People still being denied “Right to choose” their service provider for diagnostic assessments

The Society for Neurodiversity, S4Nd, says that the battle to get Neurodevelopmental diagnostic assessments accepted as part of the NHS’s commitment to Patient Choice (also referred to as Right to Choose), is ongoing. This is despite NHS England confirming in 2020, seven years after patient choice regulations came into force that these apply to Neurodevelopmental diagnostic assessments as well as to other mental and physical health issues.

S4Nd’s members have reported that they continue to meet resistance from CCGs (Clinical Commissioning Groups) when trying to apply this right when asking GPs for referrals for diagnostic assessments.

Angie Balmer, from S4Nd, outlined the problems encountered:

“The decision as to whether the referral is clinically appropriate for the assessment or treatment which is the subject of the referral is exclusively a matter for the person making the referral, your GP and not for the CCG. Yet many CCGs appear not to accept this.

At S4Nd we have compiled a guide to help neurodiverse patients and their GPs challenge their CCGs, in cases where the Right To Choose has been refused. The guide includes examples of incorrect and illegal responses from CCGs to typical requests for referral for diagnostic assessments, each paired with a correcting statement.

We think it’s important to point out that the guide and the advice it containhas recently been checked and approved by David Lock QC, a renowned a public law specialist.

The guide is intended to inform patients and GPs alike and provide them with the tools to ensure that correct procedures are followed.

The guide is available to read and download in the Right to Choice section of S4Nds website.

Meanwhile, for Angie Balmer and S4Nd, the fight goes on:

“The diagnostic process for neurodiverse people is complex and challenging enough without extra barriers being placed in their way. We believe that GPs are being wrongly misled by many CCGs and we hope that the publication of this new guide will help them provide the support our members and other neurodiverse people have a right to receive.”

Examples of what some CCGs have been saying and suggested responses:

“A diagnostic assessment is not considered to be a treatment”
This is incorrect because the legal definition of “treatment” includes diagnostic assessments.

“A provider must be commissioned by the CCG”
This is wrong. Legally, patients may choose a provider that has a contract with any CCG or NHS England.

“A referral cannot be made due to cost”
This would be an unlawful objection. The Regulations do not specify any right to restrict the choices agreed between the patient and the patient’s referring GP based on the cost of the assessment or treatment.

“A provider must have an NHS Standard Contract”
This is incorrect. The patient choice right applies if any CCG has previously entered in a contract for this form of treatment with any CCG. That includes where another CCG had entered into a “spot contract” in the past with a provider to treat a specific patient. Once that contract is placed, that contract can be relied upon by other patients to establish a right to be referred to that provider.

“The service is not led by a consultant”
In the case of physical health, the service must be led by a consultant. In the case of mental health, the service must be led by a consultant or a healthcare professional.

For more information, the full guide can be downloaded in the Right to Choice section of S4Nds website.