Right to Choose for ADHD: what the new waits mean

On 24th September 2026, the Guardian reported that four NHS integrated care boards (ICBs) in England have set a minimum wait before anyone referred through Right to Choose can be assessed for ADHD or autism by an independent provider. In West Yorkshire it is two years from referral. In the North East and North Cumbria it is around 78 weeks, in Somerset 52 weeks and in Devon 14. Kent and Medway has decided to introduce one, and in all 15 ICBs, covering 19 million people, now limit these assessments in some way, whether by capping numbers or by prioritising the most urgent referrals (Bawden & Campbell, 2026). If your child is already on a Right to Choose list, or you were about to ask your GP to start one, this is what it means for you, whichever side of the border you live on. Some of the help your child may need does not have to wait for a diagnosis at all.

What Right to Choose is

In England, when a GP refers someone for a first outpatient appointment in mental health, that person has a legal right to choose any clinically appropriate provider holding an NHS Standard Contract for the service they need, and a team led by a named consultant or healthcare professional. The right comes from the NHS Standing Rules regulations, and NHS England's patient choice guidance confirms that ADHD and autism assessments are covered, including those delivered remotely (NHS England, 2023). This is how many families have reached an NHS-funded assessment with a provider outside their local service. The family does not pay. The ICB where the patient's GP is registered does.

What has changed this week

Because the ICB pays for every assessment, a rise in referrals lands directly on its budget. West Yorkshire told the Guardian its bill for independent ADHD and autism assessments rose from £7m in 2023-24 to £21m last year, and that a minimum wait is how it is managing that cost (Bawden & Campbell, 2026). The legal right has not been abolished. What a minimum wait changes is when an assessment through that route can begin. National policy may shift again soon. The government commissioned an independent review into mental health conditions, ADHD and autism, chaired by Professor Peter Fonagy, which published an interim report on 10th June 2026 (Department of Health and Social Care, 2026). Its final report is expected in early October (Bawden & Campbell, 2026). Rules that apply today may not be the ones in place by the time your child reaches the front of a list.

If you live in England

Rules differ from one ICB to the next and change often, so ask rather than assume. Ask your GP practice which providers your ICB currently accepts for Right to Choose referrals, whether a minimum wait or a cap applies, and whether the practice will agree to shared care prescribing if medication is recommended after an assessment. If the answer is that the practice cannot refer, ask whether that is the ICB's written policy, and ask to see it. Keep a note of dates, names and what you were told. Asking these questions is not being difficult. You cannot plan around a wait until you know which route your child is really on.

If you live in Wales

Right to Choose belongs to the NHS in England. There is no equivalent legal right in Wales, so none of this week's changes apply directly to a family in Wrexham or elsewhere in North Wales. NHS assessment for ADHD and autism in Wales goes through your local health board's neurodevelopmental service, which in North Wales means Betsi Cadwaladr University Health Board. If you live near the border and your GP practice is on the other side of it, ask the practice which country's arrangements apply to your child, because it is not always the one on your address.

What does not need a diagnosis

A proper ADHD assessment is a substantial piece of work. NICE says ADHD should only be diagnosed by a specialist psychiatrist, paediatrician or other appropriately qualified professional, after a full clinical and psychosocial assessment that covers behaviour across the different settings of a young person's life, and never on rating scales or observation alone (National Institute for Health and Care Excellence [NICE], 2019). That is worth waiting for. School support is not. In England, the SEND Code of Practice defines special educational needs by what a child needs, not by a label: a child has SEN if they have a learning difficulty or disability which calls for special educational provision, and schools are told to identify need at the earliest point (Department for Education & Department of Health, 2015). The Welsh law says the same thing in its own words: a learner has additional learning needs if they have a learning difficulty or disability, whether it arises from a medical condition or otherwise, which calls for additional learning provision (Additional Learning Needs and Education Tribunal (Wales) Act 2018). The anxiety, low mood, poor sleep and school avoidance that often come alongside undiagnosed ADHD or autism can be assessed and treated in their own right, now.

Using the wait well

Because a good ADHD assessment looks at behaviour across home, school and elsewhere, the most useful thing you can bring to it is specific, dated examples from more than one setting. Keep a short diary: what happened, where, what came before it, and how long it took your child to settle. Ask the school's SENCO or ALNCo to write down what staff see in class and at break, and keep copies of school reports. Where a child has behaviour difficulties and suspected ADHD, NICE also asks SENCOs to tell parents about local parent-training programmes while helping the child with their behaviour (NICE, 2019). Ask whether one runs near you. And be honest with your child about what is happening. A young person who knows they are waiting for an assessment, and why, usually copes better than one who senses that something is being talked about behind them.

Blip is a specialist mental health service for children and young people aged 7 to 25. We do not carry out autism diagnostic assessments. We do work with young people who are waiting for an ADHD or autism assessment, or who have one already, and whose anxiety, mood, sleep or school life is under strain in the meantime, and you do not need a diagnosis or a referral to start. If the wait ahead looks long, get in touch. One of our clinicians will talk it through with you and, if it would help, arrange an assessment of what is happening now with a named clinician.