Right to Choose Autism & ADHD assessment FAQs.

Q1. What should an individual do if they think they might be autistic or have ADHD and want to talk to a professional about help, support, and assessment?

The individual should make an appointment to talk about their feelings with their GP or a referral specialist.

During the appointment, the professional should discuss all the options available, including support if applicable.

If an assessment isn’t appropriate or the individual decides not to go ahead, the professional will explain what other help and support options are available.

Q2. What does clinically appropriate mean, in terms of Autism/ADHD assessment?

This means that an individual referral meets the right medical, psychological, and developmental requirements for an assessment. This is based on set rules.

It usually includes:

  • Clear signs of ADHD or autism, based on official medical guides (like DSM-5 or ICD-11).
  • Difficulties in daily life, such as school, work, friendships, or taking care of themselves.
  • Checking the individual’s history to make sure there isn’t another reason for their symptoms.
  • A referral from the right professional, such as a GP.

For an ADHD or autism assessment, a GP will review the individual is clinically appropriate for an assessment.

Q3. What happens if it is clinically appropriate for the individual to be referred for an autism and/or ADHD assessment and the individual would like to have one?

During the appointment, the GP or professional should talk about all the choices the individual, or their carer, has. This may include their Right to Choose, which assessment service provider can help them and what support is available. To help the individual or carer choose, the professional should:

  • If the individual needs more time to decide which provider to choose, they should be given time to talk about it with family or friends before making a final decision.
  • Explain that they can choose who provides their care and when this choice applies.
  • Follow the National Institute for Health and Care Excellence (NICE) guidelines while talking about the individual’s specific situation.
  • Discuss how any new care might affect ongoing treatments, especially if the individual has other health issues.
  • Individuals can check if the potential assessment service provider offers care based on good evidence that meets their individual needs, including looking at recent reviews, ratings and waiting times online if available.
  • Discuss requirements for face-to-face appointments or consider online options for individuals 7years and over.
  • Discuss requirements for transitions from children to adult services.
  • Discuss how ongoing care after the referral might impact the individual, for example understanding the process for shared care and what would happen if shared care was not available. 
Q4. When would Right to Choose for autism or ADHD assessments apply for individuals?

  • Clinical approval: A GP agrees an ADHD or autism assessment is clinically appropriate. Each individual has the right to choose a provider that offers this service under NHS funding.
  • Approved provider: The chosen provider must be NHS-approved, with a contract via an Integrated Care Board (ICB) or NHS England. (Devon ICB contracted providers are listed in the Devon Formulary ADHD & Autism FAQ – South & West.). The current list of Devon ICB Contracted providers are available on the Devon Formulary ADHD and Autism FAQ – South & West.
  • GP registration: The individual is registered with a GP in England (RTC does not apply in Scotland, Wales, or Northern Ireland).
  • Waiting times: NHS waiting times exceed 18 weeks, including cases where RTC has not yet been offered and the person is already on a waiting list.
  • Provider choice: GPs may not supply a list of assessment providers. Individuals may need to research options themselves, using supporting information where available.
  • No IFR needed: An Individual Funding Request is not required.
Q5. When does the Right to Choose not apply for people wanting an autism/ADHD assessment?

Right to Choose does not apply to ADHD or Autism assessments when:

  • The individual has already had an ADHD or Autism assessment, regardless of outcome.
  • They are an active member of the armed forces.
  • The individual is already receiving care and treatment for their condition.
  • They are using urgent, emergency, or crisis services.
  • They are a prisoner, temporarily released from prison, or held in a special facility (like a court, secure children’s home, or young offender’s institution).
  • They are held in a hospital under the Mental Health Act 1983.
Q6. If I have already been referred to a local NHS provider and I am waiting for an appointment, can I also be referred to a Right to Choose assessments provider?

In some circumstances the individuals GP may refer the individual to a Right to Choose assessment provider, for example if the wait times are shorter.  However, once the individual has had an assessment with a Right to Choose assessment provider, they cannot also have an assessment with the Local NHS provider.

If an individual is also on an NHS Local Provider waiting list, such as DPT & LSW, they will not automatically be removed if a referral is then made by the GP to a Right to Choose assessment provider.

