The media has widely publicised the increasing wait times to access autism and ADHD diagnostic assessments. With some NHS Trusts assessing less than 5% of their rising waiting lists annually, wait times of up to 10 years and some areas closing the doors on new referrals altogether, we are facing a true crisis.
The impacts of not being able to access diagnostic assessments in a timely fashion are manifold. For example:
Escalating comorbid mental health conditions, such as anxiety and depression
Poor school attendance and performance due to emotional-based school avoidance
The inability to remain in employment because workplace adjustments are not being offered
Increased numbers of undiagnosed neuro minority people in the criminal justice system
Cumulative trauma negatively and irreversibly affecting life outcomes
At an individual level, people's lives are grossly impaired. In a broader sense, this creates extensive socio-economic ramifications, costing the Government and the UK tax payer significantly more than it needs to.
With the median wait time from referral to first clinical contact increasing from 91 days in April 2019 to 281 days in November 2023, the press coverage focuses on belittling the NHS for not being able to meet demand, and argues over whether the demand is even legitimate. However, what they fail to communicate is how the crisis can be resolved.
Do You Know Your Rights?
According to the NHS Constitution:
‘You have the right to access certain services commissioned by NHS bodies within maximum waiting times [18 weeks], or for the NHS to take all reasonable steps to offer you a range of suitable alternative providers if this is not possible.
You have the right to receive NHS services free of charge.
You can decide which provider you would like to receive care from as an outpatient.’
This applies to autism and ADHD diagnostic services, so why, if patients have a right to access these services within 18 weeks, are people waiting closer to 18 years? We believe this is largely due to people not knowing their legal rights.
Under the NHS Patient Choice Framework, patients have the Right to Choose their preferred alternative and qualifying provider, if the local wait time exceeds 18 weeks.
Who is eligible?
The NHS Right to Choose scheme is only available in England, excluding the rest of the UK. The criteria for eligibility are:
You must:
Be registered with an NHS GP in England
Have to wait, or have already waited more than 18 weeks before starting your assessment
Have the mental capacity to choose your provider and undergo an assessment
You must not be:
Currently under an urgent or emergency (crisis) care team
In high security psychiatric services
Detained under the mental health act
Detained in a secure setting, such as prison or a secure children’s home
Serving as a member of the armed forces
How to access Right to Choose
The first step is to research and choose your preferred provider. ADHD UK maintains a helpful list of eligible providers on their website.
Once you have chosen, you will need to book an appointment with your GP and advise them that you believe you need an assessment for ADHD, autism or both. It is helpful to complete a self-report screening questionnaire and prepare a letter formally requesting to exercise your Right to Choose. If your GP agrees that a referral is appropriate, then you can request this is sent to your preferred provider who will take care of things from there.
Some RTC providers have wait times of up to 52-weeks. However, ION’s preferred diagnostic provider, RTN Mental Health Solutions is a new RTC provider and currently has a median wait time from referral to first clinical contact of six weeks (42 days). They also have a helpful Right to Choose webpage covering the process in more detail and providing free templates for the GP letter and self-report screening questionnaires described above.
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