Your Options
Patient Information: Understanding Local Pathways, NHS Right to Choose and Your Options
Many families contact us because they are confused about the difference between local NHS neurodevelopmental pathways and NHS Right to Choose.Parents are often told that referrals must follow the local pathway, whilst hearing that patients have a legal right to choose their provider. This can create uncertainty and frustration for families already waiting for support. This page aims to explain the position as clearly as possible.
What Is the Local Neurodevelopmental Pathway?
The local neurodevelopmental pathway is commissioned by the local NHS system to assess children and young people for autism and ADHD.
In each area, referrals are typically directed through the local pathways. The local pathway is designed to provide assessment and support services for local residents and is funded through local commissioning arrangements. Many families enter this pathway through referral from their GP, school, paediatrician or another healthcare professional.
What Is NHS Right to Choose?
The NHS Choice Framework gives many patients in England the right to choose the organisation providing their first outpatient appointment when certain conditions are met.
For neurodevelopmental assessments, many families have used NHS Right to Choose to access alternative providers where these providers hold appropriate NHS contracts and meet regulatory requirements.
The National Autism Assessment Centre (NAAC) is a CQC-registered provider and holds an NHS contract with Mid and South Essex Integrated Care Board.
Patients who believe they may be eligible for NHS Right to Choose should discuss this with their GP and seek individual advice based on their circumstances.
Understanding Part A and Part B Commissioning Arrangement
One area of confusion relates to how autism and ADHD services are funded.
Part A: Local Block Contract Services
Part A funding generally refers to services commissioned locally by an Integrated Care Board (ICB) through block contracts or locally commissioned arrangements.
Examples include:
• Local neurodevelopmental pathways
• Community paediatrics
• Local mental health services
• Local autism assessment services
These services are funded from budgets agreed between the local NHS commissioner and provider organisations.
Patients referred into these pathways usually receive care through local waiting lists and local service arrangements.
Across England, there are differences in how local systems interpret and operationalise NHS patient choice for autism and ADHD pathways.
Why Is There Confusion?
As a result:
• Some families are referred under NHS Right to Choose without difficulty.
• Some families are advised to enter a local pathway first.
• Some families are asked to obtain additional information before referral.
• Some families are advised that local processes must be followed.
This can lead to variation between different areas of the country.
Part B: Patient Choice and Activity-Based Contracts
Part B arrangements are different.
Where NHS patient choice applies, funding may follow the patient rather than remaining solely within a local block contract.
Under these arrangements:
• The patient chooses an eligible provider.
• The referring clinician makes the referral.
• The assessment is funded through the provider’s NHS contract arrangements.
• The assessment activity is paid for separately from the local block contract.
This distinction is important because local pathway funding and patient choice funding are not necessarily the same budget stream. For this reason, a referral under NHS Right to Choose is not simply a “transfer” from one waiting list to another. It may involve a different commissioning and payment mechanism.
What Can Families Do?
If you believe your child, young person or yourself requires an autism or ADHD assessment:
Step 1 Discuss your concerns with your GP
Step 2 Ask about the local referral pathway
Step 3 If you wish to explore NHS Right to Choose, discuss this with
your GP and ask whether it may apply to your circumstances.
Step 4 If your GP advises that a Right to Choose referral cannot be
made, ask for a written explanation of the relevant policy,
commissioning arrangement or pathway guidance being relied
upon.
Step 5 Keep copies of all correspondence and referral decisions
Keep copies of all correspondence and referral decisions
Our Commitment
At the National Autism Assessment Centre we believe families deserve:
• Clear information
• Transparent processes
• High-quality multidisciplinary assessments
• Compassionate care
• Evidence-based post-diagnostic support
We encourage families and professionals to work collaboratively to achieve the best outcomes for children, young people and adults awaiting assessment.
About the National Autism Assessment Centre
The National Autism Assessment Centre (NAAC):
• Is a CQC-registered provider.
• Holds an NHS contract with Mid and South Essex Integrated Care Board
• Provides face-to-face autism assessments.
• Provides face-to-face ADHD assessments.
• Provides combined autism and ADHD assessments.
• Offers post-diagnostic support planning and guidance.
For information:
Website: www.nationalautismassessment.com
Email: RTC@nationalautismassessment.com
General Enquiries: enquiries@nationalautismassessment.com
Telephone: 0203 518 4436
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Step 5
Right to Choose
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Pathway 1
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Pathway 2
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Neurodiversity Insight Screening
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Combined Autism & ADHD
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Right to Choose ✳︎ Pathway 1 ✳︎ Pathway 2 ✳︎ Neurodiversity Insight Screening ✳︎ Combined Autism & ADHD ✳︎
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