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We appreciate that accessing an ADHD assessment and treatment can sometimes feel complicated. There are different providers and pathways, and the arrangements for assessment, investigations, medication and ongoing care are not always the same.
This page explains Right to Choose, what you should consider when choosing a provider, and what Jessop Medical Practice can and cannot provide following your referral.
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Why is Right to Choose available?
Demand for ADHD assessment has increased substantially and waiting times for traditional local services can be long.
NHS Right to Choose provides eligible patients in England with an alternative route to certain NHS-funded services. It allows you, where a referral is clinically appropriate, to choose an eligible provider which has an appropriate NHS contract.
Some Right to Choose services are delivered by independent organisations rather than the local NHS service. Although your care remains NHS-funded, the organisation providing it is responsible for delivering the service covered by its NHS arrangement.
Jessop Medical Practice supports patients who wish to access an appropriate ADHD assessment through Right to Choose.
However, it is important to understand that Right to Choose gives you a choice of provider. It does not mean that your GP practice automatically becomes responsible for parts of the provider’s service that the provider does not offer. |
Choose your provider before requesting your referral
Before requesting a Right to Choose referral, please read the information on this page and decide which provider you would like to be referred to.
There are a number of Right to Choose providers and their services differ. Please consider not only waiting times, but also what happens after assessment, including whether the provider offers treatment, prescribing, investigations and ongoing specialist follow-up.
When submitting your request to Jessop Medical Practice, please tell us which Right to Choose provider you have chosen. This allows us to process your referral without needing to contact you again to establish your choice and helps avoid unnecessary delays.
You can find further information about your right to choose healthcare services through the NHS and NHS Choice Framework. Current Right to Choose provider directories can also help you explore providers, but please check the individual provider’s current eligibility, age criteria and referral arrangements before making your choice, as these can differ between services.
Right to Choose ADHD and autism: check your area and waiting times | ADHD UK |
For children and young people
For children and young people, we would usually recommend accessing the established local NHS assessment pathway through school where appropriate. We recognise that waiting times through this route can be very long.
Families can still request an appropriate Right to Choose referral. However, if considering this option, it is particularly important to check what the chosen provider offers following assessment, including treatment, prescribing and ongoing specialist care.
Before choosing a Right to Choose provider
Right to Choose providers do not necessarily all offer the same service.
Depending upon the provider and pathway, you should establish what happens if you receive an ADHD diagnosis, including:
- whether the provider offers medication treatment;
- who starts and adjusts medication;
- who provides prescriptions during and after titration;
- who arranges any blood tests, ECGs or other investigations required by the provider;
- who carries out physical monitoring;
- who reviews and acts on investigation results;
- what ongoing specialist reviews are provided; and
- what happens if your GP is unable to accept shared care.
We strongly recommend considering these arrangements when choosing your provider, rather than only considering the waiting time for assessment.
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Investigations, blood tests and ECGs
This is particularly important to understand before choosing a provider.
If your Right to Choose provider requires blood tests, an ECG, physical observations or another investigation as part of their assessment, initiation of treatment or ongoing specialist monitoring, we would expect the provider responsible for that care to arrange the investigation and to review and act on the result.
This reflects the same principle used across NHS care, including hospital and other specialist services: where a service requires investigations as part of its assessment, treatment or monitoring, responsibility for arranging those investigations, reviewing the results and acting on them normally remains with the service providing that care. These responsibilities form part of the agreed arrangements between primary and secondary care and the way those services are commissioned.
Right to Choose does not automatically transfer this work to the GP practice simply because the patient has been referred through an NHS-funded pathway.
Carrying out an investigation is not simply a matter of taking a blood sample or performing an ECG. The clinician or service requesting an investigation also needs to ensure that:
- the correct investigation is requested;
- the result is received and reviewed;
- abnormal findings are identified and acted upon;
- the result is communicated appropriately; and
- any necessary follow-up is arranged.
For this reason, Jessop Medical Practice does not routinely undertake investigations or monitoring solely because an external provider requires them as part of its own treatment pathway.
General practice has finite clinical and administrative resources. Work transferred from another service without an agreed commissioned arrangement uses capacity that is provided for the delivery of our patients’ general-practice care. We therefore need to ensure that work forming part of another provider’s service remains with that service unless responsibility has been specifically agreed.
This does not affect investigations that your GP independently considers clinically appropriate as part of your NHS general-practice care.
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What happens if I am diagnosed and medication is recommended?
This is another important point to consider before choosing your provider.
An ADHD diagnosis does not automatically mean that Jessop Medical Practice will be able to take over prescribing.
The service assessing you should explain what treatment it provides following diagnosis, including whether it initiates medication, provides prescriptions during titration, provides ongoing specialist review and what will happen if your GP does not take over prescribing.
Once medication is stable, some providers may ask your GP to prescribe through an arrangement known as shared care
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What is shared care?
Shared care is a separate arrangement from Right to Choose.
Right to Choose is about your right to choose an eligible provider for your NHS-funded referral.
Shared care is an agreement between the specialist service, your GP and you about sharing responsibility for ongoing treatment.
It is not an automatic consequence of an NHS or Right to Choose referral and cannot simply be transferred to the GP by the provider.
Shared care requires agreement between those involved. The GP taking responsibility for prescribing must also be satisfied that the treatment can be prescribed and monitored safely. Current GMC guidance says that shared care requires agreement of all parties, and that a prescriber acting on another healthcare professional’s recommendation remains responsible for ensuring the prescription is appropriate, necessary and safe.
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Will Jessop Medical Practice prescribe my ADHD medication?
You should not choose a Right to Choose provider on the assumption that Jessop Medical Practice will subsequently take over prescribing.
Jessop Medical Practice does not routinely accept new ADHD shared-care prescribing from Right to Choose providers. There may be limited circumstances where an established NHS-funded or practice-agreed arrangement is already in place, and existing agreed shared-care arrangements will continue to be honoured.
If the practice is unable to accept shared care, this does not prevent us from making an appropriate Right to Choose referral. It means that responsibility for prescribing and associated specialist monitoring remains with the provider unless another appropriate arrangement is agreed.
For more information about why a GP practice may accept or decline shared care and what responsibilities are involved, please read our Shared Care, Prescribing and Investigations page.
The distinction is important: current BMA guidance describes shared-care prescribing as voluntary for general practice and says practices should apply consistent principles when deciding whether they can accept it.
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Questions to ask before choosing your provider
Before asking us to refer you, we strongly recommend checking:
- If I am diagnosed, does the service provide treatment as well as assessment?
- Will the provider initiate and titrate medication if required?
- Who will prescribe my medication if my GP cannot accept shared care?
- Who will arrange any blood tests, ECGs or physical monitoring your service requires?
- Who will review and act on those results?
- Who provides my ongoing and annual specialist ADHD reviews?
- How can my GP obtain specialist advice if there is a problem with my treatment?
Understanding this before choosing your provider can help avoid unexpected difficulties or delays after assessment.
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In summary
Jessop Medical Practice supports appropriate NHS Right to Choose referrals.
However, before selecting your provider, please understand that:
- your chosen provider is responsible for delivering the service it has agreed to provide;
- the practice will not undertake investigations or monitoring required solely as part of that provider’s assessment or treatment pathway;
- a Right to Choose referral does not automatically mean that the practice will take over prescribing; and
- shared care is a separate arrangement which must be agreed and cannot be assumed.
Our aim is not to discourage patients from using Right to Choose. It is to make sure that you understand how the pathway works before you choose a provider, so that you can make an informed choice about the service that best meets your needs.
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