How Right to Choose works in the former North West London 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 ADHD 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 West and North London ICB or any commissioner.
West and North London 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 North West London ICB area serves a population of about 2.2 million people (ONS mid-2024 estimate), making it one of the larger ICBs in England by population. The area covers Westminster, Brent, Harrow, Ealing, Hillingdon. GP practices in all of these areas are covered by the same Right to Choose entitlement.
It has roughly 380 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 North West London ICB area
Honest note on local data: NHS England does not publish real-time per-ICB waiting times for ADHD 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 ADHD assessment; figures reported by patient groups and academic surveys range from 2 to 7 years depending on ICB. If you know your ICB's current figure, please email us and we will update this page.
To check the current stated wait for this area: NHS England: Integrated Care in Your Area and then contact West and North London 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, but waits vary by provider and are not published.
NHS-contracted independent providers typically offer assessments within weeks to a few months of referral.
NHS-contracted ADHD providers available in the former North West London ICB area
The following providers are known to hold NHS contracts and accept Right to Choose referrals for adult ADHD assessment from GPs across England, including the former North West London 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.
Holds an NHS contract for adult ADHD assessment under Right to Choose. Shared-care prescribing after assessment is a separate question for your GP practice. We publish no wait for this provider; check its own referrals page for the current position.
Age eligibility: ADHD 360's own website currently states two different minimum ages for Right to Choose referrals. Its Right to Choose page says it accepts referrals for children aged 8 and over and adults aged 16 and over. Its diagnosis FAQ says the minimum age on the NHS or Right to Choose pathway is 7. We cannot tell which page is current, so confirm your age eligibility with ADHD 360 directly before your GP submits the referral. Checked 7 August 2026. ADHD 360 Right to Choose page, ADHD 360 diagnosis FAQ.
Holds an NHS contract for adult ADHD assessment. We publish no wait for this provider; check its own referrals page for the current position.
Holds an NHS contract for adult ADHD assessment. We publish no wait for this provider; check its own referrals page for the current position.
Holds an NHS contract for adult ADHD assessment under Right to Choose, England-wide. We publish no wait for this provider; 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.
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 NG87 is met). They cannot decline solely because:
- The provider is not locally commissioned by West and North London ICB.
- The referral would cost more than local provision.
- West and North London 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 West and North London 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 West and North London ICB, drafted upfront so you have it ready if the GP refuses or does not reply.
North West London ICB was reorganised on 1 April 2026 and this area is now commissioned by West and North London ICB. Send anything you escalate to the successor, not to the old name.
Frequently asked questions for the former North West London ICB area
How long does West and North London 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. West and North London 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 Westminster?
Yes. Any GP practice in the former North West London ICB area, including practices in Westminster and Brent, is covered by the same NHS Patient Choice Guidance entitlement. Registration with a practice anywhere in the former North West London 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 Brent said West and North London ICB doesn't commission ADHD 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 West and North London 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 NG87 (Attention deficit hyperactivity disorder: diagnosis and management) are met.
Will my GP in the former North West London ICB area prescribe ADHD medication after a Right to Choose diagnosis?
Shared-care prescribing after a Right to Choose ADHD diagnosis is GP-discretionary. There is no NHS rule requiring a GP to take over prescribing from the diagnosing provider. The Right to Choose letter separately asks your GP to confirm their position on shared care in writing, so you know where you stand before committing to any private bridge prescription. Shared-care policies vary between practices within the former North West London ICB area.
What if West and North London 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 West and North London 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: ADHD (England-wide)
The full national guide to NHS Right to Choose for ADHD 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.