Frequently Asked Questions (FAQs)

The individual should make an appointment to talk about their feelings with their GP or a referral specialist.

During the appointment, the professional should discuss all the options available, including support if applicable.

If an assessment isn't appropriate or the individual decides not to go ahead, the professional will explain what other help and support options are available.

This means that an individual referral meets the right medical, psychological, and developmental requirements for an assessment. This is based on set rules.

It usually includes:

• Clear signs of ADHD or autism, based on official medical guides (like DSM-5 or ICD-11).
• Problems in daily life, such as school, work, friendships, or taking care of themselves.
• Checking the person’s history to make sure there isn’t another reason for their symptoms.
• A referral from the right professional, like a GP.

For an ADHD or autism assessment, a GP, healthcare professional, or a local interface service*  will review the individual is clinically appropriate for an assessment.

*There may be some areas that have an interface service that work on behalf of Primary Care and can help with advice, support and pathways. Those interface services may also be a referral route into assessment.   

During the appointment, the GP or professional should talk about all the choices the individual or their carer has.

This may include their Right to Choose/Patient Choice, which assessment service provider can help them and what support is available.

To help the individual or carer choose, the specialist should:

• Explain that they can choose who provides their care and when this choice applies.
• Follow the National Institute for Health and Care Excellence (NICE) guidelines while talking about the individual’s specific situation.
• Discuss how any new care might affect ongoing treatments, especially if the individual has other health issues.
• Individuals can check if the potential assessment service provider offers care based on good evidence that meets their individual needs, including looking at recent reviews and ratings if available.
• Talk about any travel or access needs for face-to-face appointments or consider online options.
• Discuss how ongoing care after the referral might impact the individual, for example understanding the process for shared care and what would happen if shared care was not available. 
• If the individual needs more time to decide which provider to choose, they should be given time to talk about it with family or friends before making a final decision.

Right to Choose/Patient Choice applies when:

• If a GP agrees that an ADHD or autism assessment is clinically appropriate, the individual has the right to choose a provider that offers this service under NHS funding.
• The provider is NHS-approved – The chosen provider must have a contract with an NHS Integrated Care Board (ICB) or NHS England to deliver autism/ADHD assessments under Right to Choose/Patient Choice.
• The individual is registered with a GP in England – RTC applies to NHS individuals in England but does not cover Scotland, Wales, or Northern Ireland.
• There are long NHS waiting times (over 18 weeks) - this includes if Right to Choose/ Patient choice has not already been offered and the individual is on a waiting list.

Where Right to Choose applies (see above) Right to Choose/Patient Choice referrals can only be made by a GP, unless there is an ICB-commissioned interface service.

The individual may not get a list of assessment service providers from the referral source. They will need to look for assessment service provider in their own time and can use supporting information to help them make a choice.

Right to Choose/Patient Choice does not apply when:

• The individual is already receiving care and treatment for their condition. (However, it does apply for new episodes of care, even if they have been treated before.)
• They are using urgent, emergency, or crisis services.
• They need emergency or urgent treatment, like cancer services, where they must be seen within 2 weeks.
• They are a prisoner, temporarily released from prison, or held in a special facility (like a court, secure children's home, or young offender's institution).
• They are held in a hospital under the Mental Health Act 1983.
• They are an active member of the armed forces.

Yes, as long as the referral is:

• Clinically appropriate, and
• The service is led by a named consultant or healthcare professional.
• The provider has a current NHS Standard contract with the right organisation for the service needed.
• The service is for the correct age group of the individual.

In some cases, individuals can refer themselves to providers. However, if they do not meet the criteria under Right to Choose/Patient Choice the NHS will not cover the costs for these self-referrals, and these will be self-funded along with any treatment received.

There may be some areas that have an interface service that work on behalf of Primary Care and can help with advice, support and pathways. Those interface services may also be a referral route into assessment.

No prior approval from a commissioner or Integrated Care Board (ICB) is needed if the following criteria are met:

• The individual is getting a planned referral for their first outpatient appointment.
• The referral is clinically appropriate.
• The assessment service provider and team are led by a consultant or a mental healthcare professional.
• The assessment service provider has a contract with an ICB, or NHS England for the service needed.

