If patients are referred for consultant-led treatment, they have the right to choose which provider they would like to receive care from for their first appointment and for any subsequent treatment

NHS Humber and North Yorkshire ICB support every person’s Right To Choose.

It is the referrers responsibility to provide information to support patients to make informed choices for patients and to make sure that the services are clinically appropriate for that patient. To enable decision making about services and pathways which the ICB has agreed are clinically appropriate, there are a number of clinical commissioning policies which can be found here .  Patients must meet the criteria set out in these policies for any onward referral.  The ICB will not make payment for services delivered outside of these policies.

It is the referrers responsibility to decide, if the patient meets these general criteria, that the particular service they are referring to is clinically appropriate for that individual patient.  This includes any subsequent treatment for example ensuring that shared care agreements are in place for ongoing prescription/medication needs.

Referrers can request information from the Provider to confirm the appropriateness of the service for the individual patient, including any shared care agreements.

When referrals can be made

Right to Choose referrals can only be made by a suitably qualified professional working directly for a Primary Care Contractor. Referrals must be for a service that is consultant led or Mental Health professional-led, and must include first appointment and subsequent treatment (i.e. not treatment or medication only)

If HNY ICB does not commission a pathway as a consultant led service, this is outside the scope of Right to Choose.

Referrers are responsible for determining the clinical appropriateness of a referral.

Which providers can receive referrals

A “Right to Choose” provider is any provider that holds a qualifying NHS contract with an English ICB, to provide the services the patient needs for a given cohort. For example, a provider that holds an NHS contract to provide ADHD for one ICB in England, can accept referrals from any GP in the country under right to choose, so long as they have capacity to do so. However, a provider that is commissioned to provide ADHD services for adults only could not accept referrals for children under right to choose.

As holding a contract with any ICB in England qualifies an organisation to be a right to choose provider, the list of available providers is constantly changing as existing contracts expire and new providers are awarded contracts. If the referring clinician needs further information regarding this, the ICB can be contacted via email: hnyicb.contracts@nhs.net  

ADHD providers

ADHD providers should provide assessment and diagnosis services plus ongoing treatment (medication) should it be required. A referral to a provider who only ADHD provides assessment and diagnosis but not titration and prescribing is out of scope as there is no subsequent treatment pathway. However a referral for ADHD medication-only for a patient who has previously been assessed and diagnosed with ADHD does not fall within scope of right to choose as their right to choose for ADHD will have been exercised at the point they selected the provider for their assessment.

When Right to Choose does not apply

The Right To Choose does not apply if the patient is:

• already receiving care and treatment for the condition for which you’re being asked to refer and this is an onward referral
• needing urgent, emergency or crisis services
• in need of emergency or urgent treatment, such as cancer services where they have received an urgent referral for suspected cancer or for breast symptoms (where cancer is not suspected)
• a prisoner, on temporary release from prison, or detained in ‘other prescribed accommodation’ (such as a court, secure children’s home, secure training centre, an immigration removal centre or a young offender’s institution)
• someone who is held in a hospital setting under the Mental Health Act 1983
• a serving member of the armed forces
• using maternity service

Further information, including legislation, can be found in the links below:
 

🗎 NHS Choice Framework

🗎 NHS Constitution for England.

🗎 The Health Care Services (Provider Selection Regime) Regulations 2023

🗎 The Provider Selection Regime: statutory guidance

🗎 The National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) Regulations 2012 (legislation.gov.uk)

🗎 NHS England » Patient choice guidance