NHS Right to Choose (RTC) is a policy that allows NHS patients to choose a healthcare provider for their initial or first specialist appointment. It applies to both children and adults, and to physical as well as mental health services.

RTC is a legal right for NHS patients. However, you cannot self-refer. Your GP has to agree that a referral for specialist treatment is needed. If they do, then you have the right to choose the organisation to whom the referral is made. This includes NHS organisations as well as private or independent providers. The only condition is that your chosen provider must have a contract with the NHS to provide the required service in England. If your GP refers you or your child to an RTC provider and this referral is accepted and delivered in line with this contract, then this service will be paid for by the NHS.

Patients who are already on a waiting list for an NHS service and are likely to wait longer than the maximum waiting time (18 weeks for most non-urgent referrals) have the legal right to ask for their appointment to be moved to a different provider.

Do your research before requesting an RTC referral. You could ask other parents, look at NHS websites and contact potential providers. Bear in mind, however, that some providers recommended by other families may now have long waiting lists or no longer accept referrals. You should also consider the cost of travel, as the NHS does not pay for this. Another important consideration is medication. If the initial assessment shows that medication is needed, who will prescribe and monitor it? Not all RTC providers offer this service.

Top tips

• Talk to your child’s school and GP before requesting a RTC referral. This is so that you can seek additional views and information about how best to start collecting the information that will be needed for a referral to be made.
• Provider lists update frequently on RTC platforms, which means that if your GP does not act quickly, the wait list may be longer or the provider may close their wait list.
• Keep a diary of times when things have been difficult or easier for your child whilst you await an assessment. Include your child’s voice where possible. This is especially important for children who mask.
• Be aware that the RTC provider may contact you quickly and that information may be required in a short time frame for you to retain your place on the wait list.
• Choose a provider that follows NICE guidance in their assessments so that any diagnosis will quickly be accepted by the Local Authority and NHS. This is especially important if you pay for the service yourself (rather than using RTC).
• If you think that your child may need ADHD medication, ensure you choose a provider who offers this service. Keep your child on the NHS waitlist.
• If medication is required, enquire if your GP would be willing to support shared care arrangements with the RTC provider.
• If the GP refuses to take on a shared care arrangement with RTC provider, you will need to request to be added to the medications titration pathways and you may have to pay for this treatment.
• Do NOT remove your child or young person from the NHS waitlist, as when assessed on the NHS, your GP may then engage in local shared care arrangements.
• Try not to use providers who only offer virtual assessments, especially for children who mask.