NICE CG128 and CG142 describe what a diagnostic autism assessment should contain. They do not create Right to Choose. In England the legal right to choose a qualifying NHS-contracted provider and team at first outpatient referral applies to people of all ages. Age limits on clinic websites are that provider’s contract or clinical rules, not a legal adult-only bar.
This is independent information. It is not the NHS, not a clinic, not diagnostic advice and not a referral service. Written by Pete, editor, not a clinician. England only.
Who this applies to
It can apply if:
- You are in England and a GP, dentist or optometrist would make an elective first-outpatient referral for autism assessment (including via an interface service).
- The referrer judges that referral, provider and team clinically appropriate. In the Standing Rules, “clinically appropriate” means in the opinion of the person making the referral.
- The organisation already holds a qualifying NHS Standard Contract for the autism service, with any ICB or NHS England, in effect before the referral date.
- For mental health, learning disability and autism, the first appointment may be with a consultant or a health care professional; the team may be led by a named consultant or named health care professional. NHS England notes that legal rights to choice in mental health, learning disability and autism were introduced in 2014.
- Remote ASD assessments may be subject to the legal right when the other conditions are met.
- You are not in an excluded situation listed on eligibility.
Children and adults. The NHS Choice Framework applies to people of all ages. Standing Rules Part 8 and NHS England’s patient-choice guidance are not written as adult-only. Do not treat secondary blogs that say children’s Right to Choose “does not exist” as law. A particular provider may still only accept children above a stated age, or adults only: that is their published limit.
Who this does not apply to
- Scotland, Wales or Northern Ireland.
- Self-referral as the legal Right to Choose route. CG142 recommends that local areas have a single point of referral including self-referral to specialist services for autistic adults. That is a NICE local-pathway recommendation. It is not the legal choice right. NHS England is explicit: legal choice does not extend to self-referrals. You still need a GP, dentist or optometrist elective referral to use Right to Choose.
- A purely private autism assessment with no qualifying NHS Standard Contract.
- Situations where the referrer does not consider assessment, or that provider, clinically appropriate.
- Treating CG128’s 3-month “start diagnostic assessment” recommendation as a legal maximum wait. It is a NICE recommendation, not the 18-week legal waiting-time right, and not first-outpatient choice.
- Assuming NICE requires the local multidisciplinary autism team rather than any NHS-contracted independent provider. NICE describes the content of a good assessment. Choice law describes who you may choose if the provider holds a qualifying contract and the referrer judges it clinically appropriate.
This page does not diagnose autism and does not tell you that you or your child are autistic.
What the NICE autism guidelines actually require
Under 19s — CG128
- Covers recognition, referral and diagnostic assessment from birth to 19.
- Local areas should have a multi-agency autism strategy group and a multidisciplinary autism team (core: paediatrician and/or CAMHS psychiatrist; speech and language therapist; psychologist with autism experience), and a single point of referral to that team.
- Start diagnostic assessment within 3 months of referral to the autism team (recommendation 1.5.1). This is not the 18-week legal waiting-time right.
- Every assessment: developmental history against ICD-11 or DSM-5; observation of social communication; medical history; physical examination; differential diagnosis; coexisting-condition screen; a profile of strengths and needs; communicate findings. Do not rely on any autism-specific diagnostic tool alone.
- A case coordinator for every child or young person assessed.
- Do not routinely do genetic tests or EEG unless clinically indicated.
Adults — CG142
- Covers diagnosing and managing suspected or confirmed autism in people aged 18+.
- Each area should establish a specialist community multidisciplinary adult autism team.
- Consider comprehensive assessment when persistent social-interaction and/or social-communication difficulties and stereotypic or restricted behaviours plus functional impact.
- For adults without moderate or severe learning disability, consider AQ-10; a score of 6 or more or clinical suspicion should lead to an offer of comprehensive assessment. AQ-10 is a screen, not a diagnosis.
- Comprehensive assessment should be undertaken by trained, competent professionals, team-based, and where possible involve an informant or documentary evidence of early development, with direct observation of core features.
- Do not routinely use biological tests, genetic tests or neuroimaging for diagnosis.
- Offer a follow-up appointment after diagnosis regardless of whether further care is accepted.
Neither CG128 nor CG142 mentions Right to Choose, e-Referral, ICBs or independent-sector clinics.
Step by step
- Read the legal right first. What is Right to Choose? and eligibility. There is no separate “autism Right to Choose scheme”.
- Do not treat a screening questionnaire as a diagnosis. CG142’s AQ-10 is a prompt to consider comprehensive assessment. CG128 says not to rely on any autism-specific tool alone.
