NHS Right to Choose ADHD and Shared Care Crisis
Update, October 2025: NHS Right to Choose ADHD remains protected after the controversial clause in the NHS Payment Scheme that threatened it was removed. Public pressure worked. But new regional issues are emerging, and shared-care agreements remain under strain. This article explains what changed, why it mattered, and what you can do next.
In early 2024, NHS England proposed changes that could have stripped away the Right to Choose for ADHD assessments. Thousands of people spoke out, and it worked. The clause has now been withdrawn, protecting patient choice for ADHD care across England.
But that doesn’t mean the fight is over. Local Integrated Care Boards (ICBs) are now making their own decisions about referrals, and some areas are already restricting access. The pressure that reversed this policy needs to continue because people are still being turned away.
If you are trying to understand the wider ADHD support system in the UK, start with my main guide to ADHD support in the UK, covering NHS pathways, Right to Choose, shared care, Access to Work and practical support options.
NHS Right to Choose ADHD: What’s Happened Since 2024
April 2024: Public backlash stops proposed clause
After widespread criticism from ADHD advocates and charities, NHS England removed the controversial clause from the Payment Scheme that would have allowed local ICBs to block ADHD Right to Choose referrals. The reversal followed petitions, open letters, and public pressure from campaigners across the UK.
May 2025: Coventry & Warwickshire ICB pauses adult ADHD referrals
Coventry and Warwickshire ICB suspended new NHS ADHD referrals for adults over 25. ADHD UK launched a legal challenge, arguing that the decision is discriminatory and undermines the Right to Choose principle.
June 2025: NHS England responds to ADHD Taskforce report
NHS England responded to the ADHD Taskforce interim report, acknowledging major access problems and promising to improve early intervention, assessment capacity, and shared-care consistency across England.
July 2025: Service providers affected
Clinics such as Clinical Partners and Problem Shared were affected by local restrictions, leaving patients uncertain about their referral progress. Some providers temporarily paused new NHS ADHD referrals in affected regions.
September 2025: New adult ADHD services in Essex
Mid and South Essex ICB commissioned five new ADHD service providers to reduce assessment and treatment waiting times. Regional inconsistency remains a problem, but some areas are making progress.
Ongoing: Shared-care prescribing under pressure
Several Local Medical Committees (LMCs) and Primary Care Networks (PCNs) have advised GPs to stop accepting new ADHD shared-care agreements because of workload concerns and local prescribing guidance. This continues to threaten continuity of care for patients diagnosed under Right to Choose.
What You Can Do Now
- Write to your MP. If you have been refused an ADHD referral under Right to Choose, contact your MP. Use the template letter below to help structure your message.
- Report issues to ADHD UK. They are tracking where ICBs are breaching the Right to Choose framework. Each report increases pressure for NHS England to act.
- Discuss the issue directly with your GP. Stay calm and clear. Ask direct, factual questions.
- My previous GP supported my care needs under a shared-care agreement. Can you explain why this practice cannot?
- If you are unable to enter shared care, which provider can you refer me to under Right to Choose that you will work with?
- Is this refusal based on practice policy, or guidance from the Local Medical Committee or Primary Care Network?
- Can I have a copy of the policy or guidance your decision is based on?
These questions keep the conversation factual. They ask for the policy, the source of the decision, and the route forward.
- Keep records. Write down who you spoke to, when, and what was said. This is vital evidence if you need to escalate a complaint or contact your MP.
- Share your story. Personal experiences help others and highlight where the system is failing. You can comment or contact me directly.
- Stay informed. Follow updates on NHS ADHD policy, shared-care prescribing, and local ICB decisions. Each area has different rules and these change often.
When Right to Choose Isn’t Enough: The Shared Care Breakdown
Even when people finally secure an ADHD diagnosis through Right to Choose, many still face another barrier: GPs refusing shared care. In some regions, Primary Care Networks (PCNs) and Local Medical Committees (LMCs) have issued recommendations discouraging GPs from entering new shared-care agreements for ADHD medication. Practices often adopt these policies as default, even when patients have stable treatment plans in place.
This means that, even with a valid NHS diagnosis, a GP can refuse to prescribe ADHD medication locally. Patients are then left to cover expensive private prescriptions that can exceed £100–£200 per month. For many, that makes continuing treatment impossible.
Shared care is a fundamental part of the Right to Choose process. It allows external providers to work with NHS practices so that once a diagnosis and treatment plan are approved, medication can be safely managed by the GP. When shared care is withdrawn, people are left diagnosed but untreated. That is an unacceptable gap in care.
This is also why shared care should not be treated as a separate admin issue. It sits inside the wider problem of ADHD support in the UK, where diagnosis, medication, workplace support and practical help are often split across different systems.
I’ve experienced this personally. After being diagnosed privately, my previous GP agreed to shared care and everything worked smoothly. When I moved, my new GP refused to share care with my provider and insisted I get a new assessment through Psychiatry-UK under Right to Choose. That process took a year. It’s a postcode lottery, not only about whether a GP will agree to shared care, but also which providers they will recognise.
This selective approach undermines the purpose of Right to Choose. Without shared care, the pathway breaks down. People end up waiting years, paying privately, or stopping treatment altogether. It’s a systemic failure, and it’s why this fight isn’t over, even after the clause was withdrawn.
Template Letter to Your MP
Subject: Concern about NHS ADHD Right to Choose access and shared care
Dear <Your MP> MP,
I am writing as one of your constituents regarding ongoing problems with NHS ADHD services, particularly around Right to Choose referrals and ADHD shared-care agreements.
Although NHS England removed the proposed changes that threatened ADHD Right to Choose, many people are still struggling to access assessment, treatment and ongoing support. In some areas, referrals are being restricted or delayed, and some GP practices are refusing ADHD shared-care agreements even after diagnosis and stabilisation.
This leaves people stuck between services, facing long waits, high private prescription costs, or loss of treatment altogether. Access to ADHD care appears increasingly inconsistent depending on postcode and local policy decisions.
I would appreciate it if you could raise these concerns with NHS England and ask what action is being taken to ensure consistent access to ADHD assessment, medication and shared care across the country.
Thank you for your time, and I would welcome any response or update you are able to provide.
Yours sincerely,
<Your Name>
Related Resources
Frequently asked questions
Is NHS Right to Choose ADHD still available?
Yes. The clause that threatened ADHD Right to Choose was removed, but local access issues and referral restrictions can still affect people depending on their area.
Can a GP refuse ADHD shared care?
A GP practice can refuse to enter a shared-care agreement. This can leave people diagnosed but unable to get ADHD medication prescribed locally through their GP.
What should I do if my ADHD Right to Choose referral is refused?
Ask for the reason in writing, request the policy or guidance behind the decision, keep records, and consider contacting your MP or reporting the issue to ADHD UK.
Page updated: 07 May 2026
Originally published February 2024, updated October 2025 and reviewed again on 07 May 2026.
You can read more practical ADHD, NHS, shared care and workplace support articles on the ADHDaptive blog.