At Talbot Medical Centre we know that long waiting times for ADHD and Autism (ASD) assessments can be very stressful. This information is to explain how “Right to Choose” (RTC) referrals work, what we can and cannot do as a GP practice, and what you should expect if you decide to use this route.
1. What is “Right to Choose”?
Under NHS England’s Right to Choose arrangements, in some situations patients can choose to be referred to an alternative provider for certain services, including diagnostic assessments for ADHD and Autism.
Key points:
- These providers are NHS-funded , but are often separate from local NHS trusts (such as local mental health providers)
- They have been commissioned to provide assessment services , usually via remote or regional clinics.
- They often offer quicker access to diagnostic assessment than local NHS services.
2. Information we need from for referral to a right to choose provider
Adults
Please complete the ADHD referral Questionnaire on the Talbot Medical Centre website and follow the guidance in the link below.
Adult ADHD – Talbot Medical Centre
Children
When referring to Community Paediatrics or CAMHS, schools are required to prepare a detailed report. This is also required in order to access right to choose referral.
This usually includes things like:
- School reports about learning, behaviour and attention
- Observations of your child in the classroom and playground
- Any support plans, SEN support, or EHCP information
- Relevant safeguarding or pastoral concerns
Without this information, it is difficult for us to make a safe and appropriate referral.
If you are considering a Right to Choose referral, please:
- Speak to your child’s SENCO or class teacher
- Let them know you are seeking an assessment, and
- Ask them to complete any school questionnaires or reports requested by the GP or the assessment provider.
3. Assessment vs. prescribing – what’s the difference?
It is important to understand the difference between:
- Diagnostic assessment – where a specialist team assesses for ADHD and/or Autism and provides a report and recommendations.
- Prescribing and monitoring medication – if medication is recommended (for example, for ADHD), this involves ongoing prescribing, dose adjustments, monitoring of side effects, and regular reviews.
Right to Choose providers can:
- Offer an assessment and
- Make recommendations, which may include starting medication.
However, a recommendation to start medication does not mean that your GP will automatically prescribe it.
4. Our prescribing position at Talbot Medical Centre
At Talbot Medical Centre, we do not take on prescribing of any medications that are started by Right to Choose providers.
This is because of:
- Clinical safety concerns – ADHD and other neurodevelopmental medications are specialist drugs that require careful initiation, titration and monitoring by a specialist team.
- Continuity of care – when treatment is started and managed outside local NHS specialist services, it can be difficult for GPs to access the necessary support, advice and follow-up arrangements.
Therefore:
- If a Right to Choose provider recommends starting medication, they are responsible for arranging and providing that treatment, or for arranging transfer of care to an appropriate NHS specialist service where this is commissioned locally. The right to choose provider is also responsible for arranging any monitoring required to safely prescribe.
- Talbot Medical Centre will not enter into shared care or routine prescribing of medications that have been initiated solely by a Right to Choose provider.
5.What this means for you
If you choose to use a Right to Choose provider for ADHD or Autism assessment:
- You may be seen more quickly for an assessment.
- You will usually receive a diagnostic report and recommendations.
- If medication is recommended, you should not assume that Talbot Medical Centre will prescribe it.
- You will need to discuss ongoing prescribing and monitoring directly with the Right to Choose provider
We will:
- Make a referral where it is clinically appropriate, and
- Request the necessary information from school and other relevant sources.
We ask that families:
- Read this information carefully before deciding on a Right to Choose referral,
- Work with schools to provide the information needed, and
- Understand that our prescribing policy is fixed and based on safety and capacity, not on individual circumstances.
