Right to choose

In England, individuals accessing mental health services through the NHS now possess a statutory entitlement to select their mental healthcare provider and the specific team involved in their care.

 

This significant provision empowers individuals to seek alternative options if, for example, the waiting period for an ADHD assessment is deemed excessive. It's important to note that the chosen provider must offer their services to the NHS within England. A list of currently known providers is maintained and regularly updated.

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The "Right to Choose" in mental health is a relatively recent development, having been introduced in 2018. Consequently, awareness of this option and its implementation may vary among patients, general practitioners, and other healthcare professionals. Detailed information specifically for individuals undergoing the ADHD assessment process is available below.

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To understand how the Right to Choose integrates into the diagnostic pathway, please click here. Additionally, a downloadable support letter is available for individuals whose GP may have initially refused their request.

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Further comprehensive details can be found via the NHS website on NHS Choices, accessible through the following link:

https://www.nhs.uk/using-the-nhs/about-the-nhs/your-choices-in-the-nhs/

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The Right to Choose empowers patients under specific circumstances:

• The patient's NHS general practice must be located in England (different regulations apply in Scotland, Wales, and Northern Ireland).

• The patient's General Practitioner must agree that an outpatient referral is clinically appropriate. It's important to understand that the GP's decision to make a referral is separate from the Right to Choose. The Right to Choose grants the patient the authority to decide where that referral is directed.
   

While designed to provide broad patient choice, certain limitations exist regarding the Right to Choose. Patients cannot utilize this right if they are:

• Currently receiving mental health treatment following a non-emergency referral for the same condition.

• Being referred to services commissioned by a local authority, such as drug and alcohol services (unless these are commissioned under a Section 75 agreement).

• Accessing urgent or emergency (crisis) mental healthcare.

• Receiving services through a primary care contract.

• Under the care of high secure psychiatric services.

• Detained under the Mental Health Act 1983.

• Confined in a secure setting, which includes individuals in or on temporary release from prisons, courts, secure children’s homes, specific secure training centers, immigration removal centers, or young offender institutions.

• Serving members of the armed forces (it's worth noting that family members residing in England have the same rights as other English residents).
   

Furthermore, there are restrictions on the healthcare provider a patient can choose. The selected provider must:

• Hold a commissioning contract with any Clinical Commissioning Group (CCG) or NHS England for the required service.

• Have the relevant service and team under the direction of a consultant or a mental healthcare professional.
   

Common questions raised by GPs include:

• Is an Individual Funding Request (IFR) necessary? No, it is not.

• Does the CCG need to grant permission? No, it does not.
   

For clarity, it is our firm understanding, supported by the experiences of numerous individuals, that ADHD assessments fall under the scope of the Right to Choose.