If you have been told the NHS waiting list for an ADHD or autism assessment is years long, you are not imagining it. As of September 2025, nine in ten people with an open autism referral in England had already been waiting longer than the 13 weeks NICE recommends, and the typical wait now stretches beyond 16 months. What a lot of patients and parents do not realise is that you can ask your GP for a Right to Choose referral to a different provider, still funded by the NHS. This guide walks through how that works: the process, what to say at your appointment, and what to do if your GP says no. The right applies to anyone registered with a GP in England.
What Is NHS Right to Choose?
NHS Right to Choose is a legal right that lets you ask your GP to refer you to a provider of your choice for certain NHS services, including neurodevelopmental assessments for ADHD and autism. It was introduced on 1 April 2014 and is funded by the NHS, so there is nothing to pay.
The right comes from the NHS Choice Framework, which sets out the choices available to patients in England. As long as the provider you choose holds a qualifying NHS contract for that service, your GP can refer you there, even if it is not the provider your local NHS would usually use. There is no special funding request to make, and your Integrated Care Board (ICB) does not have to approve it first.
It helps to be clear about what the right does and does not do. It lets you choose where you are assessed. It is not a guarantee of an immediate appointment, and it does not make waiting times disappear. The pressure on services is real. Between 2019 and 2025, the number of people with an open autism referral in England rose more than five-fold, from around 40,000 to over 200,000. For ADHD, the Independent ADHD Taskforce found in 2025 that 40% of areas reported waits of two years or more, with some lists running much longer. Right to Choose is one practical way to find a shorter route.
Two things are worth knowing before you begin. First, the right applies in England only. It does not extend to Wales, Scotland, or Northern Ireland, where healthcare is run differently. Second, since 2025, some ICBs have brought in local limits on how many Right to Choose assessments they will fund in a year. This has not removed the legal right, but it can affect availability and waiting times in certain areas. So it is sensible to check your chosen provider’s current availability before you book your GP appointment. More on that below.
If you are weighing this up against going private, our guide to the differences between NHS and private autism assessments sets out how the routes compare. If you are not sure where to begin, our start here page helps you work out which pathway is right for you or your child.
The Right to Choose Referral Process, Step by Step
To request a Right to Choose referral: (1) choose your provider and confirm they are accepting referrals, (2) complete the relevant self-report questionnaire, (3) book a GP appointment and ask for a referral to that provider by name, and (4) hand your completed form to the GP so they can submit the referral.
Here is each step in more detail.
Step 1: Choose your provider first
Most guides start at the GP appointment. In practice, the first thing to do is decide where you want to be referred, and confirm they can take you. The provider needs to hold an active NHS Right to Choose contract for the assessment you need.
Before you settle on a provider, check two things on their website: their current waiting times, and whether they are still accepting new referrals from patients in your area. As mentioned above, some ICBs have capped the number of assessments they will fund, so a provider that was open last month may have paused new bookings this month. A quick phone call or look at their site saves a wasted GP appointment.
Provide Wellbeing offers Right to Choose pathways for children and young people, covering both ADHD and autism assessments. For adults, Provide Wellbeing currently only offers autism assessment through Right to Choose. Because Right to Choose is a national right, you can be referred to Provide Wellbeing as long as you are registered with a GP in England.
Step 2: Complete the self-report questionnaire
Your chosen provider will ask for a completed self-report questionnaire. Which one you need depends on age and condition:
- AQ-10 for autism. There are three versions: an adult version for ages 16 and over, completed by the person themselves; an adolescent version for ages 12 to 15; and a child version for ages 4 to 11, both completed by a parent or carer.
- ASRS for adult ADHD, an 18-item scale completed by the adult themselves.
- SNAP-IV for child ADHD, a rating scale completed by a parent or carer, with a separate version often completed by a teacher or SENCO.
These are standard screening tools, and the provider’s website will usually have them available to download. Completing the right form before your GP appointment is one of the most useful things you can do. It gives the GP a clear basis for agreeing to the referral on the spot.
Step 3: Book your GP appointment and ask clearly
Book a routine GP appointment. When you are seen, tell the GP you wish to use your NHS Right to Choose, and name the specific provider you want to be referred to. Bring your completed self-report form.
Be ready for the possibility that your GP has not come across the pathway before. This is common, and it does not mean the right does not apply to you. It just means you may need to point them to the relevant NHS guidance, which we cover in the section on refusals below.
Step 4: The GP submits the referral
Once your GP agrees, they complete the provider’s referral form, which is usually an online form on the provider’s website. It helps to bring a printout of the provider’s GP referral page so the GP can find the form quickly. After the referral is sent, you should receive confirmation that the provider has it.
How to Prepare for Your GP Appointment
A little preparation makes the appointment shorter and far more likely to succeed. The aim is to make it easy for the GP to say yes and submit the referral the same day.
What to say. Keep your request direct and factual. A simple spoken prompt works well:
“I’d like to request a referral under the NHS Right to Choose. I’ve already identified the provider I’d like to be referred to, and I have my completed self-report form here.”
Using the phrase “Right to Choose” signals that you know this is a legal right, not a routine favour. The GP’s job is to make the referral happen, not to decide whether they think you will be diagnosed, so there is no need to argue the case for your diagnosis in the room.
