We understand that navigating ADHD and ASD referrals can be confusing. This guide explains the routes available and what to expect.
If you’re seeking an ADHD or ASD assessment, there are three main pathways available to you. Each option has different waiting times, costs, and referral processes, so you can choose the route that best fits your needs. These include:
- NHS Neurodevelopmental Service: Free but involves significantly longer waiting times.
- Right to Choose (NHS-funded): Lets you choose an approved external provider for an NHS-funded assessment, often with shorter waits.
- Private Assessment: You can self-refer and are usually seen sooner, but you will need to cover the full cost of the assessment and any follow-up care. As a GP practice, we cannot recommend or endorse any private providers. Any private assessment or provider should be researched thoroughly by the patient before choosing.
Getting an ASD Assessment
Autism assessments do not involve medication, so shared care does not apply. Please go straight to the list of providers: www.adhduk.co.uk/right-to-choose/ and then submit the referral form.
Getting an ADHD Assessment
How do I get an ADHD assessment through the NHS?
You can request an ADHD assessment by submitting a referral request to the GP. We will ask you to complete a short questionnaire to understand your symptoms. Your GP will then refer you. Previously the only option available to us was to the local NHS Neurodevelopmental Service. This is still available to us but the waiting times are currently long nationally.
What is Right To Choose (RTC)?
Because the NHS Neurodevelopmental Service has a long waiting list, you can use a process called Right to Choose (RTC). This allows you to have an ADHD or ASD assessment through an approved independent provider, funded by the NHS.
The assessment, diagnosis, and initial treatment are covered by the NHS and are free to you.
Once your treatment is stable, your care may be transferred back to your GP under a Shared Care Agreement (SCA) – but only if both the GP and local ICB approve.
Which providers can I choose under RTC?
The following providers are currently approved for shared care under Sussex ICB:
- Psychiatry-UK www.psychiatry-uk.com/right-to-choose
- ADHD 360 www.adhd-360.com/right-to-choose/
- Psicon www.psicon.co.uk/nhs/patients
- Clinical Partners www.clinical-partners.co.uk/nhs-services/right-to-choose
There are many other Right to Choose providers – some we’ve successfully worked with before, and others we’ve declined shared care with. You can find a list of these here along with their waiting times: www.adhduk.co.uk/right-to-choose/
It’s not possible for us to stay fully up-to-date with every provider outside the ICB’s pre-approved list, as their services and policies can change frequently. We therefore ask patients to do their own research and check the details of any provider before submitting a referral.
If you wish to choose a provider not on the pre-approved list, we recommend contacting them first to ask:
- Do they follow the Sussex Specific Shared Care Protocol?
- Do they meet all the requirements listed
Some providers with shorter waiting times can continue prescribing privately if shared care is declined. We recommend checking directly with the provider if this is an option they offer.
How long does it take the practice to send my referral?
Once we receive your completed questionnaire, it usually takes up to two weeks to send your referral. We will text you to confirm once it has been submitted.
How will I know my referral has been accepted?
The provider you chose will contact you directly with next steps. Timescales vary by provider.
After Your Assessment
What happens after my ADHD assessment?
Your provider will send you:
- A diagnostic report
- A treatment plan
- A prescribing / titration plan (if medication is recommended)
They should also send this information to the GP.
Can the GP start prescribing ADHD medication straight after diagnosis?
No. We can only take over prescribing after:
- Your dose has been fully optimised and stable for at least 12 weeks
- We have received a complete Shared Care Agreement (SCA)
- Your physical health checks (BP, pulse, weight) are up to date
- The specialist provides ongoing titration and monitoring until stability is reached
Until then, the specialist must prescribe.
What if my provider hasn’t sent enough information?
We cannot prescribe until all required documents are received.
If information is missing, you will be asked to contact your provider directly.
Shared Care Agreements (SCA)
What is a SCA?
A Shared Care Agreement is a formal arrangement between your GP and your ADHD specialist.
It ensures your ongoing treatment is safe, consistent, and properly monitored.
The agreement outlines:
- What the GP is responsible for (e.g. repeat prescriptions)
- What the specialist must do (e.g. advice, medication reviews and adjustments)
- What you must do (e.g. attending follow-ups and reviews)
Shared care agreements can be void if terms are not met or adhered to; an example of this is that every patient on ADHD medication requires an annual review with their specialist and if this is not carried out GPs will be unable to continue prescribing where they had previously agreed.
