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Right to Choose restrictions

aliphil

Hi, 

I'm new here and in need of advice. I've been pretty sure for a while that I'm autistic (since my now-teenage daughter started the assessment process about six years ago) and suspect also ADHD. During an appointment with an NHS mental health person a few weeks ago, I told him this and he asked questions and did bits of the questionnaires with me and agreed it's likely. He gave me the full questionnaires to complete and send back to my GP, and told me I'd be able to get an assessment through Right to Choose. 

I've now had a response from my GP, and apparently I'm only eligible for Right to Choose if I fit certain criteria - referred by a safeguarding team, referred through legal proceedings, struggling to manage long-term physical health condition, struggling with education, or repeated loss of employment due to symptoms. And I have to provide "written evidence from a suitable authority".

Has anyone come across this before? I thought Right to Choose only depended on where you live. The only one I might fit is physical health, but I'm afraid "sometimes don't manage to take my medication" won't be enough. Are mental health difficulties likely to count if they lead to physical consequences (depression with self-harm)? I don't know what to do, and if I don't get this then it's a multiple-year waiting list.

  • in reply to Bunny

    Thank you for such detailed answers! Unfortunately you are right, my surgery does fall under an ICB but I didn't know what that meant - in fact it falls under Frimley, so probably not even any point checking with the GP! (I will check anyway, but without any optimism. Based on most of my previous dealings with the NHS, they'll tell me I'd be fine if only I'd lose weight. The mental health person I mentioned in my post was the first person not to do that.)

  • aliphil said:
    Are mental health difficulties likely to count if they lead to physical consequences (depression with self-harm)? I don't know what to do, and if I don't get this then it's a multiple-year waiting list.

    To continue on from my previous reply, this part of your question will likely also be answered via your Integrated Care Board's policy, so I suggest checking with your GP.

    In the case of Frimley (which, as explained in my previous reply, imposes the same restrictions on RTC referrals), the answer would be no, as explained here:

    Frimley ICB - Adult ADHD / Neurodivergence (over 25s) Right to Choose Access Criteria

    "Restatement of Established Position: Clients with suspected mental health co-morbidities:

    Clients who present to GPs with significant mental health comorbidities (those associated with clinical risk or causing significant impairment, or any current moderate to severe condition, or any history of an SMI) alongside neurodivergent traits should be considered as more complex cases which are not suitable for referral to RtC providers.

    Such cases should be referred to the local mental health Trusts (via BHFT’s Common Point of Entry, or SABP’s Single Point of Access, depending on geography) for a holistic assessment, which can include consideration of neurodivergent traits."

    NHS Frimley ICB - Adult ADHD / Neurodivergence (over 25s) Right to Choose Access Criteria

  • Hi and welcome to the community.

    aliphil said:
    I've now had a response from my GP, and apparently I'm only eligible for Right to Choose if I fit certain criteria - referred by a safeguarding team, referred through legal proceedings, struggling to manage long-term physical health condition, struggling with education, or repeated loss of employment due to symptoms. And I have to provide "written evidence from a suitable authority".

    Very unfortunately, it seems that your GP surgery falls under an Integrated Care Board (ICB) that has imposed stricter criteria on Right to Choose referrals for autism and ADHD.

    An example of this can be seen here, at Lightwater GP Surgery, which has imposed the same restrictions that you described:

    NHS - Lightwater Surgery - Right to Choose criteria for over 25s

    This has been done at the direction of the surgery's ICB, which advised last year:

    "Right to Choose Access Criteria for Adult ADHD/Autism Diagnostic Assessments (Aged 25+)

    Due to increased demand, NHS Frimley has implemented new thresholds for Right to Choose services for adults aged 25 and over. This ensures prioritisation of urgent cases, with specific referral criteria outlined for GPs."

    Frimley ICB Primary Care Bulletin - Oct 2025

    As the NAS article in  's reply below explains, a private diagnosis is still an option, subject to affordability:

    NAS - How to request an autism assessment > can I have a private assessment?

    The same applies in respect of ADHD (but beware of the importance of checking whether your GP will be willing to enter into a shared care agreement with any given private assessment provider in respect of medication, if needed - this can otherwise leave you also paying privately for any required, ongoing medication):

    ADHD UK - Adult diagnosis pathways  

  • Hello aliphil,

    Welcome to the community! Hopefully, members of this forum will be able to help you with their experience of dealing with Right to Choose, but in the meantime it might be worth reading NAS information about How to Request an Autism Assessment: https://www.autism.org.uk/advice-and-guidance/diagnosis/before-diagnosis/how-to-request-an-autism-assessment

    All the best,

    Karin Mod