Right to Choose – ADHD and Autism Frequently Asked Questions

Waiting times are different for each service and provider. There is not one waiting time that applies to everyone.

We are improving how we share clear and accurate waiting time information for the services we commission. We are also working to understand the full picture across local NHS services and Right to Choose providers. This includes checking that people are only on one waiting list for the same type of assessment. 

Right to Choose providers often publish their own waiting times on their websites. Please check the provider’s website for the most up-to-date information.

If ADHD medication is needed after assessment, there is usually a process to start and adjust medication safely. This can vary between providers.

We understand that waiting can be hard. You do not need to wait for a diagnosis to ask for help, advice or support

Please visit the following page to explore a range of services available to support you on your journey. You do not need a formal diagnosis or to be on a waiting list and you can self-refer into these services at any time. 

Right to Choose - Support at every stage: before, during, after, or without an assessment

Please visit the following page to explore a range of services available to support you on your journey. You do not need a formal diagnosis or to be on a waiting list and you can self-refer into these services at any time.

Right to Choose - Support at every stage: before, during, after, or without an assessment

The adult Autism and ADHD Community Hub offer is available across Hampshire and the Isle of Wight. The hubs are linked to the wider Autism and ADHD Information, Advice and Guidance service, led by Autism Hampshire and delivered with local partners. This partnership also works very closely with the Portsmouth Community Hub, Room One. 

Current Hub locations are:
•    Andover / North Hampshire 
•    Havant / South East Hampshire 
•    Southampton 
•    Isle of Wight 
•    Portsmouth – support is available through Room One
 

Community hubs & peer support - Autism Hampshire
Room One - Portsmouth City Council
 

At the hubs, people can get information, advice and guidance, learn about local support, connect with other and access peer, one-to-one or group support where available.

This is an adult support offer. Families looking for support for children and young people can still seek advice and explore local support options. A diagnosis is not needed before asking for help.
 

Right to Choose means that, in many cases, people can choose where they go for their first NHS outpatient appointment. This may be an NHS service or an independent provider, if the provider is suitable for the assessment needed, has the right NHS contract and has agreed NHS capacity to offer the service.

A locally commissioned service is planned and funded by the local Integrated Care Board for people living in the local area.

Both are NHS-funded routes. They may have different waiting times, appointment types, locations, referral routes and support offers.
 

Yes. If ADHD medication is clinically appropriate, people assessed through the NHS Right to Choose pathway can still access ADHD medication through NHS-funded care.

Medication is usually started and adjusted by the specialist service that completes the assessment. This is sometimes called titration. It means finding the right medication and dose safely.

Once medication is stable, the specialist service may ask for prescribing to be shared with primary care through a shared care agreement. Shared care means the specialist service and primary care work together, with clear information about prescribing, monitoring and who to contact if advice is needed.

If there is no shared care agreement in place, the specialist service that started the medication remains responsible for prescribing and monitoring.
 

People can only be on one waiting list for the same type of assessment at one time. This applies to locally commissioned NHS services and Right to Choose providers.

This helps keep your referral clear and avoids delays. If you are thinking about changing provider, it is important to understand what this may mean for your current referral before making a decision.
 

If you are worried about your child’s health, wellbeing or support needs while they are waiting for an assessment, you do not need to wait for a diagnosis before asking for help.

Information about support available while waiting can be found on the Hampshire and Isle of Wight ICB website: Autism and ADHD Assessment Services, and through the Right to Choose waiting list support links. These resources include support that may be helpful before, during, after, or without an assessment.

If your child’s needs change or you are worried about their wellbeing, please seek advice from a professional involved in their care.
 

If a young person turns 18 while waiting for an Autism or ADHD assessment, their referral will either continue with the same provider or move to an adult pathway. The provider will explain clearly what will happen next.

This is because assessment pathways for children and young people and assessment pathways for adults are often arranged separately and may work in different ways. Your provider will either continue the assessment or transfer it to an adult pathway. 

If anything changes, the provider should explain clearly who is responsible for the referral, what happens next and who to contact with questions. The move to an adult pathway should be clearly explained and supported. 
 

If ADHD medication is recommended, the specialist provider that completed the assessment is usually responsible for starting medication and adjusting the dose safely. This is called titration.

What happens next depends on where the young person is in the medication process. If medication has not started yet, the provider should explain who will start it and what the next steps are.

