NICE NG87 describes how ADHD should be recognised, diagnosed and managed in children, young people and adults. It does not mention Right to Choose and does not create that right. In England, a clinically appropriate elective referral for a first outpatient ADHD assessment may fall within the legal right to choose a qualifying NHS-contracted provider and team, including some remote services, if the other legal tests are met.
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 ADHD assessment (including via an interface service).
- The referrer judges that referral, and the chosen provider and team, clinically appropriate. That is the referrer’s opinion in law.
- The organisation already holds a qualifying NHS Standard Contract for the ADHD service, with any ICB or NHS England, signed and in effect before the referral.
- For mental health, the first appointment may be with a consultant or a health care professional, and the team may be led by a named consultant or named health care professional.
- You are not in an excluded situation (urgent or crisis care, already in treatment for the same condition after an elective referral, self-referral, and the other exceptions on eligibility).
NHS England’s patient-choice guidance states that remote services such as ASD and ADHD assessments may be subject to the legal right when the other conditions are met. That is not a guarantee that every online ADHD clinic qualifies. The clinic must hold a qualifying contract for that service and access model.
NG87 covers children, young people and adults. Choice law is also all ages. A named provider may still only accept certain ages (for example adults 18+ only). That is that provider’s published rule, not a legal adult-only bar. Check the providers index and the clinic’s own page.
Who this does not apply to
- Scotland, Wales or Northern Ireland.
- Self-referral to an ADHD clinic, even one that holds an NHS contract.
- A purely private ADHD assessment with no qualifying NHS Standard Contract.
- Situations where the GP does not consider a referral clinically appropriate. NG87 sets clinical standards for recognition and referral; it does not force a referral on request.
- Using NG87 as if it were the legal basis for Right to Choose — it is silent on choice of provider, e-Referral, ICBs and independent-sector clinics.
- Assuming a local NHS trust is the only lawful assessment route. NG87 describes what a good assessment contains; choice law says who you may choose if the provider qualifies and the referrer agrees it is clinically appropriate.
- Assuming a GP must accept shared care after medication is started. NG87 recommends shared-care protocol arrangements after titration and dose stabilisation. Whether a GP agrees is a local professional and contractual issue, not something Right to Choose law forces.
This page does not diagnose ADHD and does not tell you that you have ADHD.
What NG87 actually requires of an ADHD assessment
These are clinical standards, not Right to Choose rules. Professionals must take NICE guidelines fully into account; they are not mandatory and they do not override individual clinical decisions.
- Diagnosis should only be made by a specialist psychiatrist, paediatrician, or other appropriately qualified healthcare professional with training and expertise in diagnosing ADHD.
- It should be based on a full clinical and psychosocial assessment, developmental and psychiatric history, observer reports and mental state — not solely on rating scales.
- Diagnostic criteria: DSM-5 or ICD-11 hyperkinetic disorder criteria; at least moderate impairment; symptoms in two or more important settings.
- Primary care must not make the initial diagnosis or start medication in children and young people.
- Adults without a childhood diagnosis should be referred to a mental health specialist trained in ADHD diagnosis and treatment where typical manifestations began in childhood, persist, are not explained by other diagnoses (coexistence is allowed), and cause moderate or severe impairment.
- Medication only after environmental modifications have been reviewed, and only initiated by a trained specialist. After titration and dose stabilisation, prescribing and monitoring should be under shared-care protocol arrangements with primary care.
- First-line medicines in NG87: methylphenidate for children aged 5+ and young people; lisdexamfetamine or methylphenidate for adults. This site does not advise on medicines.
NG87 last had a recommendation change on 13 September 2019 (ECG clarification). The overview page recorded a surveillance review on 23 July 2026; that review is not a clinical rewrite of ADHD recommendations.
NG87 does not say whether assessment must be face-to-face or may be remote. Modality is a clinical-appropriateness judgement for the referrer, alongside the provider’s contract.
Step by step
- Read the legal right first. What is Right to Choose? and eligibility. The right is first-outpatient choice of a qualifying provider and team, not an “ADHD scheme”.
- Do not treat a questionnaire score as a diagnosis. NG87 is clear that diagnosis is not made on rating scales alone, and not by primary care for children and young people.
- 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 decides clinical appropriateness.
- Check what the provider actually offers. Some organisations that claim NHS-funded ADHD Right to Choose work assess adults only; some also see children in stated age bands; some offer titration and some do not. Some keep prescribing if the GP declines shared care; others need a shared-care arrangement. Those are provider claims, listed on the providers index, not verified contracts.
