GP Refused ADHD Right to Choose? Next Steps

First Find Out What Was Refused

A GP saying no to an ADHD Right to Choose request can mean several different things. The correct next step depends on which decision was made:

1. The GP does not consider any ADHD assessment referral clinically appropriate.
2. The GP agrees referral is appropriate but questions whether your chosen provider or service is eligible or clinically suitable.
3. Referral is agreed, but a local administrative process is blocking your choice.
4. The practice needs a screening form, history or provider referral document before it can decide.

Right to Choose does not remove clinical judgement. NHS England says the referrer decides whether referral and the chosen service are clinically appropriate. However, where an eligible referral is agreed, local processes and commissioner prior approval should not obstruct a legal provider choice.

Read ADHD Right to Choose: NHS assessment guide if you need to check eligibility and provider requirements first.

If executive-function difficulties are stopping you from preparing a clear request, the Right to Choose letter support session can help you organise your own words and documents. It is practical admin support, not medical or legal advice, and it cannot require a GP to refer.

Ask for the Exact Reason

Use a calm, specific question:

Can you clarify whether you are declining referral for ADHD assessment altogether, or whether the concern is about my chosen provider? Please explain the clinical or eligibility reason and what next step is available.

Also ask:

• What information was considered?
• Is any form, history or clinical information missing?
• Does the provider lack a qualifying NHS contract for this service?
• Is the concern about age range, complexity, risk, treatment scope or another suitability issue?
• Is there an eligible alternative provider?
• Can the reason and next step be added to your record or sent in writing?

Make a dated note of the response. Avoid recording a consultation without understanding the applicable rules and impact on trust. A written summary you send through the practice's normal secure channel may be enough.

If the GP Declines Any ADHD Referral

This is a clinical referral decision, not only a patient-choice dispute, and it needs a different approach from the rest of this page. What to do when a GP will not refer you for ADHD covers the NICE NG87 referral criteria in detail and how to evidence them, which is the part that actually shifts a clinical decision.

Ask the GP to explain:

• why assessment is not currently considered appropriate
• whether another condition or immediate need should be assessed first
• what evidence or change would prompt reconsideration
• whether a follow-up appointment would help
• whether another clinician at the practice can review the request

Bring concise examples of current impact and relevant childhood history. Be accurate rather than trying to match a checklist. A screening tool can support discussion, but NICE says ADHD should not be diagnosed solely from a rating scale and a screening score does not create an automatic right to referral.

You can ask for another clinical opinion within the practice, but another GP may reach the same decision. Registering elsewhere is not a guaranteed solution and may interrupt continuity of care.

If you are concerned that symptoms have been dismissed without proper consideration, use the practice's feedback or complaints process. A complaint can review the process, communication and reasoning. It cannot substitute for clinical judgement.

If the GP Accepts Referral but Rejects the Provider

Ask for the precise provider concern. Right to Choose does not cover every private ADHD clinic. The relevant service normally needs a qualifying NHS contract, must accept the type of NHS referral and must be clinically appropriate.

Check the provider's current NHS Right to Choose page for:

• the exact service and age range
• current referral forms
• confirmation that it accepts NHS-funded patient-choice referrals
• assessment, treatment and follow-up scope
• how it supports people with your clinical needs

Send that information to the practice. If the provider cannot meet your needs or is not eligible, consider another eligible service rather than arguing from an outdated provider list.

If the objection is only that the practice prefers its local service, point to the official NHS Choice Framework and ask how the local restriction fits the national guidance.

If an Administrative Pathway Blocks the Choice

NHS England says referral management centres, single points of access and similar services should not obstruct legal patient-choice rights. Commissioner prior approval is not required for an elective referral when a patient is exercising a legal right to choice.

Ask the practice to distinguish:

• a clinical suitability decision
• a provider eligibility issue
• a missing referral requirement
• a local administrative or funding instruction

If the reason is a local instruction, ask for the policy in writing and which organisation issued it. This makes it easier for the integrated care board or NHS England to review the actual issue.

A Proportionate Escalation Path

1. Send a Short Written Follow-Up

Summarise what you understood, attach the provider's current NHS referral instructions and ask one clear question. The guide to writing a Right to Choose request includes a concise template.

2. Ask the Practice Manager to Clarify the Process

The practice manager can check whether the correct referral process was followed and route a complaint. They cannot overrule a clinical decision simply because you disagree with it.

Your message should include:

• your name and date of birth
• the date of the decision
• whether referral or provider choice was declined
• the reason you were given
• the outcome you want, such as a written explanation or review of the choice process
• links or copies of the relevant official guidance

Do not send your NHS number or detailed health information through an insecure channel.

3. Raise a Patient-Choice Concern

The NHS Choice Framework says that if you believe you were denied your legal choice, you should first speak to the referrer. You may then complain to your local integrated care board, which must ensure choice is offered. It also explains that you may raise concerns with NHS England, which can advise on patient-choice matters and may engage with the organisations involved.

Use the official NHS England ICB contact directory to find the correct board.

This route is most relevant when referral was clinically agreed but provider choice was not offered. Be clear about that distinction.

4. Make a Formal NHS Complaint

For a complaint about primary care, NHS England says you can complain either:

• directly to the GP practice, or
• to the integrated care board that commissions the service

You cannot submit the same complaint to both at the same time. Choose the route most likely to examine the issue independently.

NHS complaints should be acknowledged within three working days. There is no universal fixed number of days for the full response. The organisation should discuss or tell you how the complaint will be handled and the expected response period.

State:

• what happened and when
• what decision you are challenging
• why you think the process or explanation was inadequate
• the official guidance you believe is relevant
• the practical outcome you seek

An appropriate outcome might be a clear explanation, correction of an administrative error, consideration by another clinician, or a review of whether choice was properly offered. Do not frame diagnosis or guaranteed referral as the only acceptable outcome.

5. Go to the Ombudsman After Local Resolution

If you receive a final complaint response and remain dissatisfied, the Parliamentary and Health Service Ombudsman explains how to ask it to consider an NHS complaint. It normally expects you to complete the local complaints process first.

Independent NHS complaints advocacy may also be available locally. Your council or local Healthwatch can help you find the service.

Contacting your MP is optional and can be useful for a wider access or system problem, but it does not replace clinical review or the NHS complaints process.

Responses to Common Explanations

What Not to Claim

Avoid statements such as:

• "A GP can never refuse."
• "Any CQC-registered clinic must be accepted."
• "The ICB must fund whichever provider I name."
• "Right to Choose guarantees a faster assessment."
• "An assessment guarantees diagnosis, medication or shared care."

These claims weaken a request because they ignore clinical appropriateness, provider eligibility and service scope.

Before You Escalate

• Confirm that the request concerns an eligible first outpatient referral in England.
• Verify the provider's current NHS contract and service offer.
• Get the reason for refusal or delay.
• Separate clinical referral from provider choice.
• Use current official guidance rather than a social-media provider list.
• Ask for a specific, realistic resolution.
• Keep dated copies of correspondence.

Practical ADHD mentoring can help you plan these steps, organise documents and complete your own letter. It cannot provide a legal opinion, challenge a clinical decision on your behalf or guarantee referral. The Right to Choose support page sets out the paid session and its boundaries.

Sources and Review Status

This article was substantively updated on 29 July 2026. It has been checked against official NHS guidance but has not been reviewed by a clinician or healthcare lawyer.

• GOV.UK: NHS Choice Framework
• NHS England: Patient choice guidance
• NHS England: Feedback and complaints about NHS services
• NHS England: Contact your local integrated care board
• Parliamentary and Health Service Ombudsman: How to complain about the NHS