Explained - The proposed changes to the NHS Right To Choose
I have had a couple of questions about the proposed change to the right to choose, so I thought I would take the time to explain in more detail why they matter.
What is happening?
NHS England is currently undergoing a short consultation on the 2025/26 NHS
Payment Scheme. The NHS Payment Scheme (NHSPS) is the system that decides how NHS services get paid
in England. It sets the rules and prices for how hospitals, clinics, and other providers are funded for
the care they give to patients.
This consultation document conceals a change that allows
ICBs (Integrated Care Boards) to limit funding for activity-based services, including ADHD assessments.
What are ICBs (Integrated Care Boards)
ICBs are local organisations that plan and manage NHS services in different regions of England. They decide how funding is allocated to hospitals, community care, and other health services, working with local partners to ensure care is coordinated and meets their area's specific needs.
Why Does this Matter?
This isn’t an explicit ban on the right to choose, which would be unpalatable politically. However, it creates a plausible pathway for ICBs to decide not to fund certain referrals (such as ADHD assessments), restricting patient choice through financial controls rather than clear policy changes.
The consultation documents don’t openly discuss this shift—the language is technical and buried in sections on payment adjustments. The key issue is that NHS England doesn't clearly assure us of how ADHD services will be protected.
Given the long-standing inconsistency in the application of Right to Choose and shared care plans (which
are a crucial part of Right to Choose), this doesn’t bode well. Just ask anyone with a shared care
agreement with a Right to Choose provider who was denied for financial reasons, something that is already
happening.
Considering that so many neurodivergent people rely on the Right to Choose as their only
viable option for assessment, this is a massive red flag.
What Can I do?
Spread the word, share this blog to raise awareness
Get in Touch | ADHDaptive - ADHD Coaching & Consultancy
- Write to your MP (you can use the template in this post)
- Respond to the consultation, which is now open to the public.
- Spread the word and share this blog to raise awareness.
- Get in Touch | ADHDaptive - ADHD Coaching & Consultancy