NHS Right to Choose: what it means, who you can choose and what to check.

What is NHS Right to Choose?

The NHS Choice Framework gives patients in England legal choice rights for certain first outpatient referrals. For mental-health referrals, NHS England says the choice can include any clinically appropriate provider holding a qualifying NHS Standard Contract for the service the patient needs. The right normally applies at the point of referral and can include subsequent treatment required as a result of that referral, subject to the rules and exceptions.

The referring clinician decides whether the referral and proposed provider are clinically appropriate. That is different from saying a patient can simply pick any clinic, or that every provider must offer every part of an ADHD or autism pathway.

The current Kent & Medway position

NHS Kent and Medway currently tells patients that Right to Choose remains available for ADHD and autism where the national rules apply. For adults, it publishes a local list of evaluated contracted providers for ADHD assessment/treatment and providers offering autism as well as ADHD. The list can change as accreditation continues.

For adult autism, NHS Kent and Medway currently says referrals should go through the Kent Community Health NHS Foundation Trust triage route before the chosen provider. For adult ADHD, its current page says referrals go to the chosen provider, while also warning that a central screening process is due to be introduced. Always check the live NHS page before sending a new referral.

How to choose a Right to Choose provider

There is no single “best” provider for everyone. Compare the service against the person's actual needs before asking a GP to refer.

Right to Choose provider comparison

Kent & Medway adult contracted providers

NHS Kent and Medway currently lists the following providers as evaluated/contracted for adult ADHD assessment and treatment, with several also providing autism services.

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Other England-wide RTC providers worth checking

The national right is not limited to a local preferred list: where the legal choice rules apply, NHS England says a patient may choose another clinically appropriate provider with a qualifying NHS Standard Contract for the service required. These examples are useful because their service models differ.

Can a GP refuse a Right to Choose referral?

The referrer is responsible for deciding whether referral and the proposed service are clinically appropriate. If the GP considers referral inappropriate, ask what clinical information or reason the decision is based on. If referral is considered appropriate but the requested provider is still not being used, ask whether the issue is provider eligibility, age, service scope, referral process or another specific reason.

A blanket statement such as “we do not do Right to Choose” is not the same thing as an individual clinical decision. NHS England says commissioner prior approval is not required where a patient is exercising a legal right to choice and the rules are met.

GP refusing or delaying RTC? Work through it →

Before changing provider

• Ask the current service to confirm your referral status and whether your place is protected.
• Check the new provider's current ICB-specific position, not just its national waiting-time headline.
• Confirm age range, condition, referral forms and clinical exclusions.
• For ADHD, confirm assessment, titration, prescribing, annual review and shared-care arrangements separately.
• Only cancel an existing route once you understand what the change actually does.

What happens after an ADHD or autism assessment?

An assessment outcome is not the same thing as an ongoing treatment package. For ADHD in particular, assessment, medication titration, ongoing prescribing, annual review and shared care can be separate stages with separate waiting lists or responsibilities.

NHS Kent and Medway states that a GP is not obliged to accept a shared-care agreement. That makes it sensible to ask about the provider's prescribing and follow-up arrangements before referral rather than discovering the problem after diagnosis.

If your RTC referral is delayed, rejected or unclear

The right escalation depends on which of those is actually happening. Ask for the decision in writing and avoid arguing about “funding” in the abstract until you know who made the decision and why.

What In Your Corner can do

• Read GP, provider and ICB correspondence and identify what has actually been decided.
• Help compare provider/service scope before a family changes pathway.
• Help separate clinical-appropriateness questions from provider capacity or commissioning problems.
• Help formulate focused questions, organise professional evidence and use the appropriate complaint/review route where needed.
• Help parents in Kent & Medway keep a clear record of referral dates, provider status and unanswered questions.

We do not select a provider for a family, guarantee RTC eligibility, tell a clinician to make an inappropriate referral or promise that any provider will be faster.

Common Right to Choose questions