Right to choose means you can pick a healthcare provider which is funded and contracted by the NHS for your first appointment, as long as your GP or another designated professional agrees that a referral is clinically appropriate. Patients cannot self-refer to a Right to Choose provider. The right to choose does not apply in all situations.
There is more information about Right to Choose on the NHS website.
Patient choice is at the heart of the NHS. The significant increase in waiting lists for autism and ADHD assessments means that many more people are selecting a provider under their legal Right to Choose (RTC).
This means they are opting to be referred to independent providers, contracted and paid for by the NHS. Therefore, waiting times for all providers (NHS and independent) are now getting longer.
Information will differ slightly depending on whether you are seeking a referral or treatment for an adult or a child or young person.
NHS Kent and Medway has commissioned local services for autism and ADHD but we recognise people may wish to choose an alternative NHS-funded provider through Right to Choose.
If a GP, health visitor, school or any other professional is making a referral for an ADHD or autism assessment, they should discuss Right to Choose with parents and carers.
It is important to consider if an independent provider under Right to Choose is the right option or not as some providers will not meet the child's or family's needs.
From 1 April 2025, all referrals for adult ADHD assessments, diagnosis, prescribing and titration (the process that introduces your body to medication safely and establishes an effective dosage), as well as autism assessments, fall under RTC, in line with new procurement legislation.
The following have been evaluated and are the contracted Right to Choose (RTC) providers for adult ADHD assessment and treatment services in Kent and Medway.
The following also provide autism services, as well as ADHD.
Sinclair-Strong is also commissioned to deliver diagnostic assessment and treatment services for those with complex needs, including those who have intellectual disabilities and/or co-occurring moderate to severe mental health conditions.
The accreditation process is ongoing as providers can apply for accreditation at any time so the list of contracted providers will continue to be added to.
Your GP can help you choose the most appropriate provider based on your clinical needs and the options available.
You may find it useful to read the information about RTC providers at ADHD UK's Right to Choose information.
All referrals for autism assessment must be sent to Kent Community Health NHS Foundation Trust (KCHFT) to clinically screen/triage. This is to ensure that patients' needs are met appropriately and that referrals made are clinically appropriate for assessment.
If you are referring for an autism assessment, send the paperwork to KCHFT. Further information can be found on the Adult Autism Triage Service.
You can complete the Adult Neurodevelopmental Autism Triage Service Form.
If you are unable to complete an online form and do not have alternative means to make the referral, please email kentchft.adultautismtriage@nhs.net.
If you are referring for an ADHD assessment or medication review, send the paperwork to the RTC provider the patient has chosen.
Information on how to refer can be found on the relevant provider's website.
PLEASE NOTE: This will change shortly and all adult ADHD referrals will be required to go through a central referral management screening process.
The first step is to visit the NHS website to see if Right to Choose is appropriate for you. You can then talk to your GP to find out if a referral is clinically appropriate.
As different providers provide different services, your GP will determine which provider is the most appropriate to refer to.
RTC may not be the best choice for you. For example, if you have complex needs and selecting RTC would mean your care would be split between too many providers. For those individuals, we have commissioned services from local NHS providers which your GP will be able to advise you of.
The NHS must stay free for everyone and decisions about care should be based on clinical need, not on whether someone can pay. Because of this, NHS rules say that NHS money must not be used to support private treatment.
This means you cannot mix private and NHS funding for the same stage of care (this is called “co funding”). If you choose to have private treatment, it has to be completely separate from any NHS care you receive.
In line with this national guidance, NHS Kent and Medway will only support shared care arrangements when the specialist provider is delivering an NHS commissioned service.
Find out more on mixing private and NHS treatment.
A Shared Care Agreement is an agreement between you, your GP practice, and your specialist care provider.
care is a formal agreement that enables your GP to accept responsibility for the safe prescribing and monitoring of specialist medicines, such as ADHD medications.
The Shared Care Agreement means that when the specialist provider has started prescribing your medicine, it can be continued by your GP practice, providing your condition is stable.
No, your GP is not under any obligation to undertake shared care so we would advise discussing this with your GP before a referral is made to a specialist provider.
For your GP to prescribe ADHD medicines, the provider will also need to support your GP with advice and guidance should there be a change in your condition or your response to the medication. The provider will also need to be able to provide ongoing monitoring as needed.
The GP will decide if a referral is clinically appropriate. A second referral will only be made if there is new evidence or symptoms that were not considered during the first NHS assessment.
If your GP thinks another referral is clinically appropriate, you can be referred again.
However, you should not be referred to more than one provider at the same time for the same condition.
Being on more than one waiting list can slow things down or disadvantage other patients - it is not a good use of NHS resources.
The full statement from NHS England is below.
Can patients exercise the legal right to choose the organisation and team who provides their elective care on more than one occasion for the same condition?
Yes, as described in Section 3 of the DHSC guidance the NHS Choice Framework provided the patient is not currently in treatment for the condition; or subject to one of the other exclusions, and the referrer (GP in this case) believes the referral to be clinically appropriate they can be referred. This applies to Physical & Mental Health, ADHD, Learning Disabilities and Autism which are all in scope of the choice regulations.
However, it is not expected clinical/operational practice to make more than one referral at any given time for the same condition. Regardless of the underpinning policy/regulation, it is hard to see how multiple referrals for one person to different providers is clinically appropriate, nor would it be a good use of NHS resources and being on duplicate waiting lists also has the potential to delay or disadvantage other patients.
There is no guarantee that your chosen provider will prescribe the treatment that you may need, and some providers will only diagnose.
However, all RTC providers accredited by NHS Kent and Medway will prescribe the treatment you may need.
As GP practices in Kent and Medway will not be able to start treatment for patients with ADHD, it is important to check the provider can start the medication, should it be needed. If the provider can prescribe, they should do so until your dose is stable.
After that period, the provider sends a Shared Care Agreement (SCA) to your GP to consider taking over regular prescribing. Your GP is not under any obligation to undertake shared care so we would advise discussing this with your GP before a referral is made.
For your GP to prescribe ADHD medicines, the provider will also need to support your GP with advice and guidance should there be a change in your condition or your response to the medication. The provider will also need to be able to provide ongoing monitoring as needed.
If you normally pay a prescription charge for medication, it will still apply with Right to Choose providers.
You can select any appropriate qualified provider across England, as long as the provider is commissioned by an Integrated Care Board to provide the service needed for you. ADHD UK regularly updates its list of providers for both ADHD and autism Right to Choose providers.
This includes NHS organisations as well as independent providers that are commissioned to provide a service to the NHS.
For adults, NHS Kent and Medway has a preferred list of accredited providers that meet our quality checks and service requirements.
Your GP can help you decide which provider is most appropriate for you, based on the service they offer.
There is lots of advice and information on this website that can support both adults and children and young people.