When the NHS Local Provider gets in touch with you regarding an appointment or during routine waiting list management, the individual should inform them the appointment is no longer required, or you can let them know sooner by calling directly.

Q7. Should my GP refer me to the provider I choose?

Yes, as long as the referral is:

  • Clinically appropriate, and
  • The service is led by a named consultant or healthcare professional.
  • The provider has a current NHS Standard contract with the right organisation for the service needed.
  • The service is for the correct age group of the individual.
  • The service is delivered in an appropriate way. For example, face to face for children under 7 years of age.
Q8. Is approval from a commissioner needed for a referral under the ‘Right to Choose

No, prior approval from a commissioner or Integrated Care Board (ICB) is not needed if the following criteria are met:

  • The individual is getting a GP referral for their first appointment.
  • The referral is clinically appropriate.
  • The assessment service provider and team are led by a consultant or a mental healthcare professional.
  • The assessment service provider has a contract with an ICB, or NHS England for the service needed. The current list of Devon ICB Contracted providers are available on the Devon Formulary ADHD and Autism FAQ – South & West.
Q9. How will an individual know which assessment service providers they can choose?

Choosing the right service for an Autism and/or ADHD assessment is an important decision. 

There are some things to think about or to find out when you are choosing a service.

All NHS Devon Contracted Right to Choose Providers are listed on the Devon Formulary: ADHD and Autism FAQ – South & West.

These are listed in Alphabetical order and will have varying wait times and availability of virtual or face to face appointments. Look at their websites and do your own research as this is not something your GP will be able to help with.

Once you have decided on the provider you can inform the GP which provider you would like to be referred to.

The GP will need to check that the service you have chosen meets the NHS criteria before they can refer you. If they don’t meet the criteria you will have to choose a different provider. You can discuss this with your GP.

Q10. How do Children and Young people assessments differ to Adults, including transitions and medications.

Individuals are classed as an adult on their 18th birthday.

ADHD

Children must be 7 years or above to be referred for an ADHD assessment. ADHD assessments can be completed virtually or face to face.

AUTISM

Children under 2 years old cannot be referred to Right to Choose assessment providers.

Children between the ages of 2 and 7 years old must be assessed face to face.

Children between 2 years old and 5 years old must be assessed by a paediatrician. Some Right to Choose assessment providers have paediatricians, some do not.

Where individuals are likely to transition between children’s to adults services around the time of referral and assessment, research into Right to Choose assessment providers ability to meet these requirements is helpful.

Questions below here are only applicable for ADHD

Q11. What is a shared care agreement?

A shared care agreement is an arrangement between the assessment service provider the individual has chosen for their ADHD assessment and their GP. This is needed when the individual is on medication prescribed by a specialist, and they are to receive on-going prescriptions from their GP.

The individual should be under the care of the Right to Choose assessment service provider and could have appointments/reviews as required.

If the GP and the service provider agree to share care, the GP will write prescriptions and check on the individual as described in the shared care agreement.

The GP does not have to agree to a shared care arrangement. In these circumstances, the individual will remain under the care of the assessment service provider.

NHS Devon ICB contracted Right to Choose ADHD providers all provide end to end services, including titration, diagnostics and ongoing medication and reviews as applicable. These are on the first part of the formulary: ADHD and Autism FAQ – South & West.

If the Right to Choose provider has started the ADHD medication it is their responsibility to prescribe it. They are also responsible for keeping track of the patient’s progress until the dose is stable and the GP decides about shared care. This should follow local or national shared care guidelines. The Right to Choose provider is responsible for all applicable health checks, such as heart history, heart rate, blood pressure, weight, and ECG (if needed).

Q12. Will I need more care or prescriptions from the assessment service provider in the future?

Yes, if you are taking ADHD medication.

Shared care means that both your Right to Choose assessment service provider and your GP work together to look after your health.

The Right to Choose assessment service provider should check on you at least once a year.

Q13. What happens if I change GP practice? Such as moving to a new area?

If you change GP practice, the Right to Choose assessment service provider must write to them and ask if they can enter shared care. Your old GP might help by asking the new GP too. If the new GP doesn’t agree, the Right to Choose assessment service provider will need to keep looking after you and giving you your medicine and prescriptions. If you are moving GP practice, please inform your Right to Choose assessment service provider promptly.