If medication has already started and the young person is still in titration, this should not stop just because they turn 18. The provider that started titration should continue to support this safely until medication is stable, unless there is a clear and agreed plan for another service to take over.

Once medication is stable, the provider should explain the ongoing prescribing arrangements. This may include shared care with primary care, or support from an adult ADHD pathway, depending on local arrangements and the provider involved.

The young person and their family should be told who is responsible for prescribing, what happens next and who to contact with questions.
 

Shared care means a specialist service and a GP practice agree to share responsibility for ADHD medication. This usually happens once medication has been started by the specialist service and the dose is stable.

A GP practice may agree to shared care when they have clear information from the specialist, understand what monitoring is needed, and feel able to prescribe safely.

A GP practice may decline shared care if the information is not clear, if the medication is not yet stable, if monitoring arrangements are not in place, or if the practice does not feel able to take on prescribing safely.

If there is no shared care agreement in place, the specialist service that started the medication remains responsible for prescribing and monitoring.
 

Not receiving a diagnosis does not mean that your experiences are not real or important. It simply means that based on the information available at the time of your assessment, it did not identify a neurodevelopmental profile that matches the current diagnostic criteria. 

Support, advice and guidance can still be accessed without needing a formal diagnosis. Further information of support available can be found here - Right to Choose - Support at every stage: before, during, after, or without an assessment

If a patient already has an ADHD diagnosis and is seeking NHS-funded prescribing, shared care, or to restart treatment, this may be considered ongoing management, where the Right to Choose does not always apply. However, if a new referral to a specialist ADHD service is required (for example, for medication titration or reassessment), patients may still be able to exercise their Right to Choose, provided eligibility criteria are met. Shared care arrangements remain subject to GP agreement and are not a legal right.

No formal, standardised prioritisation criteria are held centrally by the Integrated Care Board.
•    Prioritisation criteria for Right to Choose referrals are set by individual providers and may vary.
•    Practices should direct specific queries about eligibility or prioritisation to the relevant provider.
 

The contractual basis for NHS Right to Choose Indicative Activity Plans (IAPs) is outlined in the NHS Standard Contract 2025/26, which grants Integrated Care Boards (ICBs) authority to set Indicative Activity Plans.

The below principles were considered in making this decision: 

• The legal requirement for Integrated Care Board’s to achieve financial balance over the year 2025/26 and to set affordable Indicative Activity Plans (IAPs) accordingly
• Understanding the impact these decisions will have on waiting lists and patient risk and working collaboratively with providers to mitigate risks
• Completion of a Quality Impact Assessment supported by the Mental Health, Learning Disability & Autism, and Children’s Care Senior Leadership Team
• Reviewing the system transformation plan to ensure it supports the reduction of waiting lists and patient risk in the longer term
• Keeping new developments under review and revisiting this decision should there be any material changes

NHS Hampshire and Isle of Wight has applied a consistent approach to the development of Indicative Activity Plans across all providers. A Quality Impact Assessment formed a key part of the decision making process, ensuring that the impact on patient access, equity, and service quality was fully considered. This assessment highlighted that access rates within our locally commissioned services significantly exceed those available through the Right to Choose pathway.

We recognise that providers have been unable to meet the access times they previously advertised due to the introduction of these plans, and we apologise for the frustration and uncertainty this has caused. We are working closely with providers to ensure that future plans are agreed and communicated clearly ahead of the financial year, enabling patients to receive timely and transparent information. We remain committed to keeping our website updated so that individuals can make informed choices about their care.

There is no specific commissioning policy in place for ASD/ADHD assessments, however, NHS Hampshire and Isle of Wight have a transformation programme in place to redesign the pathway. This includes:

• Support before diagnosis: We are expanding services that offer advice and guidance around Autism and ADHD, including new ways to access help sooner. This includes using digital tools and improving how you receive support from services, as well as giving people clear, trustworthy information to help them understand their options and make informed decisions about medication as part of their own ADHD assessment journey.
• Strengths and Needs Assessments: By March 2026, every child in Hampshire and the Isle of Wight will have access to a joined-up team of professionals who can offer tailored advice and support. These teams will work across education and healthcare and will be available to anyone with concerns – helping to meet needs while waiting for a diagnosis.
• Redesigning the diagnostic pathway: We’re working to improve how assessments are carried out, including using new technology and making the process of prescribing and reviewing medication more efficient. We will talk with local groups and people who have real-life experience to help shape the design. A new assessment pathway will be designed by March 2026.

