For resources covering consultations and sources of easy-read materials, visit the Neurodiversity Resources page (see Resources).

What is neurodiversity?

Neurodiversity recognises and values the natural variation in human brain function and behaviour, which can lead to learning difficulties and challenges in education.  

A learning difficulty is not always a learning disability. People with learning difficulties can be supported by the Special Educational Needs (SEN) system. 

Learning difficulties include:

• dyslexia
• dyspraxia
• difficulties arising from brain injury occurred later in life
• ADHD
• autism (ASD)
• dementia.

Right to Choose ADHD/Autism

Patients registered with a GP in England have a legal right to choose the provider and team for their mental health care. If a patient’s treatment has not or will not start within the maximum waiting times of 18 weeks, then when notified the patient’s responsible commissioner has a duty to take all reasonable steps to offer suitable alternative providers.

Here is a list of Right to Choose providers on the ADHD UK website. 

Please be aware that this comprehensive list of providers has not undergone a quality assurance process. It is recommended that you review your local guidelines for guidance on selecting appropriate providers to ensure you make an informed decision that aligns with local standards and recommendations. 

Conditions for a patient to qualify under ‘right to choose’     

Conditions for patient eligibility under 'right to choose'

1. Elective referral for first outpatient appointment
2. Referral made by a GP
3. Referral is clinically appropriate* 

*The guidance explains that ‘clinically appropriate’ is a clinical judgement about what is in the best clinical interests if the patient, working within published NICE guidelines. There is also further advice for GPs (page 17 of the national guidance) on considerations for clinical appropriateness. See more information under NHS England's patient choice guidance.

Exclusions

Patients who are:

• already receiving treatment for the condition
• referred to a service that is commissioned by a local authority, for example a drug and alcohol service (unless commissioned under a Section 75 agreement)
• accessing urgent or emergency (crisis) care
• accessing services delivered through a primary care contract
• in high-secure psychiatric services
• detained under the Mental Health Act 1983
• detained in a secure setting. This includes people in or on temporary release from prisons, courts, secure children’s homes, certain secure training centres, immigration removal centres or young offender institutions
• serving as a member of the armed forces (family members in England have the same rights as other residents of England.

Requirements for mental health care providers under 'right to choose'

1. Registered with CQC
2. Existing commissioning contract with an NHS commissioning body (ICB) or NHS England for the required service 
3. Service led by a consultant or mental healthcare professional

Local shared care guideline for the management of medications prescribed to adults with ADHD

ADHD treatment regimens outside NICE recommendations are not evidence-based, e.g. combination therapies. 

ADHD stimulant drugs are Schedule 2 controlled drugs with the potential risk for misuse or diversion.

NICE recommends that primary care may take over the prescribing and monitoring of ADHD medication after titration and dose stabilisation under a Shared Care Protocol arrangement. Within NCL there are formally approved shared care guidelines (NCL SCG) which have been agreed via a formal NCL process with our NCL ADHD providers (not service providers outside of NCL). It is not intended that the NCL SCG is used or adopted by any service provider other than the locally commissioned NCL ADHD services.

GPs are not under obligation to accept shared care and the proposed responsibilities if they are not happy about any aspect of the proposed shared care arrangement. GPs are advised to discuss this with patients prior to referral to manage expectations. 

See NCL Prescribing Dilemmas - a guide for primary care prescribers.

Important additional information

Where the patient has self-referred and is seen privately, they should also have any medication, monitoring tests or treatment intervention provided privately as part of that episode of care.