ICB Right to Choose Register, August 2026 edition: NHS Right to Choose status for adult ADHD and autism assessment across all 42 English commissioner footprints

A dated register of NHS Right to Choose availability for adult ADHD and adult autism assessment across all 42 English commissioner footprints, with a named primary source, a date and an archived copy for every row. Why this exists. NHS Right to Choose gives a patient in England the right to ask for referral to any NHS-contracted provider rather than only the local service. From late 2025 a number of commissioners began capping or pausing how much of that activity they would fund. No single body publishes which areas have done this: each commissioner discloses it, if at all, in its own board papers, an FOI response or a provider notice. This register is the consolidated national picture, compiled by reading those sources directly. Headline findings, as at 1 August 2026. Adult ADHD Right to Choose is recorded as capped or paused in 17 of 42 commissioner footprints; adult autism in 15 of 42. Two rows are marked contested. One holds no status because the commissioner was abolished. Those areas are home to about 24.2 million adults, 52% of adults in England (ONS mid-2024 resident population aged 18 and over, summed across affected footprints). The November 2025 restrictions did not expire in April 2026. In most affected areas they reset into a capped 2026/27 financial year, several with no published end date. Twelve commissioners were abolished on 1 April 2026 (England went from 42 to 36). Some caps were set by bodies that no longer exist, and no successor has published whether they carry over. Coventry and Warwickshire formally ended its restriction: board approved 18 March 2026, implemented 13 May 2026. Method. Each of the 42 footprints was checked against commissioner publications (board papers, policy pages, FOI responses) and provider Right to Choose service notices. Every row asserting a restriction carries at least one named source with a working URL and, where one exists, a Wayback Machine snapshot, because commissioner pages are removed frequently. Confidence is recorded per condition, not per row: "high" means a commissioner-published position, "medium" means provider publications only, "low" means sources are incomplete or conflicting. The autism evidence base is systematically weaker than the ADHD one, and where the two differ this is stated rather than borrowing the ADHD grade. Known limitations, stated plainly. The 52% figure is thin. Reclassifying any one of the four largest affected footprints takes it below 50%. Treat "more than half" as a close call, not a comfortable margin. "No restriction found" is not a confirmation. It records the absence of a reported restriction, not a positive statement from the commissioner. Thirty-four rows were verified for the first time at this sweep, so for those no earlier observation is held and no change over time can be described. The register distinguishes a first verification from an observed change and never presents one as the other. The geography is the pre-April-2026 one: the 42 footprints are the commissioner boundaries the evidence was gathered against, and twelve of those bodies no longer exist. This is a snapshot, not a maintained feed. No refresh cadence is promised. Read every row against the date on it. Acknowledgement. Compiled substantially from Freedom of Information responses obtained and published by ADHD UK, which supplied 17 of the 28 FOI documents behind this edition, and from reporting by Special Needs Jungle. Files. icb-rtc-register-2026-08.csv and .json contain one row per footprint (slug, name, successor, ADHD and autism status, per-condition confidence, last-verified date, note, register URL). evidence-corpus-2026-08-01.json contains the underlying research corpus with per-footprint evidence prose and named sources. README.md documents the method and limitations. Reuse. CC BY 4.0. You may republish, reformat, merge or build on this, including commercially, with attribution. You do not need permission. Finally Seen is a commercial site that also sells one-off self-advocacy letters; this register is free, has no paywall and no signup, and is published in full including the parts that are commercially inconvenient. Live register: https://finallyseen.org.uk/right-to-choose/icb-status This frozen edition: https://finallyseen.org.uk/right-to-choose/icb-status/2026-08