- Talk about aftercare before the referral is sent. NHS England tells referrers to consider ongoing care after assessment, including how the service interacts with local pathways and shared-care protocols for prescribed medicines.
- No prior ICB approval is required when the legal right applies.
- Do not assume a shorter wait. This site does not publish wait times. Provider-reported waits are snapshots only, dated, and change. Official sources do not guarantee that choosing an independent NHS-contracted provider will be faster than a local list.
- If choice is not offered, follow If your GP refuses. A practice policy of “we don’t do Right to Choose” is not how the Standing Rules work. A GP may still decline a referral that is not clinically appropriate.
Charity navigation (not law): ADHD UK maintains a Right to Choose hub, GP-letter tone, and provider signposting. It is a charity, not an official NHS directory.
Sources
Primary sources. Retrieved 1 September 2026.
- NICE NG87, Attention deficit hyperactivity disorder: diagnosis and management. Published 14 March 2018; last recommendation update 13 September 2019; overview last reviewed 23 July 2026. Clinical standards only; silent on Right to Choose. 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. Remote ASD and ADHD assessments may be subject to the legal right when other conditions are met; qualifying contract with any ICB or NHS England; no prior approval; referrer decides clinical appropriateness within NICE and other guidelines. Long-read
- Standing Rules Part 8, SI 2012/2996 as revised, including SI 2023/1105 (in force 1 January 2024). Elective referral; clinically appropriate means the referrer’s opinion (reg 39(6)); qualifying contract; exceptions. Revised Part 8 · SI 2023/1105
Secondary (not law):
- ADHD UK Right to Choose hub — patient navigation, not statute. Hub
Do not cite NG87 as the legal basis for this right. Do not treat provider websites as proof of a contract.
Frequently asked questions
What is Right to Choose for ADHD?
Shorthand for using England’s legal right to choose a qualifying NHS-contracted provider and team for a first outpatient ADHD assessment, if a GP, dentist or optometrist makes a clinically appropriate elective referral.
Does NICE NG87 give me Right to Choose?
No. NG87 is clinical guidance on recognition, diagnosis, treatment and shared care. It does not mention Right to Choose, ICBs, e-Referral or independent clinics.
Can children use Right to Choose for ADHD?
Choice law is not limited to adults. The Choice Framework applies to all ages. Whether a named clinic accepts children is that clinic’s contract and clinical rule. Some publicly claim child ADHD under NHS-funded choice; some do not. Check eligibility and the providers index.
Can I self-refer for an NHS ADHD assessment under Right to Choose?
No. Legal choice does not apply to self-referrals.
Can ADHD assessment be done online under Right to Choose?
NHS England says remote ADHD assessments may fall within the legal right when the other tests are met. NG87 is silent on modality. The referrer still decides clinical appropriateness, and the provider must hold a qualifying contract for that service and access model.
Does my GP have to start ADHD medication after a Right to Choose diagnosis?
No. NG87 says medication is initiated by a trained specialist, and that after titration, prescribing should be under shared-care arrangements with primary care. GPs can decline shared care in practice. That is local and contractual, not an NG87 “must accept”, and not something choice law forces. Some providers claim they will keep prescribing if the GP declines; that is their claim, not this site’s guarantee.
Does the provider need a contract with my ICB?
No. A qualifying NHS Standard Contract with any ICB or NHS England is the test. Prior commissioner approval is not required when the legal right applies.
Will Right to Choose get me a faster ADHD assessment?
Official sources do not promise a shorter wait. Do not rely on undated social-media ranges. This site does not invent wait times.
Can my ICB ban Right to Choose for ADHD?
ICBs must make arrangements so patients can exercise legal choice, and must rectify if choice was not offered. Operational friction (panels, activity plans, booking pauses) is documented by providers and secondary sites in 2026; that is not the same as the legal right having been repealed. This site does not publish a live ICB-ban list.
Can a GP refuse an ADHD Right to Choose referral?
They may refuse if they do not consider the referral, provider or team clinically appropriate. They are not required to refer against clinical judgement. A blanket practice policy of “we don’t do Right to Choose” is not how the Standing Rules describe the duty. See If your GP refuses.
Is diagnosis based on a questionnaire?
Not according to NG87. Rating scales alone are not enough. Diagnosis is a specialist clinical assessment.
Does this site refer me to an ADHD clinic?
No. Use the providers index to see what organisations claim, then ask your GP using the GP script.
Next steps
- Confirm eligibility.
- Print or copy the GP script — it does not instruct the GP to ignore clinical judgement.
- Compare claims on the providers index, including who they say they see, whether they prescribe, and their own RTC page.
- If the referrer will not offer choice, use 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.