The 'right to choose' (RTC) pathway information below is for Sheffield only. It is not relevant for other areas of South Yorkshire. 

The national NHS Choice Framework gives all NHS patients in England the legal ‘right to choose’ (RTC) the service that provides their healthcare in certain circumstances. It is a relatively new option in neurodevelopment and as such not all patients, GPs or other clinicians are aware of it and how it works.

 A RTC pathway may be a preferred option for some patients to get assessed for ADHD and/or autism.  If you receive a diagnosis of ADHD, medication may be an option that is offered.  You need to consider what the RTC provider can offer;

  • a diagnosis service
  • diagnosis and initial titration/prescribing service, but not an ongoing prescribing/monitoring service
  •  diagnosis, initial titration and prescribing and ongoing prescribing and monitoring.    

Referral process

To go through the Right to Choose pathway, you will first need to speak to a GP at your practice about why you think you or another adult, or child / young person has ADHD or autism. It might be helpful to provide observations and information in writing. This could include letters from the SENCO or school. The GP then needs to agree the clinical appropriateness to make a referral for an assessment to the provider of your choice.

This would also be a good opportunity to discuss the benefits and disadvantages of choosing a different providers offering care funded through the NHS. Some Right to Choose providers or services may not be the most appropriate solution for some people, depending on type of need or circumstance. It is important to make an informed decision. 

Should you decide to proceed, the GP would then complete the referral to your chosen provider. The provider will then contact yourself.  

Choosing a provider

NHS South Yorkshire ICB is not able to provide recommendations about which provider you should choose with your GP under an NHS Choice pathway. We do not hold a list of private providers across the country. However, there are restrictions on who can provide your care, which should be considered. For a provider to provide assessment and care under right to choose they must have:

  • a commissioning contract with any Integrated Care Board or NHS England for the required service you are wanting to access (diagnosis with or without prescribing/ongoing monitoring)
  • a service and team led by a consultant or a mental health professional
  • a CQC-regulated service. This may be confirmed by searching the full list of services CQC regulate at: https://www.cqc.org.uk

The reviewing guidance from ADHD charities/organisations below may be helpful in deciding on a provider, some of these websites detail providers offering services through right to choose and highlight the services they offer. However, please note the ICB cannot guarantee the accuracy of the information on these websites.

What you need to do

  • Discuss with your GP what you want from the service, be that just an assessment to see if you have ADHD or if you also want access to any medication, should that be considered needed.  You need to discuss with your GP as to whether they would engage in shared care prescribing and/or monitoring with a RTC provider, and if they do not offer this service you will need to choose a right to choose provider which includes an ongoing prescribing and monitoring service.
  • Check if the Right to Choose Provider/s can prescribe ADHD medication under NHS funding.  Some providers offer a diagnosis only service, which would mean that if you then needed medication this would not be covered by the service. If you required medication following assessment and this is not provided on the NHS by your chosen right to choose provider you may need a re-referral to an NHS service for medication (subject to your GP agreeing a re-referral was clinically appropriate and you would again be subject to waiting lists).  Therefore, most people would look to be referred to a Right to Choose provider that offers diagnostic assessment, medication initiation/titration, and agree with their GP and the right to choose provider whether they are willing to undertake shared care, adopting the local protocol, post diagnosis.
  • Confirm with your GP whether they will accept the diagnosis and shared care arrangements for medication (if this is prescribed) from the selected Right to Choose provider.
  • Check if the Right to Choose Provider/s will agree to local shared care arrangements. Your GP can confirm what these are.

Please note the above relates to accessing NHS funded services. Patients retain the right to privately fund assessments and medication initiation / titration outside the scope of Right to Choose.

ADHD medication is specialist which means it requires ongoing review from an appropriate professional (such as paediatricians, psychiatrists and nurse prescribers). Therefore, unless your Right to Choose provider offers ongoing shared care, your GP may be unwilling to prescribe due to insufficient clinical oversight of the drug and its effectiveness.

Medication for ADHD from private diagnosis

It is important that if you receive a privately funded diagnosis (i.e. not paid for by the NHS) which includes medication for ADHD, you know how you will receive ongoing prescriptions and review. 

Useful resources while waiting for diagnosis