Changes to Right to Choose arrangements for ADHD and autism assessments
This page explains changes affecting some non-urgent ADHD and autism referrals made through the NHS Right to Choose process in Greater Manchester.
It does not describe every NHS autism or ADHD assessment pathway. Different arrangements may apply depending on your age, the type of assessment and the service holding your referral.
We understand that waiting for an assessment can be difficult and worrying. This page explains what the changes mean, what to do if your needs change and where to find help while you wait.
Current challenges
- Long waiting times: Demand for ADHD assessments has grown beyond service commissioned capacity. Waiting lists are expected to exceed 30,000 people across Greater Manchester without changes.
- Unequal access: We have changed the way our services work so that people who need help most urgently are prioritised. This means we no longer use a “first come, first served” approach. Instead, we look at each person’s needs to make sure the right support is provided at the right time. We also know that access to support has not always been the same across Greater Manchester, depending on where people live. We are working to make services fairer and more consistent, so everyone can access the care they need.
- Concerns about long-term service quality: We are making changes to how services are delivered to make sure they can continue to meet people’s needs now and in the future. Demand for support has increased, and services are being updated to use resources more effectively. These changes will help ensure that care is focused on people who need it most, while also making services more sustainable and easier to access across Greater Manchester.
What services does this page cover
This page is about the management of non-urgent ADHD and autism referrals and appointments with Right to Choose providers commissioned through NHS Greater Manchester.
It should not be used as a description of every children’s or adult autism and ADHD pathway in Greater Manchester.
If you are looking for information about changes affecting children and young people aged 0 to 18, visit our page about changes to autism and ADHD support and assessments for children and young people.
NHS Greater Manchester has changed how new non-urgent ADHD and autism appointments are arranged with Right to Choose providers.
Appointments are being scheduled within the capacity and activity available to each provider. This means that some people may wait longer to be seen.
Providers are expected to consider clinical need when deciding how urgently a person should be seen.
If your referral is covered by the arrangements described on this page, it should remain recorded with the relevant provider or service. Contact the provider holding your referral if you are unsure whether it remains active.
NHS Greater Manchester is the Integrated Care Board responsible for planning and funding local NHS services.
It must manage services within its agreed budget. Demand for ADHD and autism assessments is currently higher than the level of activity that can be funded and delivered through existing services.
NHS Greater Manchester has therefore agreed planned activity levels with Right to Choose providers. This affects how many appointments each provider can offer.
If your referral is being managed through the arrangements described on this page, it will remain recorded with the relevant service or provider. How referrals are reviewed and prioritised may depend on the pathway and the person’s clinical needs.
- You still have the right to choose your provider
- This may mean some people face longer waits on right to choose pathways. Everyone will stay on the waiting list and will be offered an assessment as soon as capacity allows, guided by clinical priority. People who are currently being assessed, have already received a diagnosis, or are receiving treatment will continue to be supported.
If you or your child are feeling anxious, stressed or overwhelmed there’s a range of support available. Visit our Get to Know Where to Go for mental health support page or the Hub, designed to support young people Mental Health | Greater Manchester Integrated Care Partnership.
If you feel you need more urgent help, options are available without needing to contact your GP practice first visit our Get to Know Where to Go for mental health support page
Higher clinical need means that the information available indicates that a person’s situation may be more urgent or complex, or that waiting longer may create a greater risk to their health, safety or wellbeing.
Clinical professionals make prioritisation decisions using the information available to them. Being prioritised does not necessarily mean that an appointment will be available immediately.
If your needs have significantly changed, contact the provider holding your referral. Explain what has changed and provide any relevant new information.
You do not need to ask your GP to make another referral unless the provider advises you to do so.
Children and Young People
Schools and colleges should consider appropriate support and reasonable adjustments based on the child or young person’s needs.
If a child or young person may need more help than is normally available through special educational needs support, a request can be made to the local authority for an Education, Health and Care needs assessment.
Schools do not issue Education, Health and Care plans. The local authority is responsible for deciding whether an assessment is needed and whether a plan should be issued.
Adults
Employers must consider reasonable adjustments where the legal requirements apply. Examples may include:
- written instructions
- a quieter working environment
- changes to working patterns
- support with planning and prioritisation
You may also be eligible for support through the government’s access to work scheme.
