If you are waiting for an ADHD, autism, or mental health assessment in the UK, you already know the grim reality. Local NHS waiting lists can span anywhere from two to five years. For many, that wait is simply too long to put life, education, or career goals on hold.
Fortunately, there is a legal shortcut built directly into the NHS framework that many people don't know exists: Right to Choose (RTC).
What is Right to Choose?
Introduced for mental health services in England in 2018, Right to Choose is a legal right that empowers patients to select which organisation handles their first outpatient appointment. If your local NHS trust has a massive backlog, you do not have to wait in that specific queue. Instead, you can choose to be referred to an independent, private clinic that holds an NHS commissioning contract—and the NHS will pick up the bill.
The Criteria: Who is Eligible?
You can legally exercise your Right to Choose if:
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You are registered with a GP in England (unfortunately, the rules differ in Scotland, Wales, and Northern Ireland).
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Your GP agrees that a referral for the condition is clinically appropriate.
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The private or independent provider you select already has a contract with an NHS Integrated Care Board (ICB) or NHS England to provide that specific service.
Note: You cannot use RTC if you are self-referring, already receiving care for the exact same condition locally, or require emergency/crisis mental health support.
How to Use Right to Choose: Step-by-Step
Navigating the process is straightforward, but it requires a little prep work before you see your doctor.
Step 1: Find a Provider
Look for independent clinics that offer Right to Choose pathways (popular options include Psychiatry-UK, ADHD 360, ProblemShared, or The Owl Centre). Check their websites to compare current waiting times for assessments and, crucially, medication initiation (titration).
Step 2: Download the Paperwork
Most RTC providers have a "GP Referral Pack" on their website. This usually includes a self-report screening questionnaire (like an ASRS form for ADHD or an AQ-10 for autism) and a template letter addressed to your GP. Fill these out completely.
Step 3: See Your GP
Book an appointment to discuss your symptoms. Present your completed screening forms and state clearly: "I would like to be referred to [Provider Name] for an assessment under the NHS Right to Choose pathway."
Two Things to Watch Out For
While Right to Choose is an incredible tool, you need to be aware of a couple of systemic hurdles:
1. Shared Care Agreements (The Medication Trap)
If you receive a positive ADHD diagnosis and want to start medication, the private provider will titrate your prescription until you are stable. After that, they will ask your GP to take over the ongoing monthly prescriptions under a Shared Care Agreement. GPs are not legally required to accept these. If your GP refuses, you might be stuck getting your medication via the RTC provider long-term, which can sometimes cause logistical delays. It is always wise to ask your GP upfront if they accept shared care from your chosen provider.
2. Emerging Local Restrictions
Because of the massive influx of patients using Right to Choose, some regional Integrated Care Boards (ICBs) have begun attempting to restrict funding or introduce central triage screens. While some of these local hurdles are legally questionable, it means you should check with your chosen provider to ensure your specific local area is currently being accepted.
The Takeaway
You do not have to sit silently on a five-year waiting list while your mental health, education, or career suffers. Right to Choose is your legal right to demand faster, NHS-funded care. Gather your evidence, print off your provider's pack, and book that GP appointment.