Right to Choose ADHD assessment
Assessment is no longer the hard part. Getting medication titrated and shared care accepted is where the pathway breaks.
Right to Choose lets patients in England pick any NHS-contracted provider for ADHD assessment, including independent providers, free of charge. Assessment commonly takes 6 to 20 weeks against multi-year NHS waits. The slower stage is now titration and shared care, which typically adds 3 to 9 months.
right to choose adhd | Reviewed August 2026
| Stage | NHS local service | Right to Choose provider |
|---|---|---|
| Referral to assessment, adults | 2 to 5 years | 6 to 20 weeks |
| Referral to assessment, children | 12 months to 3 years | 10 to 30 weeks |
| Diagnosis to titration start | 3 to 12 months | 2 to 10 weeks |
| Titration to stable dose | 3 to 9 months | 3 to 6 months |
| Shared care accepted by GP | Variable, often declined | Variable, often declined |
Ranges from live Scale Health provider mandates, 2026. Shared care acceptance is the least predictable step in the whole pathway.
The right, in one paragraph
In England, a patient referred for a first outpatient appointment can choose their provider, including independent providers holding an NHS contract for ADHD services. The GP makes the referral to the named provider. The patient pays nothing. This is what people mean by Right to Choose, or RTC.
Where the pathway actually stalls
Independent providers solved assessment throughput. They did not solve what comes after it. Titration requires an independent prescriber or consultant psychiatrist, structured monitoring including cardiovascular checks, and a documented review schedule. That workforce is scarce, and it cannot be scaled with assessors.
The second stall is shared care. Once a patient is stable, the intention is that the GP takes over prescribing under a shared care agreement. Many practices decline, citing capacity, unfamiliarity with the provider, or local prescribing policy. When shared care is declined, the patient stays with the provider indefinitely, which quietly consumes the capacity that would otherwise serve new referrals.
Questions worth asking before you choose a provider
Do you provide titration in-house, or only assessment?
What is your current wait from diagnosis to first titration appointment?
What happens if my GP declines shared care?
Who supervises prescribing decisions, and how often am I reviewed?
A provider that answers only the first question is running an assessment business, not a pathway.
What this means for providers and commissioners
Throughput without prescribing capacity creates a diagnosed population with nowhere to go. The economics follow the same shape: assessment revenue is front-loaded, while the retained titration caseload accumulates cost for years. Providers who scale sustainably build prescriber and supervision capacity ahead of assessment volume, not behind it.
Scale Health supplies consultant psychiatrists, independent prescribers and supervising clinicians into these pathways, with credentialing, DBS, indemnity and right-to-work completed before a caseload is allocated.
Common questions
- How long is the Right to Choose ADHD wait in 2026?
- Commonly 6 to 20 weeks from referral acceptance to assessment with an independent provider, against 2 to 5 years on many NHS adult services. Titration adds a further 3 to 9 months on most pathways.
- Can I get ADHD medication through Right to Choose?
- Yes, where the provider offers titration as well as assessment. Not all do. Check before you choose, because an assessment-only provider will diagnose you and then refer you back into a queue.
- What happens if my GP refuses shared care?
- The provider continues prescribing and monitoring. Shared care is voluntary for GPs, so refusal is common. It does not invalidate your diagnosis or your treatment, but it can affect how you collect prescriptions.
- Is Right to Choose ADHD assessment free?
- Yes. It is NHS-commissioned care. You pay nothing for assessment or NHS-funded titration. Prescription charges apply as normal in England unless you are exempt.
- Can children use Right to Choose for ADHD?
- Yes, where a provider holds the relevant NHS contract for children and young people. Availability is narrower than for adults and quoted waits are usually longer.
Keep reading
Right to Choose autism assessment
The legal right is straightforward. The bottleneck is provider capacity, and that is a workforce problem before it is a policy one.
ReadADHD titration under Right to Choose
Titration, not assessment, is the true capacity constraint in UK ADHD services.
ReadRight to Choose waiting times in 2026
Quoted waits are a capacity readout. When a provider's wait doubles, it almost always means a clinician left, not that demand spiked.
ReadExplore next
Running a Right to Choose service?
Scale Health builds the clinical benches these pathways depend on: assessors, independent prescribers, supervising clinicians and consultant psychiatrists, credentialed before they start.