How Right to Choose works in the former BOB ICB area
The NHS Right to Choose pathway is governed by NHS Patient Choice Guidance published by NHS England on 19 December 2023. It applies to all elective first outpatient referrals, which includes adult Autism assessment. When you request a referral under this guidance, your GP must submit it via the NHS e-Referral Service (e-RS) to the provider you name. The GP does not need prior approval from Thames Valley ICB or any commissioner.
Thames Valley ICB is bound by the NHS Standard Contract, like every ICB in England. That contract is the mechanism that makes NHS Patient Choice Guidance operationally enforceable. The ICB cannot instruct GPs to block Right to Choose referrals on cost grounds. If your GP does block a referral, that refusal should be documented in writing and can be escalated first to the ICB's Patient Experience team and then to NHS England's National Contact Centre.
the former BOB ICB area serves a population of about 1.9 million people (ONS mid-2024 estimate), making it one of the larger ICBs in England by population. The area covers Oxford, Reading, High Wycombe, Aylesbury, Slough. GP practices in all of these areas are covered by the same Right to Choose entitlement.
It has roughly 310 GP practices. That practice count is approximate and not recently verified, so treat it as a rough scale indicator rather than a current figure.
NHS waiting time in the former BOB ICB area
Honest note on local data: NHS England does not publish real-time per-ICB waiting times for Autism assessment. What follows is the national picture; your ICB's wait may be shorter or longer.
What we know
NHS England does not publish a single national average wait for adult autism diagnostic assessment. Patient surveys and NHS Digital community mental health data suggest median waits of 18-36 months in most ICBs, with some exceeding 5 years. If you have a local figure, email us.
To check the current stated wait for this area: NHS England: Integrated Care in Your Area and then contact Thames Valley ICB directly via their website or PALS service.
Right to Choose puts you in a different queue, not out of the queue. In an area with no reported cap that queue is usually shorter. Here it is capped, so treat any promise of weeks rather than months with caution and get the current position from the provider.
NHS-contracted Autism providers available in the former BOB ICB area
The following providers are known to hold NHS contracts and accept Right to Choose referrals for adult Autism diagnostic assessment from GPs across England, including the former BOB ICB area. You must name your chosen provider in the Right to Choose letter; your GP submits the referral to that provider via e-RS.
Lists adult autism diagnostic assessment. NHS contract scope for autism differs from ADHD, so check its own referrals page before naming it.
Holds an NHS contract for adult autism diagnostic assessment. We publish no wait for this provider; check its own referrals page for the current position.
Holds an NHS contract for adult autism diagnostic assessment. The autism list is managed separately from ADHD; check its own referrals page for the current position.
Provider lists can change. Always verify NHS contract status and Right to Choose acceptance on the provider's own website before submitting the letter. Finally Seen is not affiliated with any provider.
Autism-specific note: The pool of NHS-contracted providers for adult autism diagnostic assessment is smaller than for ADHD, and provider availability changes. We hold no dated record of which providers are open to new autism referrals today, so before naming a provider in your letter, check their own website or ask them directly what their current position on NHS Right to Choose autism referrals is. The NICE guideline you are invoking is CG142.
What to do if your GP refuses
A GP can decline a Right to Choose referral on clinical grounds (i.e., they do not believe the referral threshold under CG142 is met). They cannot decline solely because:
- The provider is not locally commissioned by Thames Valley ICB.
- The referral would cost more than local provision.
- Thames Valley ICB does not have a block contract with the provider you have named.
- The local NHS waiting list is long (this is the reason for the referral).
If your GP refuses, ask them to put the refusal in writing and add it to your medical record. Then:
- Step 1: escalate to your ICB. Contact Thames Valley ICB's Patient Experience team (or PALS office). Cite NHS Patient Choice Guidance (NHS England, 19 December 2023) and the NHS Standard Contract.
- Step 2: NHS England National Contact Centre. 0300 311 22 33. They can instruct the ICB and, ultimately, the GP practice.
- Step 3: Parliamentary and Health Service Ombudsman (PHSO), if you have exhausted the above and the GP's refusal was not on clinical grounds.
The £39 Right to Choose letter includes a second, pre-written Stage 1 complaint to Thames Valley ICB, drafted upfront so you have it ready if the GP refuses or does not reply.
BOB ICB was reorganised on 1 April 2026 and this area is now commissioned by Thames Valley ICB. Send anything you escalate to the successor, not to the old name.
Frequently asked questions for the former BOB ICB area
How long does Thames Valley ICB take to action a Right to Choose letter?
Once your GP submits the referral via NHS e-Referral Service (e-RS), the provider, not the ICB, manages the booking. Thames Valley ICB does not need to approve or process the referral; the NHS Standard Contract requires providers to accept e-RS referrals directly. Contact times vary, are set by the provider, and are not published. Ask the provider for their current position when you check availability. If the GP delays submitting, ask them in writing and give a 10-working-day deadline, citing NHS Patient Choice Guidance (2023).
Can I use Right to Choose if I'm registered with a GP in Oxford?
Yes. Any GP practice in the former BOB ICB area, including practices in Oxford and Reading, is covered by the same NHS Patient Choice Guidance entitlement. Registration with a practice anywhere in the former BOB ICB area is sufficient. The right does not depend on which GP practice you're with, which neighbourhood you live in, or whether your practice has used Right to Choose before.
My GP in Reading said Thames Valley ICB doesn't commission Autism assessment externally, is that right?
That framing is not accurate when a patient invokes their legal Right to Choose. NHS Patient Choice Guidance (2023) explicitly states that a referral under the right to choice does not require prior commissioner approval. Whether Thames Valley ICB holds a block contract with a given provider is irrelevant: the GP must submit the referral via e-RS if you invoke the guidance and clinical referral criteria under NICE guideline CG142 (Autism spectrum disorder in adults: diagnosis and management) are met.
Does Right to Choose cover autism diagnosis in the former BOB ICB area specifically, or only ADHD?
Right to Choose applies to any elective first outpatient referral in England, which includes adult autism diagnostic assessment. The relevant NICE guideline is CG142. The autism Right to Choose pathway has fewer active NHS-contracted providers than ADHD, and some providers have paused new autism Right to Choose referrals, including currently in this area, so always check current availability before naming a provider. But the legal right itself is the same.
What if Thames Valley ICB or my GP doesn't respond after I send the letter?
If your GP doesn't respond within 10 working days, follow up in writing referencing the letter and asking for a response date. If there is still no response after a further 5 working days, escalate to Thames Valley ICB's Patient Experience team (or PALS). If the ICB doesn't resolve it within 20 working days, you can escalate to NHS England's National Contact Centre on 0300 311 22 33. The £39 Right to Choose letter includes that escalation letter to the commissioner, drafted upfront, so you already have it if you need it.
Related guides
Right to Choose: Autism (England-wide)
The full national guide to NHS Right to Choose for Autism assessment.
Shared care agreements for ADHD in the UK
What shared care means, which GPs typically accept it, and what to do if yours doesn't.
Right to Choose ADHD providers compared
Side-by-side comparison of NHS-contracted ADHD providers: wait times, assessment format, shared-care support.