GPs and referrers should let people know their options and support them in choosing their provider through shared decision-making.

However, if they are not offered these choices, the NHS Choice Framework gives information on what patients can do. 

People should first contact their local ICB.

They can also visit the WY ICB Comments, Concerns, and Complaints page for more help: WY ICB Comments, Concerns, and Complaints.

A shared care agreement is an arrangement between the assessment service provider the individual has chosen for their autism and/or ADHD assessment and their GP. This is needed when the individual is on medication prescribed by a specialist and they are to receive on-going prescriptions from their GP.

The individual should be under the care of the assessment service provider and could have appointments once a year or more often.

If the GP and the service provider agree to share care, the GP will write prescriptions and check on the individual as described in the shared care agreement.

The GP does not have to agree to a shared care arrangement. In these circumstances, the individual should remain under the care of the assessment service provider.

Choosing the right service for an Autism and/or ADHD assessment is an important decision. 

There are some things to think about or to find out when you are choosing a service, click here to public information relating to choosing your NHS funded Autism and/or ADHD assessment service.  

Once you have decided on the provider you can inform the GP/referral professional who you want to be referred to.

The GP/referral professional will need to check that the service you have chosen meets the NHS criteria before they can refer you. If they don’t meet the criteria you will have to choose a different provider. You can discuss this with your GP/referral professional.

No: The NHS Individual Funding Request (IFR) is for treatments not usually paid for by the integrated Care Board (ICB), and where the individual has clinically exceptional reasons why they should be able to access that treatment, (if it isn’t available to other people with a similar condition). A GP can apply if they believe an individual has special medical needs. This is different from the Right to Choose/Patient Choice, which lets patients pick an NHS provider for treatment. IFRs are only for funding special treatments, not choosing providers.

No – it’s the Right to Choose provider’s job to arrange any tests they think are needed.

The Right to Choose provider who started the ADHD medication is responsible for prescribing it. They are also responsible for keeping track of the patient’s progress until the dose is stable and the GP decides about shared care. This should follow local or national shared care guidelines. The Right to Choose provider must handle all health checks, like heart history, heart rate, blood pressure, weight, and ECG (if needed).

Yes, shared care means that both your Right to Choose/Patient Choice assessment service provider and your regular doctor (GP) work together to look after your health. The Right to Choose/Patient Choice assessment service provider should check on you at least once a year. If the Right to Choose/Patient Choice assessment service provider stops helping you, your regular doctor won't be able to give you medicine anymore.

If you get a new GP or change GP practice, the Right to Choose/Patient Choice assessment service provider must write to them and ask if they can enter shared care. Your old GP might help by telling the new GP too. If the new GP doesn’t agree, the Right to Choose/Patient Choice assessment service provider will need to keep looking after you and giving you your medicine and prescriptions.

This question was raised with Dr Janine Robinson, National Speciality Adviser for Autism and here is her response:

In April 2023 the National Autism Team produced guidance for services and clinicians around optimising processes and patient experiences. This includes information shared with both referrers and the public around local pathways, processes and what to expect. Whilst we understand that seeking an autism assessment can be a daunting experience for some, it remains important that a balance is reached with respect to the detail of information that is provided about exact tools used since several factors may affect clinical decisions about the type of assessment that is conducted and any standardised tools that might be employed.

In fact, it is not essential for a diagnostic assessment tool to be part of the process since it is often only used to support the information gained from the developmental assessment. Hence, the diagnosis of autism is a clinical diagnosis. For people who meet the classification criteria a diagnosis can be made.

This does not preclude services from providing general information about what to expect from the assessment process or encouraging individuals from preparing their own questions and notes in advance of the assessment.  Whilst there are no specific or validated assessment tools for women or girls, national guidance advises assessment services on various factors that may need to be considered when assessing individuals from previously or typically under-represented populations and emphasises the importance of clinical decision-making regarding contextual factors rather than reliance on any tools per se.