Right to Choose Autism: Faster NHS Assessments in England

If your GP has suggested an autism assessment, you’ve probably heard about NHS waiting lists stretching well over a year in some areas. The good news is that England residents have a legal right to choose a faster route—and that route is called Right to Choose. Patients registered with a GP in England can ask for a referral to an approved provider like Psychiatry UK, potentially cutting months off their wait. This guide walks through exactly how it works, who qualifies, and what to expect at each stage.

NHS Right to Choose Applies To: Autism assessments in England ·
Key Provider Example: Psychiatry UK ·
Eligible Ages: Children 5+ and adults ·
Referral Required From: GP ·
Supporting Since: 2018 (Psicon)

The table below summarises the key facts about who can use Right to Choose for autism assessments and which providers operate in England.

Does right to choose apply to autism?

Yes. The Right to Choose (RTC) policy gives patients in England the legal right to select an NHS-approved provider for their first outpatient appointment for Autism Spectrum Disorder (ASD) assessment. This right is embedded in the NHS Constitution and applies specifically to new assessments—not to people who already have a diagnosis on their NHS record.

To use RTC for autism, three conditions must be met. First, you must be registered with a GP in England. Second, your GP must agree that an autism assessment is clinically appropriate and make the referral. Third, the provider you choose must hold an NHS contract and have been formally approved by an NHS commissioner or Integrated Care Board (ICB).

Providers like Psychiatry UK, Psicon, ProblemShared, and RTN Mental Health have all undergone this approval process. By commissioning these providers, the NHS has confirmed that their assessment teams meet national standards and that their diagnostic reports are suitable for NHS use.

RTC does not apply in Scotland, Wales, or Northern Ireland, and eligibility is lost if you move out of England during the process. The policy also excludes urgent or emergency care, existing care for the same condition, armed forces personnel, and patients in secure settings.

NHS England rules

• Only GPs can make RTC referrals; schools, colleges, or other agencies cannot initiate the process
• The service must be consultant-led or led by a qualified mental health professional
• All RTC providers must follow NICE guidelines for autism assessment
• Patients can request RTC even if they are already on another NHS waiting list for a different condition

How to get an autism diagnosis right to choose?

The process starts with a conversation with your GP. You discuss your symptoms or concerns, and if your GP agrees that an autism assessment is warranted, they initiate the Right to Choose referral. This is not a standard NHS referral—it explicitly invokes your right to choose an alternative provider.

Your GP should provide you with a list of RTC-approved providers operating in England, along with details about each provider’s location, quality ratings, and adherence to NICE guidelines. You then indicate which provider you would like to be referred to.

For some providers, the referral requires specific paperwork. Dr J & Colleagues, for example, asks for a GP letter stating that the referral is under RTC, a medical summary, and a completed AQ10 questionnaire—a validated screening tool that helps clinicians understand your symptoms before the full assessment.

GP referral process

• Book an appointment with your GP and explain that you would like to be assessed for autism under Right to Choose
• Your GP discusses your symptoms, agrees on the clinical need, and confirms you are a first outpatient for this condition
• Ask your GP for the AQ10 form to be completed—this is often included in the referral package
• Your GP sends the referral letter to your chosen provider, which then contacts you to schedule an appointment

You may also want to read our guide to Universal Credit eligibility if you are applying for benefits while awaiting assessment.

Requesting specific providers

• You have the right to name a preferred provider; your GP cannot insist on a default local service if an RTC option exists
• If you have a specific provider in mind—such as Psychiatry UK, Psicon, ProblemShared, or RTN Mental Health—state this clearly at the appointment
• Some providers offer online assessments, which can be helpful if you live in an area with limited local NHS services
• After a positive diagnosis, some providers offer post-diagnosis support—such as psychoeducation sessions for under-17s (ProblemShared) or multidisciplinary follow-up care (RTN Mental Health)

What are the 7 signs of autism?

Autism presents differently in each individual, but clinicians typically look for a combination of signs across two broad areas: social communication challenges and repetitive or restricted behaviours. The NHS and specialist assessment providers use standardised tools and clinical interviews to evaluate these areas.

Common signs that may prompt a referral include difficulty with social interaction—such as trouble understanding tone of voice, body language, or implied meanings in conversation. Many autistic people also find processing sensory information differently, which can mean heightened sensitivity to sounds, lights, textures, or smells.

