NHS Right To Choose

NHS ‘Right To Choose’ Guidance

Many don’t realise that ‘Right to Choose’ applies not only to physical NHS services but also to mental health services (including ADHD) . . . . with some stipulations!

I need to say that I have diagnosed ADHD, I’m not a medical professional and do not work for the NHS. Therefore this information comes from research that I’ve carried out and my comments are my interpretation based on the NHS links that I reference below.

Please chip in and feel free to correct if you know better 👍

In essence though, if you have been on an NHS Waiting List for ADHD Assessment with a specialist longer than 18 weeks, then the NHS should refer you to a private clinic at their cost, so that you can be assessed and diagnosed.

Here is the NHS page that discusses Right To Choose: www.nhs.uk – Can I choose where to receive treatment

Taken from the link above:

Can I choose where to receive treatment?

The NHS Constitution gives people living in England the right to choose where to receive treatment.

You have the right to:

choose your GP surgery, unless there are reasonable grounds to refuse (for example, you live outside the area that the surgery covers)

make choices about your NHS care, and to receive information to support these choices

This also means you can choose the organisation that provides your NHS care when you’re referred for your first appointment with a consultant.

COMMENT: This seems to indicate that if your GP recommends that you see a specialist, you can choose where and when to see them.

NHS e-Referral Service

The NHS e-Referral Service is an electronic booking service for people living in England.

It allows you to choose from different hospitals and clinics across England (including some private hospitals).

Finding a hospital

If you’re unsure about which hospital or clinic to choose, your GP can advise you on what might be the best choice for you.

Find and choose hospitals is the most sophisticated hospital comparison system in the UK.

It allows you to compare hospitals using a wide range of factors, including:

overall quality of service (judged by the regulator)

other patients’ views

COMMENT: I would assume waiting times as well, given the information below

When choice is limited

There are some exceptions that may limit your choice – for example, not all hospitals are able to treat every condition, and a hospital must meet NHS conditions on standards and costs.

You also can’t choose when and what services to use in cases where speed of access to diagnosis and treatment is particularly important, such as:

emergency services

Rapid Access Chest Pain Clinics, where you must be seen within the 2-week maximum waiting time

cancer services, where you must be seen within the 2-week maximum waiting time

maternity services

mental health services

COMMENT: This implies that it’s not possible to use Right To Choose BUT it seems that the premise changes when you have had to wait for 18 weeks or more. See the Guide To NHS waiting times in England included below:

The following people can’t choose where to receive treatment:

people held under the Mental Health Act 1983

military personnel

prisoners (including prisoners on temporary release)

For more on choosing treatments, see ‘Your choices in the NHS’


Thats the first part, here is the NHS page that discusses Waiting Times: www.nhs.uk – Guide to NHS waiting times

Guide to NHS waiting times in England

If you’re referred for a physical or *mental health condition, you have the legal right to start non-urgent consultant-led treatment*, or be seen by a specialist for suspected cancer, within maximum waiting times.

This right only applies to services commissioned by the NHS in England and does not include public health services commissioned by local authorities, maternity services, or non-consultant-led mental health services.

COMMENT: This would seem not to apply since assessment and diagnosis can be found using a consultant (Specialist) led mental health service.

Find out more about access and waiting times for mental health services.

Your waiting time starts from when the hospital or service receives your referral letter or when you book your first appointment through the NHS e-Referral Service.

COMMENT: The referral will be sent by the GP to the NHS Foundation with ADHD Assessment capability or to a private clinic of the same

During this time period, you may:

have tests, scans or other procedures to help ensure that your treatment is appropriate for your condition

have medicine or therapy to manage your symptoms until you start treatment

be referred to another consultant or department

Your waiting time ends if a clinician decides no treatment is necessary, if you decide you do not want to be treated, or when your treatment begins.

This could include:

being admitted to hospital for an operation or treatment

starting treatment that does not require you to stay in hospital, such as taking medicine

beginning fitting for a medical device, such as leg braces

agreeing to have your condition monitored for a time to see whether you need further treatment

receiving advice from hospital staff about how to manage your condition

Tip: Did you know that in most cases you have the legal right to choose the hospital or service you’d like to go to, as well as the clinical team led by a consultant or named healthcare professional?

For more information, see our guidance on NHS hospital services and accessing mental health service.

Maximum waiting times for non-urgent referrals

The maximum waiting time for non-urgent, consultant-led treatments is *18 weeks* from the day your appointment is booked through the NHS e-Referral Service, or when the hospital or service receives your referral letter.

COMMENT: Surely this means that once you have been on the NHS Foundation ADHD Assessment waiting list for more than 18 Weeks (which is highly likely in most areas), you have the right to be refered by the GP to a private service provider that the NHS pays for under this Right To Choose scheme.

However, your right to an 18-week waiting time does not apply if:

you choose to wait longer

delaying the start of your treatment is in your best clinical interests, for example, when stopping smoking or losing weight first is likely to improve the outcome of your treatment

it is clinically appropriate for your condition to be actively monitored in secondary care without clinical intervention or diagnostic procedures at that stage

you fail to attend appointments that you had chosen from a set of reasonable options

the treatment is no longer necessary

Everyone clear now?! 👀🤯😆