What to bring:
- Your completed self-report questionnaire or questionnaires
- The provider’s contact details, or a printout of their GP referral page
- Brief notes on how your symptoms affect daily life, work, relationships, or school
- For children: any school reports, teacher letters, or SENCO correspondence that shows the difficulties observed
If you are requesting on behalf of a child. The referral is made by your child’s GP, so you book the appointment and make the request for them. In some areas, a school SENCO can refer a child into local NHS pathways, but only a GP can make a Right to Choose referral. A short written summary of the behaviours you see at home and at school, backed by any school documentation, helps the GP understand the impact across settings and strengthens the case.
Managing the conversation. Speaking up in a medical setting can feel uncomfortable, especially for neurodivergent adults or for an anxious parent. Keeping the request calm, factual, and anchored to a named legal right tends to work better than describing every symptom and asking whether the GP thinks a referral is warranted. If you would like support, the Patient Advice and Liaison Service (PALS) can offer free, confidential guidance.
Can a GP Refuse a Right to Choose Referral?
Yes, but only in limited circumstances. A general refusal, or simply not being familiar with the pathway, is not a valid reason to turn you down.
Non-clinical refusals. If your GP has not heard of Right to Choose, or raises concerns about cost or funding, the right still stands. These are not clinically valid grounds. You can point them to the NHS England patient choice guidance or the NHS Choice Framework, both of which confirm that no funding request or ICB approval is needed in advance.
Valid clinical exclusions. There are genuine eligibility criteria that can rule a patient out. The ones you are most likely to come across are:
- Currently receiving specialist NHS treatment for the same condition
- An intellectual disability with an IQ below 70
- An active psychotic episode within the last three months
- Currently detained under the Mental Health Act
- Currently looked after by a local authority, for example under guardianship
This is not the full list, and criteria vary slightly between providers, so always check your chosen provider’s referral guidance for the complete set.
If the GP refuses without a valid clinical reason. Ask for the refusal to be put in writing, including the specific reason. You can then raise it with PALS, who can point you to your local ICB, and if needed, make a formal complaint to the ICB, which is responsible for making sure patients are offered the choices they are entitled to. In most cases, though, it does not come to this. Once a GP is shown the relevant NHS guidance, they will usually agree to refer.
What Happens After the Referral Is Submitted?
Once your GP submits the referral, the provider takes over. The typical sequence looks like this:
- The provider confirms it has received your referral and contacts you for any further information. For children, this often means a developmental history from the parent or carer, plus school observation reports.
- A clinical triage process checks that you meet the eligibility criteria and places you on the waiting list. You receive written confirmation that you have been accepted.
- When your turn comes, a multidisciplinary clinical team carries out the assessment. This usually involves a clinical interview, a review of your questionnaire responses and supporting information, and a written diagnostic report sent to you and your GP.
Waiting times vary by provider and by ICB area. Because some ICBs have set local limits on funded activity, waits in certain areas can be longer, and they can change without much notice. This is why it matters to check a provider’s current waiting time estimate before you choose them, rather than after.
One point is worth confirming in advance. If ADHD is diagnosed and medication is appropriate, some providers offer medication titration through the same service, but not all do. If treatment matters to you, check whether titration is included before you choose.
Accessing Right to Choose Through Provide Wellbeing
Provide Wellbeing is an NHS Right to Choose provider offering ADHD and autism assessments for children and young people and autism assessments for adults. Because Right to Choose is a national right, you can be referred to us from anywhere in England as long as you are registered with a GP here.
We are part of Provide CIC, a Community Interest Company that has delivered frontline NHS care for more than 20 years, and our neurodevelopmental service is rated “Outstanding” by the CQC. Our multidisciplinary team includes occupational therapists and speech and language therapists, and we offer virtual assessment options to reduce travel where appropriate.
A note on adult assessments: Adult ADHD through Right to Choose is not currently available with Provide Wellbeing, though a self-pay option exists for adults who would prefer not to wait. An adult autism Right to Choose pathway is in development. If you would like to understand the routes open to you, our Start Here page is the best place to begin, and you can read more about our Right to Choose pathway for children and young people. If you are considering the private route, our assessment pricing is set out in full.
Frequently Asked Questions
Can a GP refuse a Right to Choose referral?
Yes, but only for valid clinical reasons, such as the patient not meeting the eligibility criteria. A GP cannot refuse simply because they are unfamiliar with the scheme or have concerns about funding. If this happens, you can ask for the reason in writing and escalate through PALS.
Do I need a GP referral to use Right to Choose?
Yes. Unlike a private assessment, Right to Choose needs a GP to formally submit the referral. The GP does not assess how likely a diagnosis is. Their role is to make the referral to the provider you have chosen.
Can I use Right to Choose for my child’s ADHD or autism assessment?
Yes. Right to Choose applies to children and young people as well as adults, provided they meet the eligibility criteria and are registered with a GP in England. The referral is made by the child’s GP, and parents or carers are closely involved throughout.
What is a self-report questionnaire and why do I need it?
It is a standardised clinical tool that gathers information about symptoms before the assessment. Different tools are used depending on age and condition: the AQ-10 for autism, the ASRS for adult ADHD, and the SNAP-IV for child ADHD. Completing it before your GP appointment helps avoid delays.
How long will I wait after the referral?
Waiting times vary by provider and by local ICB. Some areas have set limits on how many assessments a provider can carry out each year, which affects availability. Always check the provider’s current waiting time guidance before your GP appointment.
