NHS Right to Choose / Patient Choice

The NHS Right to Choose, also called Patient Choice, is a legal entitlement that puts you in control of your care. You can ask to see any NHS commissioned provider for your first outpatient referral - and once you're with that provider, they'll typically continue your full pathway of care (assessments, treatment, and follow-ups) unless clinical reasons suggest otherwise.

We'll use the term ‘Right to Choose' throughout for clarity.

Understanding Your Rights

If your GP agrees you need a referral for a physical or mental health issue, you generally have the legal right to choose which NHS approved service delivers your care. This includes ADHD assessments and related services.

Once referred under your Right to Choose, you normally remain with that provider for the entire episode of care for that condition - not just the first visit.

How Right to Choose Works

To use your Right to Choose:

• Your GP must refer you for a consultant-led outpatient appointment
• You select a provider that holds an NHS contract for your required service (i.e. ADHD Assessment / Diagnosis)
• For mental health referrals, the service must be led by a consultant or another qualified mental health professional

NHS England explains that this right applies at the point of referral for a first outpatient appointment and any subsequent treatment that may be required, unless there is a significant change in diagnosis or a clinical reason to switch provider.

The NHS 18-Week Standard

Additionally, under the NHS Constitution, you have the right to start consultant-led treatment within 18 weeks of a GP referral (unless you choose to wait longer, or a clinician advises otherwise).

If your local service cannot offer treatment within this timeframe, you can use your Right to Choose to ask your GP for a referral to another NHS approved provider that may be able to see you sooner.

When Right to Choose Might Not Apply

• If you're already receiving care for the same condition - the Right to Choose resets only with a new episode of care or after discharge
• If you need emergency or urgent care (e.g., urgent cancer diagnosis), Right to Choose typically does not apply
• If you're detained under the Mental Health Act, serving in the armed forces, or remanded in custody, this right may not apply
• If your diagnosis changes significantly during your care, your treatment plan may need to be reviewed and managed by a different NHS provider

If You're Not Happy with Your Provider

If you have concerns about your provider once your care has started, you should speak with your GP in the first instance. In some cases, it may be possible to request a transfer or seek a second opinion, but this is handled separately from the Right to Choose pathway.

MHWS and Right to Choose

While everyone has the legal Right to Choose, we currently accept referrals only from Integrated Care Boards (ICBs) where we hold NHS contracts. This approach allows us to:

• Maintain high care standards
• Manage capacity effectively
• Ensure timely access to assessment and treatment
• Meet our commitments to NHS commissioners

We are a trusted NHS commissioned provider with the credentials to deliver services under the Right to Choose (RTC) pathway.

Of particular note - for many patients we are able to start the medication process from the point of assessment - if medication is chosen and agreed as clinically appropriate. Unlike some services that separate diagnosis and treatment with additional waiting lists, we aim to provide timely access so that you can begin experiencing its benefits as soon as possible.

At present, we provide ADHD assessment and treatment services under NHS contract for patients registered with GPs in the Shropshire, Telford and Wrekin ICB area.

We know access matters, and we are working to expand availability. This page will always show the ICB s we hold contracts with, so if your area isn't listed now, please check back for updates.

All our RTC services are delivered by qualified clinicians in line with NHS standards and NICE guidelines, ensuring the same quality of care you'd expect in any NHS setting.

If you're registered with a GP in one of our contracted ICB areas and would like to exercise your Right to Choose, the next steps are simple and outlined in ‘Getting Started' below:

Getting Started

If you're eligible and live in one of our contracted ICB areas:

1. Speak with your GP about using Right to Choose / Patient Choice
2. Request a referral to our service under this pathway
3. Your GP completes the referral
4. We'll contact you once it's received and arrange next steps

Need More Information?

• NHS Patient Choice Guide: Find details about when you're entitled to choose where to go for care and information on raising concerns if you aren't offered choice: NHS Choice Framework - what choices are available to you in your NHS care
• NHS England's Patient Choice Guidance: Clarifies how the Right to Choose applies to outpatient referrals and continued treatment: NHS Patient choice guidance
• Visit the NHS website on patient choice or email NHS England's Choice team: england.choice@nhs.net
• Consult your GP or local ICB for region-specific information

Right to Choose Frequently Asked Questions (FAQ)

Can my GP refuse to refer me under Right to Choose?

Your GP should support your legal right to choose. They may only refuse if the referral is not clinically appropriate, or if the service you request does not hold a valid NHS contract.

Can I use Right to Choose more than once?

You can only use Right to Choose once for each episode of care. If you are already receiving treatment for the same condition, you would usually need to complete that care before requesting a new referral.

Does using Right to Choose affect my relationship with my GP practice?

No. You remain registered with your GP as normal. Your GP will continue to provide your general healthcare, while the chosen provider delivers the specialist assessment and treatment for your condition.

What if I'm not happy with the provider I chose?

If you have concerns after your care has started, speak with your GP. In some cases, it may be possible to request a transfer or seek a second opinion, but this is separate from the Right to Choose process.

Does Right to Choose apply everywhere in England?

Yes, if the provider has an NHS contract for the service you need. However, not all providers hold contracts with every ICB . Our own services are currently available only to patients registered in areas where we have existing NHS contracts.

What types of care are excluded?

Right to Choose does not apply to:

• Urgent and emergency care
• Maternity services
• Services commissioned by local authorities (such as social care or public health)
• Care provided in secure settings (e.g. prison health services)
• Care under the Mental Health Act or for serving members of the armed forces