Right to Choose Autism Assessments in Wales

If you have been researching autism assessments online, you have probably come across the phrase “Right to Choose”. It is widely discussed on forums, social media and provider websites, often as a way to access an NHS-funded assessment more quickly.

Most of that information is written for people in England. The NHS in Wales is organised differently, so it is important to understand which arrangements apply to you before making plans or contacting a provider.

In England, eligible patients who are referred by their GP for a first outpatient appointment have a legal right to choose which provider they are referred to, provided the provider holds an appropriate NHS contract and the service is clinically appropriate.

For autism, this has meant that some eligible patients registered with a GP in England can ask to be referred to an alternative NHS-funded assessment service, rather than waiting for their local service. Eligibility rules and exceptions apply, and the referral still needs the agreement of the referring clinician.

No — not in the way it works in England. Health is devolved, and NHS Wales has its own referral and commissioning arrangements. If your GP is in Wales, your NHS autism assessment is normally provided through the neurodevelopmental or autism service commissioned by your local health board.

This means people living in Wales do not have the same statutory Right to Choose entitlement as eligible patients registered with a GP in England, even if an English provider advertises Right to Choose assessments.

In some situations, an NHS referral to a service outside Wales may be possible — for example where a service is not available locally and a referral is clinically appropriate. These referrals normally need to be authorised through the relevant NHS Wales arrangements, and are decided case by case.

This is not the same as using England’s Right to Choose pathway, and it should not be expected as a standard option. If you live near the border, or your GP arrangements are unusual, ask your GP practice or health board which rules apply to you.

The usual first step is to speak to your GP or another appropriate professional about your concerns. They can explain the local pathway and, where appropriate, make a referral.

For adults, referrals are usually made to an adult neurodevelopmental or autism assessment service in your health board area.

For children and young people, referrals may come from a GP, health visitor, school or other professional, and are usually made to the health board’s children’s neurodevelopmental service. Local routes vary.

Our guide to getting an autism assessment in Wales explains the process in more detail.

Discussions of Right to Choose often treat adults and children as if the same options apply to both. In practice, eligibility, referral routes and the services available can differ by age — in England as well as in Wales.

The same is true of private providers: not every provider assesses both adults and children. Always check the age groups a provider works with before making contact. You can start with our adult autism assessment guide or the main autism assessment guide for Wales, which covers children and young people.

If you are waiting for an NHS assessment, you could:

• Contact the service to confirm your referral has been received
• Ask how you will be kept informed about your place on the waiting list
• Let your GP know if needs or circumstances change
• Look for support that does not require a diagnosis, such as local autism organisations, family support and school or workplace adjustments
• Explore the assessment options available to you, including private routes

Our page on autism assessment waiting times in Wales explains how waits work and what to ask.

A general comparison of the two routes. Details vary by health board and by provider.

Some people choose to explore a self-funded assessment. A private assessment is paid for by you — it is not NHS-funded and is not the same as Right to Choose.

When comparing providers, it is worth considering:

• The professional qualifications and registrations of the assessing clinicians
• The assessment methods and tools used
• The total cost, and what is included
• Whether you will receive a detailed written report
• What post-diagnostic support or signposting is offered

See our guide to private autism assessment costs or browse the autism assessment directory.

General information only. Always check current arrangements with your GP, health board or provider.