Do GPs accept all SCAs?
No. We can only accept SCAs based on the National Institute of Clinical Excellence (NICE) guidelines. At any point GPs can decline shared care especially if they believe for it to be unsafe for any reason.
Some private assessments cannot be supported under shared care.
Unfortunately, we cannot engage in a shared care agreement from any specialist from abroad.
Why does my GP need an updated SCA?
ADHD medication is controlled, high-risk, and requires specialist supervision.
SCAs must reflect:
- Your current dose
- Stability of medication
- Results of recent health checks
- The provider’s commitment to ongoing specialist support
If your treatment changes, a new SCA is required.
Who prescribes during titration?
Your specialist provider. GPs do not prescribe during titration. We can only take over prescribing once your dose is stable and safe.
Medication and Monitoring
What physical checks do I need before starting ADHD medication?
Most providers require:
- Blood pressure
- Pulse
- Weight
- Sometimes cardiac history or ECG (if clinically indicated)
These checks must be carried out by the provider and be up to date.
How often do I need monitoring once stable?
Usually every 6–12 months, depending on the medication. Your GP will ask you to book routine monitoring appointments to maintain safe prescribing.
You will require an annual review with the specialist to maintain the terms of the SCA and enable a GP to continue to prescribe.
What happens if I run out of medication during titration?
You must contact the specialist provider, not the GP. We are unable to issue prescriptions until your dose is stable and shared care is agreed.
What if I already have an ADHD diagnosis and want to be referred for medication titration-only?
If you have a diagnosis from a private provider or from overseasand you would like to be referred to the NHS or Right to Choose for medication then you will need to submit a new referral.
If you have a diagnosis from the NHS or a Right to Choose provider then it is recommended to go back to that provider to start titration.
NHS RTC generally do not accept a diagnosis or treatment plan from another provider. They consider it too risky to prescribe controlled medication based on another provider’s assessment or titration plan. The only options are a new referral and full assessment, or returning to your original provider if they accept this.
Right to Choose – Common Questions
Can I be referred to more than one provider?
No. You can only be on one waiting list at a time – this includes the NHS Neurodevelopmental Service.
Can I change provider after my referral is sent?
Yes. You can request a new referral but this will reset waiting times.
My provider hasn’t contacted me – what should I do?
Please contact the provider directly. They manage their own waiting lists and appointment booking.
Private Assessments (Non-NHS)
Can the GP prescribe after a private diagnosis without shared care?
No. We cannot prescribe any ADHD medication without:
- A valid SCA
- A stable dose
- Required monitoring results
- Ongoing specialist support
I can no longer afford private costs – can I transfer my care to NHS/RTC?
If you wish to move to an NHS or RTC service, you can submit a new referral. However, you would need to start at the beginning of that waiting list, as NHS and RTC services cannot take over care part-way through private treatment. This is to make sure the process is fair for all patients and that no one is able to skip ahead on the waiting list.
Changing GP or Moving Area
What happens if I move GP surgery?
Your shared care agreement does not automatically transfer. Your new practice must decide whether they can take on prescribing.
Will my new GP continue my medication?
Possibly, but not guaranteed. They will need:
- Your diagnostic report
- Full titration summary
- A valid SCA
- Recent physical observations
If anything is missing, the new GP may require the specialist to continue prescribing until safe handover is possible.
I’ve moved to Sussex – how long will I wait to transfer my ADHD care to the local NHS service?
If you move to Sussex and need to transfer your care to the local NHS Adult ADHD service, this is usually treated as a new referral, even if you already have a diagnosis or were part-way through medication titration elsewhere.
At present, waiting times for Sussex Adult ADHD services are several years, and transfers of care are not prioritised over new referrals. Being previously assessed or treated by another service does not usually reduce the waiting time.
The local service may review previous reports for background information, but medication is not normally continued until you are formally accepted into their service.
Your GP can discuss your options with you, including referral to the local Sussex service or, if you are eligible, the Right to Choose pathway.
How Do I Submit My Referral Request?
Once you have read the above information and chosen your preferred provider, please complete the online referral form.
After we receive your form, it may take up to two weeks to process and send your referral to the provider you’ve chosen. We’ll text you to confirm as soon as it’s been submitted.