Early indicators

• Difficulty making eye contact or avoiding it entirely
• Late or unusual speech development in childhood
• Repeating words or phrases (echolalia) without apparent purpose
• Strong preference for routines and distress when routines are disrupted
• Intense, focused interests that dominate attention
• Difficulty understanding social norms or unwritten social rules
• Repetitive movements or gestures—such as rocking, hand flapping, or finger flicking

Common behaviors

• Monotropism: a tendency to focus attention narrowly on one thing at a time, which is theorised by some neuroaffirming researchers as a core autistic cognitive style
• Stimming: self-stimulatory behaviours like finger flicking, which serve regulatory functions such as managing sensory overload or expressing excitement
• Tunneling: a state of deep focus on a specific interest or activity, sometimes to the exclusion of other stimuli—this is related to monotropism
• Sensory processing differences: either heightened or reduced sensitivity across the five senses

What is finger flicking in autism?

Finger flicking is a form of stimming—self-stimulatory behaviour that many autistic people use to regulate their sensory experience or manage emotional states. It involves rapid, repetitive flicking or waving of the fingers, sometimes in front of the eyes.

Far from being a meaningless quirk, stimming serves a real function. For many autistic individuals, finger flicking and similar repetitive movements help manage sensory overload, express excitement or anxiety, or maintain a sense of calm in overwhelming environments.

Stimming explanation

• Stimming is common across autistic children and adults and is considered a normal part of the autistic experience
• It is not harmful and should not be suppressed unless it causes distress or safety concerns
• Assessment clinicians recognise stimming as part of the behavioural criteria for autism diagnosis
• Some autistic people find that stimming reduces when sensory environments are adjusted—for example, by reducing background noise or dimming lights

Sensory processing

• Many autistic people process sensory information differently from neurotypical individuals—this is known as sensory sensitivity variation
• This can mean hypersensitivity (over-responsive) or hyposensitivity (under-responsive) across the senses
• Stimming is one way the nervous system self-regulates in response to sensory differences
• Understanding sensory processing differences is a core part of autism assessment under NICE guidelines

What level is mild autism?

The term “mild autism” does not appear in clinical diagnostic manuals, but it is widely used informally to describe individuals who meet criteria for Autism Spectrum Disorder but require relatively limited support in daily life. In the DSM-5, autism is categorised across three support levels.

Level 1, sometimes informally described as “mild” autism, means that the individual has some difficulty with social communication and may need support with organising and planning, but does not require significant daily assistance. Historically, Level 1 autism was sometimes called Asperger’s syndrome, though this term is no longer used in formal diagnostics.

DSM-5 levels overview

• Level 1: “Requiring support.” Social communication difficulties are present without significant structural language impairment. Difficulty initiating social interactions and reduced or absent response to social overtures from others.
• Level 2: “Requiring substantial support.” Marked deficits in verbal and non-verbal social communication skills. Visible difficulty initiating social interactions and reduced or abnormal response to social overtures.
• Level 3: “Requiring very substantial support.” Severe deficits in verbal and non-verbal communication causing severe impairment in functioning. Very limited initiation of social interactions and minimal response to social overtures.

Support needs

• Level 1 autistic individuals may need support in areas such as employment adjustments, social relationship navigation, and managing sensory sensitivities
• Even “mild” autism can significantly impact daily functioning depending on the individual’s environment and stressors
• Post-diagnosis support needs vary widely—some Level 1 autistic people need little ongoing intervention, while others benefit from therapy, workplace adjustments, or community support
• The level assigned at assessment is not fixed and can be reviewed if circumstances change

Steps: How to exercise your Right to Choose for autism

Patients who successfully navigate the RTC process report that receiving a diagnosis sooner allows them to access support adjustments earlier, potentially improving outcomes at work or in education.

The pattern from advocacy organisations and NHS commissioning bodies is consistent: RTC diagnoses carry the same clinical weight as any other NHS-funded assessment. The PDA Society’s position is explicit—commissioning a provider means the NHS has already validated their competence, safety, and diagnostic standards. Any reluctance from other parts of the NHS to recognise those diagnoses is, in the Society’s view, unreasonable.

Patients with suspected ADHD alongside autism often turn to the NHS Right to Choose ADHD and autism for streamlined GP referrals and quicker NHS diagnostics in England.

Frequently asked questions

You may also find our guide to Statutory Sick Pay eligibility helpful if you need to take time off work for appointments.