While we make these improvements, we are not yet able to give a specific timeframe for when you, your child, or the person you care for will be seen. We know many of you have already been waiting a long time, and we are truly sorry for the delay.

Private assessment can speed up diagnosis, but NHS-funded treatment is not guaranteed afterward.

A private diagnosis is not automatically accepted by the NHS. NHS clinicians may require an NHS assessment before starting treatment, even if you have a private report. This is because the NHS clinician takes legal responsibility for prescribing and ongoing care. Some GPs will accept a private diagnosis under a Shared Care Agreement, but this is at their discretion, and not guaranteed.

Private providers may offer diagnosis only, leaving medication titration and monitoring to the NHS. NHS services, including GPs, are not required to prescribe medication recommended by private providers. This decision will always be based on clinical judgement and NHS prescribing guidelines. If the GP declines Shared Care, you may need to pay privately for prescriptions and follow-up care, which can be costly. NHS guidance states that private and NHS care should remain clearly separate — NHS resources cannot subsidise private care.

NHS Hampshire and Isle of Wight Integrated Care Board (ICB) follow national rules that make sure more money is spent on mental health services as overall NHS funding increases. This means there is a protected budget each year specifically for mental health care.

Autism is only included in the Mental Health Investment Standard (MHIS) when there is a co-occurring mental health need. Services for autistic people without a diagnosed mental health condition are not counted under MHIS spending and therefore do not receive the same level of ring-fencing.

As part of the NHS planning cycle we will review all of our priority areas to ensure available funding is allocated to where it is needed most. In addition to diagnostic assessment services, supporting patients prior to their diagnosis and after diagnosis is a key priority area and we have a number of transformation programmes underway to greater meet these needs.

A significant focus in recent years has been on the Autism diagnosis pathway, and we are moving to a needs-led approach to provide early help and a holistic approach to improving outcomes.

For Children & Young People:

• By March 2026 every child in Hampshire and the Isle of Wight will have access to the following universal offer:
• Single point of access; Front door to an Integrated Multidisciplinary Team (MDT) with expertise in Neurodivergence, who are accessible and open to anyone who has a concern.
• Information and advice: Different levels of information (self-help) and advice (options and pathways) with all messages and information managed by the Neurodivergent MDT.
• Early identification and support (parents / carers); Parental support, ND online platform and toolkit, contact line, small group training and workshops, peer support.
• Early identification & support (professional & wider workforce); ND profiling tool, training and development, Autism in Schools project, Partnership for Inclusion of Neurodiversity in Schools, whole-school audits, ND Champions, community of practice

For Adults:

• There is an existing Autism and ADHD information, advice, and guidance service across Hampshire and the Isle of Wight, delivered by Autism Hampshire. This service currently includes a community hub in Southampton.
• In addition, two community hubs in have been piloted since October 2024, providing support, advice, and resources to adults regardless of diagnostic status — including those who are pre-diagnostic, without a formal diagnosis, and those with a confirmed diagnosis.
• The hubs are located in Andover (Our Community Hub | More Education) and Havant (ADHD and Autism Support Service – Havant & East Hants Mind).
• The Integrated Care Board has agreed to adopt the community hub model for autistic people, individuals with ADHD, and those who are otherwise neurodivergent — including people without a formal diagnosis — across Hampshire and the Isle of Wight. We have just concluded a procurement exercise to secure a more consistent offer across the Hampshire and Isle of Wight, which will commence April 2026.
• We are working to improve the visibility and promotion of these services.

There is no protected national funding for the provision of services to autistic/neurodivergent people. However, such services being a key local priority for Hampshire and Isle of Wight, a dedicated budget has been allocated to help improve them. In 2025/26 £1m of this new money has been invested in establishing strengths and needs assessments aimed at providing individualised support for children, young people and their families across education and healthcare. During the same period the ICB has funded a 167% rise in spending on diagnostic services for autistic people and those with ADHD

Any patient with a co-occurring mental health need and therefore being supported by our mental health services will have a named co-ordinator and/or responsible clinician if appropriate. We have also expanded our Learning Disability and Autism Key-worker service in 2025/26. This means that any individual on our Dynamic Support Register up to the age of 30 will be allocated a named Key-worker or Intensive Support Practitioner.