Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the proposal to require prior approval introduced by the Black Country Integrated Care Board for ADHD and autism assessments; and what steps they are taking to ensure that such schemes do not infringe upon the statutory right to choose established in the NHS Constitution, particularly where referrals to independent providers are being paused or restricted.

It is the responsibility of integrated care boards (ICBs) in England to make appropriate provision to meet the health and care needs of their local population, including providing access to attention deficit hyperactivity disorder (ADHD) and autism assessments, in line with relevant National Institute for Health and Care Excellence guidelines.

NHS England issued advice to systems on ADHD service delivery and prioritisation on 7 October 2025. This advice includes guidance on managing service provisions, reviewing waiting lists and providing patient support. The advice can be found on NHS England’s website.

The Medium-Term Planning Framework, published 24 October, was explicit that ICBs and providers are expected to optimise existing resources to reduce long waits for ADHD and autism assessments and improve the quality of assessments by implementing existing and new guidance, as published.

The NHS Black Country ICB has a prior-approval process to make sure referrals meet clinical criteria and that providers meet required quality and governance standards. This applies to all Right to Choose providers offering ADHD and autism assessments. This does not affect patient choice, as people will still be able to choose their preferred provider when their general practitioner makes a referral.

Patients already have the legal right to choose the provider and team who will provide their elective care in certain cases. These rights extend to any provider in England who holds a contract with an ICB, or NHS England, for the service/s the patient requires, as per the NHS Choice Framework. This includes independent sector providers. ADHD services are already in scope of this legislation.