NHS Right to Choose: What UK Parents Actually Need to Know

Most parents I speak to don't know about NHS Right to Choose, and most parents who do know about it are using it wrong. That isn't their fault. The information is buried, the language is dense, and the local NHS teams sometimes act as though the right doesn't exist. But it does, and for families stuck on a long waiting list, it is one of the most powerful tools in the UK system.

Here is what it is, who it applies to, and how to actually use it.

What Right to Choose is

In England, the NHS Constitution gives patients the right to choose where they receive their first outpatient appointment for almost any non-urgent referral. That includes referrals to community paediatrics, ADHD assessment services, autism assessment teams, speech and language therapy, and CAMHS. The right exists in legislation. It is not a favour your GP can decide whether or not to grant.

The detail that most parents are never told: the provider you choose does not have to be the one your local Integrated Care Board normally commissions. As long as the provider is qualified, has an NHS contract for that service, and is in England, you can ask to be referred there.

This is what makes it powerful. If your local CAMHS has a three-year waiting list and a provider in another part of the country has a six-week wait under an NHS contract, you can ask your GP to refer to that other provider, and it is still NHS-funded. You don't pay. The waiting list barrier dissolves.

Who qualifies

The right covers most non-urgent referrals for adults and children in England, with a few specific exceptions (urgent or two-week-wait cancer pathways, maternity services, some mental health crisis pathways, prison healthcare, and a small number of others). For SEND-relevant services, the right applies to:

ADHD assessment
Autism assessment
Community paediatrics
Speech and language therapy
Mental health services through CAMHS, including talking therapies
Some occupational therapy referrals where commissioned

Wales, Scotland, and Northern Ireland have different systems and Right to Choose does not apply outside England. If you are reading this from outside England, the equivalents are limited and worth a separate conversation with your local team.

How it works in practice

The mechanism is straightforward, but the conversation with your GP often is not. The script that works:

You say: "I'd like to use my Right to Choose under the NHS Constitution to be referred to [provider name] for [service]. They have an NHS contract for this service."

If your GP isn't sure whether the provider qualifies, it is reasonable to ask them to check. Most NHS-contracted private providers maintain a published list of the conditions under which they accept Right to Choose referrals, and many will email a one-page guide directly to the GP if you put them in touch.

The referral is sent in the normal way through e-Referral Service (sometimes called Choose and Book). You select the provider in the system rather than the local default. Your GP cannot refuse the request because they prefer the local service, because they think the local service is fine, or because the wait is shorter than the local one. The right is yours, not theirs, to exercise.

If the GP pushes back, the most common reasons are misunderstanding rather than refusal. They may say "we don't usually do that" or "we send everyone to the local team". Polite persistence usually resolves it. If it doesn't, you can ask to speak to the practice manager, or you can submit the referral request in writing so there is a paper trail.

What providers actually offer

The set of NHS-contracted providers who accept Right to Choose referrals for SEND services has grown significantly since 2020. The reason is policy: as NHS waiting lists for ADHD and autism assessments hit historic levels, the system started commissioning more independent providers under NHS contracts to absorb the backlog.

Typical waits at Right to Choose providers as of early 2026: ADHD assessment for children, six to twelve weeks from referral to first appointment depending on provider; autism assessment for children, four to eight weeks for triage and longer for the full multi-disciplinary assessment; CAMHS-equivalent talking therapy, two to six weeks for assessment.

Compared to the local NHS waits in most parts of the UK, which run from eighteen months to three years for autism and two to four years for some CAMHS pathways, this is transformational. The CQC reported in 2023 that children referred for autism assessment in England were waiting an average of more than three years from referral to diagnosis. Right to Choose is the explicit reason that average is not even worse.

What it isn't

A few things to clear up that get parents in trouble.

Right to Choose is not the same as paying privately. A private assessment paid out of pocket is a different route, faster still, and not bound by NHS commissioning rules. Right to Choose is NHS-funded. You don't pay. The provider invoices the NHS.

Right to Choose does not give you a free second opinion if you've already had an assessment elsewhere on the NHS. It applies to first referrals, not to redoing an assessment because you didn't like the answer.

Right to Choose also doesn't override local pathways for ongoing treatment. The right is for the first outpatient appointment. After diagnosis, follow-up care often goes back to the local NHS team. That is sometimes a problem, and worth understanding before you start, but it doesn't stop the diagnostic process.

And finally: Right to Choose is not a guarantee that the provider will accept your child. Some providers have age limits, some only assess specific conditions, and some have closed waiting lists from time to time when demand spikes. You may need to call two or three before finding the right fit.

Why parents miss it

Most parents I speak to didn't hear about Right to Choose from their GP, their school, or even their local autism support group. They heard about it from another parent, usually after months of being told there was nothing more that could be done. That gap matters. Children who could be assessed within weeks are instead waiting years because nobody told the family the option existed.

This is partly a knowledge problem and partly a system one. GPs are not trained on every patient right in detail. Local NHS commissioning teams do not always advertise that referrals can leave their region. And the providers who accept Right to Choose, being independent, can't market directly to NHS patients in the way local services do.

The result is a quiet inequity. Families who are connected, who know how to research, who have time to push, find the route. Families who don't, often wait for years.

What to do next

If you are currently on a waiting list for an ADHD assessment, an autism assessment, speech and language therapy, or community paediatrics, and the wait is more than six months, look at Right to Choose. Read the providers' eligibility criteria. Pick one whose waits and approach suit your child. Then ask your GP for the referral.

If your GP is willing but unsure, the providers themselves usually have a clear one-page guide for GPs that explains the contract terms. Ask the provider to email it across. Most do this within a day.

If you would like to talk to a specialist about whether assessment is the right next step for your child before you start the Right to Choose process, you can browse our vetted UK assessors directly. Many of them work both privately and under NHS contracts and can talk you through both routes honestly.

You don't need to wait two years for your child to get answers. The system is more flexible than it looks, but only if you know which lever to pull. This is one of them.

NHS Right to Choose: What UK Parents Actually Need to Know | ChildWize