You can find further information onour support page
Under the NHS Right to Choose, you can choose which provider you are referred to for your ADHD or autism assessment.
Once your care has started, your assessment and any follow-up treatment will be provided by the same provider. This helps make sure your care is safe, consistent, and well-coordinated.
This means you cannot move to a different provider part-way through your care for the same condition.
If you have concerns about your care, you should speak to your current provider in the first instance, as they are best placed to support you and discuss your options.
Who you should complain to depends on what your concern is about.
If your complaint is about the care or service provided
You should complain to the provider organisation that delivered the service. This includes concerns about assessments, treatment, waiting times, communication, discharge, or how the provider delivered the service under its National Health Service contract.
If your complaint is about a provider’s National Health Service contract
You may complain to the commissioner (Integrated Care Board) that holds the contract with that provider.
If your complaint is about a referral or access to the Right to Choose
You should complain to NHS GM. This includes concerns about referrals not being made or being refused the opportunity to use the Right to Choose.
If you are unsure
You can contact your local Integrated Care Board complaints team, who can advise you or pass your complaint to the correct organisation.
If your provider is unable to continue operating, the Integrated Care Board (ICB) will already be aware and will work as quickly as possible to arrange alternative services.
In the meantime, your first point of contact should be your GP practice, particularly if you receive regular medication or ongoing care. While they may not have information about next steps, they can help ensure there are no immediate risks to your health while new arrangements are being put in place.
NHS Greater Manchester (NHS GM) understands that some patients may be concerned that their assessment or treatment pathway has been interrupted.
We have been working with providers to identify patients whose care has been affected and to put arrangements in place to enable these pathways to be completed.
If your pathway has been interrupted, you do not need to contact NHS GM or ask your GP to make a new referral. Your provider will contact you directly to arrange any outstanding appointments.
Please be aware that providers will have different waiting times and appointment availability. As a result, the time taken to complete assessment and treatment pathways will vary between providers.
Patients should expect to hear directly from their provider over the coming months. If you have not been contacted and have concerns about your care, please contact your provider in the first instance.
People in Greater Manchester do not have to wait a set period of time before they can be referred for an ADHD or autism assessment. While some Integrated Care Boards (ICBs) have introduced minimum waiting times, NHS Greater Manchester has not.
If your needs become more urgent, support is available. For urgent mental health concerns, you can call NHS 111 and choose option 2 for Mental Health or contact your GP practice. If you feel you need an ADHD or autism assessment to be prioritised, please speak directly to your current provider, as they are able to review requests for urgent consideration.
The Integrated Care Board (ICB) is not able to make decisions about individual urgent cases or expedite assessments, as this requires clinical judgement.
If a GP declines to enter into a shared care agreement for ADHD medication, this does not affect your access to treatment or the quality of your care. In these circumstances, the specialist provider responsible for the ADHD diagnosis and treatment will continue to oversee and prescribe the medication directly. The GP’s decision relates only to who issues the prescription, and should have no impact on clinical oversight, medication review, or ongoing care.
We have made some changes to how ADHD and autism assessments are provided to make sure care is safe, high quality, and follows national guidance.
Across NHS Greater Manchester, providers are now expected to offer autism assessments face to face, and to carry out ADHD physical health checks in person. These changes help ensure assessments are thorough, clinically robust, and meet NICE (National Institute for Health and Care Excellence) guidelines.
Some providers have not been able to move to this model of care. In these cases, NHS Greater Manchester has worked with them to return patients to local services so that assessments can be completed in line with these standards.
These changes do not affect your right to choose where you receive care. You can still choose from a range of providers, including local services and Right to Choose providers. The aim is to make sure that, wherever you are seen, your care meets the same high standards.
NHS Greater Manchester gave all Right to Choose providers their planned workload and funding allocations (known as Indicative Activity Plans) in April 2026. These plans comply with national guidelines around how NHS services are planned and managed. However, providers will only be able to see a certain number of patients within the capacity and activity levels set out in their Indicative Activity Plan. This means that they will only be able to assess those with the most urgent clinical need.
While you wait
We know waiting can be tough. In the meantime, you can:
- Visit the NHS web pages ADHD in adults – NHS and Autism – NHS
- Explore local support groups or charities
- Talk to your GP about self-management strategies
Thank you for your patience and understanding.
