Right to Choose
Can my GP refuse a Right to Choose referral?
In England, your GP decides whether a referral is clinically appropriate, but the choice of where a needed referral goes is generally yours under NHS Right to Choose. A GP may only decline a referral if it is not clinically appropriate or if the provider you name does not hold an NHS contract for that service. If you are not offered a choice you are entitled to, you can raise it with the practice and then your Integrated Care Board. This is information, not medical or legal advice.
Information only, not medical advice and not a diagnosis. Right to Choose applies in England only. Speak to your GP about your own situation.
What the rules say
NHS England patient choice guidance explains that if a GP, dentist or optometrist refers you for a physical or mental health condition, you generally have a legal right to choose which NHS provider delivers that care, at the point of referral, as long as the provider holds an NHS contract for the service. ADHD assessments are within scope of this right. The clinician decides whether a referral is needed and clinically appropriate; you then choose where it goes.
When a GP can say no
The same guidance sets out narrow grounds on which a referral can be declined. Broadly, a GP may decline if:
- The referral is not clinically appropriate in their judgement.
- The provider you have named does not hold a valid NHS contract for ADHD assessments.
Disagreeing with the principle of Right to Choose, or a practice preferring its local service, is not on its own a clinical reason. The clinical thresholds for referral should be the same whichever provider is used.
What to do if you are refused
NHS England suggests raising it first with the person referring you. If you still feel you were not offered a choice you are entitled to, you can complain to your Integrated Care Board, which must ensure patients are given the choices they are entitled to. It can help to check that the provider you named holds an NHS contract before you ask again. Our GP letter template gives you wording that names an approved provider, and the Right to Choose explainer covers how the route works.
Sources: NHS England, Patient choice guidance; GOV.UK, The NHS Choice Framework; NHS, Your choices in the NHS. Last reviewed June 2026.
Frequently asked questions
On what grounds can a GP refuse a Right to Choose referral?
According to NHS England patient choice guidance, the referring clinician decides whether a referral is clinically appropriate. They may decline if a referral is not clinically appropriate, or if the provider you name does not hold a valid NHS contract for that service. The choice of where a needed referral goes is generally yours.
Does a GP have to give a reason in writing?
It is reasonable to ask the practice to set out the reason. If you are not offered a choice you are entitled to, NHS England says you can raise it with the person referring you first, and then with your Integrated Care Board, which must ensure patients are given the choices they are entitled to.
What can I do if I am told no?
Ask the practice to explain, check the provider you named holds an NHS contract for ADHD assessments, and if you still believe you were not offered a choice you are entitled to, contact your local Integrated Care Board. This is general information, not legal advice.
Editor, ADHD Helper
Adam leads ADHD Helper's editorial coverage of adult ADHD, and he writes it from lived experience: Adam has ADHD himself, diagnosed as an adult, and has been through the assessment routes and the daily workarounds this site covers. He is the founder and managing director of Muswell Rose and researches the plain-English explainers on getting an ADHD assessment through NHS Right to Choose or privately, and on the products and tools people use to manage ADHD, drawing on guidance from the NHS, NICE and the Royal College of Psychiatrists. He is clear that the site is information, not medical advice, and that diagnosis is for a registered clinician.
Last reviewed: 20 July 2026