Right to Choose

The national NHS Choice Framework gives all NHS patients in England the legal ‘right to choose’ (RTC) the service that provides their healthcare in certain circumstances.

A RTC pathway may be a preferred option for some patients to be assessed for ADHD and/or autism due to the very long NHS waiting times.   
Process for patients seeking referral for ADHD or Autism via Right to Choose. 

1.  You will need to book a routine GP appointment to discuss. You are welcome to bring anything with you in writing such as written observations/ letters from school.
2. Please have a look at the list of current providers, which explains the current and waiting times and what service each offers at https://adhduk.co.uk/right-to-choose/
3. It is important to consider what each one offers, especially if you feel you would like to consider medication, then you need to check if the service offers that and whether it offers initial titration only or ongoing monitoring.
4. The GP can look through the list with you. The GP will advise if they feel it is more suitable to be referred to an NHS service, for example if there are other mental health issues which might make the diagnosis more complicated.

For a provider to provide assessment and care under right to choose they must have:

• A commissioning contract with any Integrated Care Board or NHS England for the required service you are wanting to access (diagnosis with or without prescribing/ongoing monitoring).
• A service and team led by a consultant or a mental health professional.
• Aa CQC-regulated service. This may be confirmed by searching the full list of services CQC regulate at: https://www.cqc.org.uk .

Patients cannot use Right to Choose is they are:

• Already receiving mental health care following an elective referral for the same condition.
• Referred to a service that is commissioned by a local authority, for example a drug and alcohol service (unless commissioned under a Section 75 agreement).
• Accessing urgent or emergency (crisis) care.
• Accessing services delivered through a primary care contract.
• In high secure psychiatric services.
• Detained under the Mental Health Act 1983.
• Detained in a secure setting. This includes people in or on temporary release from prisons, courts, secure children’s homes, certain secure training centres, immigration removal centres or young offender institutions.
• Serving as a member of the armed forces (family members in England have the same rights as other residents of England.

Private Providers

Please note the above relates to accessing NHS funded services. Patients retain the right to privately fund assessments and medication initiation / titration outside the scope of Right to Choose.  

Patients accessing private care only should be consider how they will receive ongoing prescriptions and review.  

Shared care is a voluntary arrangement, and GPs are not obliged to accept shared care arrangements or to take over the prescriptions of medication which they feel is beyond their scope of expertise or not in the best interest of the patient. If we refuse to undertake the ongoing prescriptions, then prescribing this medication must remain with the Consultant (private or NHS). 

The decision on whether to enter a shared care agreement with a given provider will be made on a case by case basis following discussion at MDT Monday meeting. Decision will be based on whether the organisation is CQC registered, based in the UK and follows standard shared care protocols.   
Should the patient not engage with the private providers requirements then Dykes Hall will reserve the right to stop prescribing the medication.