Using your Right to Choose (RTC) to get an ADHD assessment
NOTE: This information on how to get an ADHD assessment is currently only applicable for adults in England (not applicable to those serving in the armed forces)
The usual pathway for getting an ADHD assessment (this is the process most GPs are familiar with):
- You visit your GP (who may or may not be familiar with ADHD in adults).
- A well-informed GP will usually refer you to their local ADHD clinic.
- Sometimes a GP may dismiss your symptoms as not ADHD- or refer you for other mental health support first. However, according to NICE guidelines, your GP is not qualified to say if you definitely have ADHD or not. They should just acknowledge there is a possibility that you may have it and refer on for assessment.
- The waiting list for assessment for ADHD is often long – usually over a year (now longer due to Covid).
An alternative to this process is to use your Right To Choose (RTC)
- This allows you to choose any ADHD assessment service delivered by an NHS provider.
- Most services still have long waits (see above) but the NHS provider Psychiatry-UK (P-UK) is an online service and therefore has a large pool of Psychiatrists to choose from. It is accessible wherever you live in England, with a much shorter waiting time. This may be just a couple of weeks rather than months/ years. (This is the only online service I am currently aware of with such a short waiting list. I will add other such services on discovery.)
- RTC is a recently discovered option. It is legally robust, and many people now use this option to reduce their wait for assessment.
- Many local Clinical Commissioning Groups (CCG) are slowly becoming more aware of RTC. They are beginning to understand that they can’t legally refuse funding for this (as agreed by NHS England).
- Although legally the CCG can’t refuse to fund an assessment under RTC, your GP & CCG may well not be familiar with the process and this can delay a referral.
- P-UK now accept all patients who have been GP-referred via RTC. They will obtain funding from the CCG separately without delaying your assessment.
What to do if you want to be assessed for ADHD
Get prepared beforehand!
Having a supportive GP is key. However you need to make sure they do the referral correctly- mentioning RTC and referring directly to P UK (if they send it to the CCG instead this can delay the process considerably).
- Before you visit or speak with them, you could allow them time to get grips with a new/ different way of doing things, by sending them this NHS document explaining how RTC works.
The key points on this document are:
“Patients must be offered, in respect of a first outpatient appointment with a team led by a named consultant or a named healthcare professional, a choice of any clinically appropriate health service provider with whom any relevant body has a commissioning contract for the service required as a result of the referral, and a choice of a team led by a named consultant or a named healthcare professional. This is subject to exclusions set out in legislation3.
…It is important to note that the right to choice does not mean that a patient only has their first outpatient appointment with their chosen provider: consistent with physical health care, once a patient has chosen a provider, that provider will normally treat the patient for their entire episode of care, unless the patient’s diagnosis changes significantly.”
- It’s also often helpful to make a list of your ADHD symptoms/ examples of how your life is affected or to complete a self-rating questionnaire like this one or this online version. Do send this to them first. Then visit/ book a call with your GP – saying you believe you may have ADHD.
Send them the above NHS document and your notes/ questionnaire BEFORE your appointment so that they are clear what you’re asking for.
Your GP visit/ call
Tell your GP saying you believe you may have ADHD and ask for a referral for an ADHD assessment: Be clear you’d like to use your Right To Choose and ask them to refer you directly to the Psychiatry-UK service.
P-UK is an online NHS service on the NHS provider list. Your GP will need to make a referral EITHER by writing directly to firstname.lastname@example.org OR by using the separately supplied RTC form. (You may want to fill in your own details first.)
Make sure that your GP includes your email address so that P-UK can contact you to progress your diagnosis.
It takes just a few minutes of their time to do the referral directly. The best approach with many GPs may be to ask them to “could you please just take the few minutes to do it?”, or direct them to the psychiatry UK website https://www.psychiatry-uk.com/right-to-choose/ where the form can be found.
NB Make sure the referral goes directly to P-UK (NOT to the CCG as an Individual Funding Request. An IFR is usually be refused and does NOT use your legal Right To Choose). P-UK does not require approval from the CCG, but if the CCG is contacted first, they may require that the GP applies for this. This can lead to lengthy delays.
If you come up against ongoing problems:
You can contact NHS Improvement. They will spell out the rules to your CCG (who may still be obstructive). However most will generally pay up at that point.
There is more information on ADHD including assessments and RTC on the Adult ADHD UK Facebook Group. (Search Right To Choose)