- Ask for a clinically appropriate elective referral if that is what you and the referrer are considering. Use the GP script. Name a preferred provider only as a preference. The GP is not required to refer to a named independent provider against clinical judgement.
- Match the provider to age and service. Some organisations that claim NHS-funded autism choice see children from a stated age and adults; some see adults only; some see children only. Check their pages via the providers index. This site does not verify contracts and does not refer you.
- Ask what “assessment” includes. NICE describes a multidisciplinary, history-plus-observation process. A provider’s model still has to be something the referrer can judge clinically appropriate.
- No prior ICB approval is required when the legal right applies.
- Do not assume a shorter wait, and do not treat CG128’s three-month start-assessment target as a legal deadline you can enforce through Right to Choose.
- If choice is not offered, see If your GP refuses.
Sources
Primary sources. Retrieved 1 September 2026.
- NICE CG128, Autism spectrum disorder in under 19s: recognition, referral and diagnosis. Overview last reviewed 14 June 2021. Clinical content of assessment; does not create Right to Choose. Guideline · Recommendations
- NICE CG142, Autism spectrum disorder in adults: diagnosis and management. Overview last reviewed 23 July 2026 (surveillance; not an assessment rewrite). Includes the local-pathway self-referral recommendation, which is not the legal RTC right. Guideline · Recommendations
- NHS Choice Framework, DHSC. England; all ages; first-outpatient choice (section 3). Published 29 April 2016; landing last updated 23 October 2024. HTML
- Patient choice guidance, NHS England, 19 December 2023. Choice in mental health, learning disability and autism; remote ASD assessments may be in scope; qualifying contract with any ICB or NHS England; legal rights do not apply to self-referrals. Long-read
- Standing Rules Part 8, SI 2012/2996 as revised, including SI 2023/1105 (in force 1 January 2024). Condition-neutral choice of provider; clinically appropriate = referrer’s opinion (reg 39(6)). Revised Part 8 · SI 2023/1105
Do not cite CG128 or CG142 as the source of the legal right.
Frequently asked questions
What is Right to Choose for autism?
Shorthand for using England’s legal right to choose a qualifying NHS-contracted provider and team for a first outpatient autism assessment, if a GP, dentist or optometrist makes a clinically appropriate elective referral.
Does Right to Choose exist for children?
Yes, as a matter of primary sources. The Choice Framework applies to people of all ages. NHS England’s guidance and the Standing Rules are not an adult-only scheme. A clinic may still refuse under-18s because of its contract or clinical criteria. That is not the same as the right “not existing” for children.
Does NICE create Right to Choose for autism?
No. CG128 and CG142 are clinical guidelines. They do not mention the legal right.
Can I self-refer for an adult autism assessment under Right to Choose?
No. CG142’s self-referral recommendation is about local specialist-team access, not the legal choice right. Right to Choose still needs a GP, dentist or optometrist elective referral.
Can autism assessment be remote?
NHS England says remote ASD assessments may be subject to the legal right when other conditions are met. NICE still describes history, observation and a team-based process. The referrer judges whether a named remote service is clinically appropriate.
Does the 3-month NICE target mean I must be seen in 3 months?
No. CG128 recommendation 1.5.1 is that diagnostic assessment should start within 3 months of referral to the autism team. It is not the 18-week legal waiting-time right, and it is not first-outpatient choice.
Does the provider need a contract with my ICB?
No. Qualifying contract with any ICB or NHS England. Prior commissioner approval is not required when the legal right applies.
Will choosing another provider be faster?
Official sources do not promise that. This site does not invent wait times.
Can a GP refuse an autism Right to Choose referral?
They may refuse if they do not consider the referral, provider or team clinically appropriate. They should not refuse solely because the provider is independent or out of area. See If your GP refuses and the GP script.
Is an AQ-10 score a diagnosis?
No. In CG142 it is a screening prompt toward comprehensive assessment.
Do I have to use the local autism team?
NICE describes a local multidisciplinary team as good service design. Choice law still allows you to choose another clinically appropriate qualifying NHS-contracted provider if the legal tests are met.
Does this site diagnose autism or make referrals?
No. Use eligibility, the GP script and the providers index.
Next steps
- Confirm eligibility — England, elective GP/dentist/optometrist referral, qualifying contract, not an excluded situation.
- Take the GP script to the referrer. It asks; it does not order the GP to ignore clinical judgement.
- Check autism age-bands and modality claims on the providers index.
- If choice is not offered, follow If your GP refuses.
Last reviewed: 1 September 2026
Author: Pete, editor, not a clinician
Right to Choose Pathway is an independent England-only information site. It is not the NHS, not affiliated with the NHS, not a clinic, not a diagnostic service and not a referral service.