ADHD & Autism (ASD) Assessment Pathways

 

BACK TO MAIN INDEX

 

Information for Parents, Carers and Patients

We understand that seeking an assessment for ADHD or Autism Spectrum Disorder (ASD) can feel overwhelming. This page explains the referral options available through the NHS, including both local NHS services and the NHS Right to Choose pathway. It also outlines what our practice can and cannot provide during and after assessment.

 

NHS Local Referral Pathway

Your GP can refer you or your child to local NHS specialist services for an ADHD or ASD assessment.

What to expect

Screening questionnaires will usually be required before referral.

Waiting lists for local NHS services can be very long, especially for children.

Assessments are completed by local NHS clinicians, and any recommended treatment and prescriptions remain within local NHS services.

Shared Care

If local NHS services diagnose ADHD and recommend medication, they may offer a Shared Care Agreement (SCA) with the practice. We can usually accept these shared care arrangements, provided:

  • The diagnosis and treatment plan come from a local NHS specialist service,
  • Appropriate monitoring is carried out by the specialist team, and
  • A formal Shared Care Agreement is issued and signed.
 

NHS Right to Choose (RTC) Pathway

Under NHS regulations, patients in England can choose an approved provider for ADHD or ASD assessment using the Right to Choose pathway. This includes providers such as Psicon, Psychiatry UK, Clinical Partners, and others.

You do not need to pay privately — these assessments are NHSfunded.

Understanding Right to Choose Referrals

Many people are unaware that they can select which NHSfunded provider carries out their mental health assessment. If local waiting times for ASD or ADHD assessment are very long, Right to Choose (RTC) allows you to choose another approved provider.

Although the scheme was introduced in 2018, it remains unfamiliar to many patients and families.

Who Can Provide Right to Choose Assessments?

Several clinics across England offer ADHD and/or ASD assessments via Right to Choose. To qualify, a clinic must:

  • Provide the same service directly to an NHS organisation in England, and
  • Hold a contract enabling them to accept Right to Choose referrals.

Providers that operate exclusively as private clinics cannot offer Right to Choose assessments.

The list of eligible providers changes over time. Please check:

Choosing a Right to Choose Provider

Our GPs cannot select a provider on the patient's behalf. Patients must:

  • Research their options.
  • Choose a provider that meets their needs.
  • Inform the practice of their choice so that we can advise on the next steps.

Things to Be Aware of With Right to Choose

Providers offering Right to Choose assessments vary in what they deliver after diagnosis:

  • Some offer a diagnosis only.
  • Some offer diagnosis plus medication titration.
  • Some offer diagnosis, titration, and longer term followup.

If a provider does not offer titration or medication prescribing, you will still require a referral to local NHS services for post diagnostic support—this usually involves a waiting list.

When Right to Choose Cannot Be Used

You are not eligible for Right to Choose if:

  • You need urgent or emergency care
  • You are already receiving treatment for the condition being assessed
  • The provider cannot offer appropriate care for your needs
  • You are in prison or certain secure settings (including secure hospitals or detained under the Mental Health Act)
  • You are currently serving in the armed forces
 

Diagnosis and Follow-up

Most RTC providers operate remotely and conduct online assessments.

NHS services may not accept these diagnoses, and additional assessments may be required before transitioning into NHS care.

The RTC provider is responsible for arranging any transfer of care into the NHS. Some providers claim they cannot do this, but this is incorrect and leads to unnecessary delays and additional work for our team.

Prescriptions and Shared Care Agreements

If an RTC provider diagnoses a patient with ADHD, they may recommend medication. However:

  • ADHD medications are specialist-prescribed drugs, meaning GPs cannot routinely prescribe them.
  • The prescribing responsibility remains with the specialist service.

RTC providers may request a Shared Care Agreement After a review of capacity, clinical workload and safety requirements, the practice has taken the decision not to accept Shared Care Agreements for ADHD medication initiated via the Right to Choose pathway.

This applies to all RTC providers and all new requests.

Why we cannot accept these Shared Care Agreements

The monitoring and prescribing of ADHD medication requires specialist expertise and significant clinical capacity.

The volume of requests has increased substantially, and the practice does not have the resources to safely provide this level of ongoing monitoring.

We must prioritise services that fall within core general practice responsibilities.

This decision is not based on:

  • The patient’s diagnosis,
  • Social circumstances,
  • Age, or
  • The provider used.

It is a practicewide policy based on capacity and patient safety.

Patients should consider this before choosing a provider and ensure their RTC provider will continue prescribing any recommended medications.

 

Next Steps for Patients

  • Step 1: Patient/Carer contacts practice with an enquiry about ADHD or ASD.
  • Step 2: We will send the patient a questionnaire by text/email to complete and return, this will include a link to practice website for more information on ADHD and ASD Assessment pathways.
  • Step 3: Practice will action referral to patient’s chosen provider.
 

Summary: Key Points to Consider Before Choosing an RTC Provider

Choosing a provider

  • Patients must research and select their own provider. A good starting point is ADHD UK.

Referral process

  • We will send a questionnaire by text/email to collect necessary details.

Diagnosis acceptance

NHS services may not accept RTC diagnoses without reassessment.

NHS transfer responsibility

  • The RTC provider must arrange any transition into NHS care. Some may claim they cannot, but this is not true.

Prescriptions

  • Our GPs cannot routinely prescribe ADHD medication. Prescriptions remain the responsibility of the RTC provider.

Shared Care Agreements

  • We are not entering into a Shared Care Agreement due to patient safety concerns and service continuity risks.
 

Frequently Asked Questions

Can the practice make an exception to shared care policy?

We are unable to offer individual exceptions, as the policy applies equally to all patients to ensure fairness and patient safety.

Can I appeal the decision?

There is no appeals process for this specific policy. You may, however, raise general feedback through our usual complaints or feedback procedure.

Can I transfer care to local NHS services later?

This may be possible in some cases, but it depends entirely on the local specialist team and their capacity. You will need to discuss this with the provider who completed the assessment.

Why Consider Right to Choose even if Medication May Be Hard to Access?

For many people, receiving a formal diagnosis is enough to unlock support at school, in the workplace, or through other services. Others may find they can managed their conditions without medication altogether, making the assessment itself the most valuable part of the process.