board (ICB) or NHS England.
This could be an NHS service or an independent provider. Their NHS standard contract needs to be for the service you have been referred to and for your age group e.g. an adult Autism assessment contract.
Referral for NHS funded Autism and/or ADHD assessment
If you and the GP/referral professional decide that you can be referred for an Autism and/or ADHD assessment, you can ask to be referred to your preferred provider. (You may not know which provider you want to be referred to. If you're unsure which provider to choose, the next section will help you decide.)
The GP/referral professional will need to check that the service you have chosen has an NHS contract before they can refer you. If they don’t meet the criteria you will have to choose a different provider. You can discuss this with your GP/referral professional.
It can be uncomfortable to ask for things from your GP/referral professional. To help you ask for your choice of provider, we have created the following information and a downloadable letter you can use at your GP appointment.
Click here for the downloadable letter.
Questions to help you choose an NHS funded Autism and/or ADHD assessment service
Choosing the right service for an Autism and/or ADHD assessment is an important decision. These are some things to think about or find out when you are choosing a service.
Services might share reviews about what people think about them. This could be the NHS Friends and Family Test, or other feedback forums from their patients. There may be reviews online about the service.
When choosing an Autism and/or ADHD assessment, please consider the following questions:
- Does the provider have a contract that meets NHS England criteria?
- Does the service specialise or provide a service that has experience in assessing particular groups of people? For example, Autism in women, are they culturally competent, ADHD in older people, complex trauma, offer services in other languages
- How and when should I expect to hear from the assessment service?
- Who should I contact if I don't hear anything for longer than expected?
- How long will you have to wait for your first appointment?
- How long does the assessment process usually take?
- What happens next in the process, and how long might it take?
- Are appointments offered online or in person, or both?
- If only in person, where are they based and can you get there easily. What if you need to go more than once?
- How will the service communicate with you? Is this just online, over the phone, text - do their methods suit your communication style and follow the correct consent procedures?
- Would the service provide you with regular waiting list updates including when you have been accepted onto their waiting list?
- Do they offer any support while you are waiting to be assessed?
- Do they offer any support after your assessment - whether you are diagnosed or not?
- Are they CQC registered? If the service is prescribing medication they must be CQC registered.
ADHD assessment and treatment
It is important to know if the NHS funded service you choose will be able to prescribe you medication if it is suitable, as this requires a specialist to start and monitor you until the medication and dose is correct for you.
When choosing an ADHD assessment and possible medication pathway please consider the following:
- Can your chosen provider offer medicine treatment options under Right to Choose/Patient Choice (if this is not an option you may need to pay for a private prescription)
- Would there be another wait before you were prescribed the medicine?
- The medicines used to treat ADHD are specialist (amber) medicines that need to be started by your chosen provider and not your GP. The dose should be gradually increased until you are on an effective dose with minimal side effects (this process is called titration). How will you be supported to find the best dose for you? (Click here for more information on amber drugs).
- If your GP is unwilling to continue prescribing medication (shared care), would the service continue to prescribe for you and provide routine monitoring and your annual review?
- Does the service provide prescriptions, and what is their process for doing this?
- If the GP does take on shared care you will still need specialist health checks and reviews every year – is this part of their service?
Shared care
Once you have settled on a medicine at the right dose that works for you the service may ask your GP to prescribe your medicine and do routine monitoring. This is called ‘Shared Care’. The service should review your treatment each year as part of their responsibilities.
When GPs take on prescribing medication they become fully responsible so they need to consider things like: whether they are confident the treatment is appropriate, they have the skills and knowledge to be able to prescribe safely, and whether they have the necessary ongoing support from the specialist.
Please note that GPs do not have to take on shared care prescribing arrangements with your chosen provider if they feel the above conditions are not met.