The Right to Choose
escape route

England only · Last updated August 2026 · Sources listed at the end

Right to Choose gets you assessed on an NHS pathway, free, which means "we don't accept private diagnoses" stops being a sentence anyone can say to you.

It isn't winning the fight. It's leaving the building.

What it actually is

Under the NHS Constitution and the Patient Choice Regulations 2023 — SI 2023/635, write that number down, you'll need it — if your GP refers you for specialist assessment, you choose the provider. Any provider holding an NHS Standard Contract for that service, anywhere in England.

Not "you can ask nicely." Not "if your practice feels like it." A legal entitlement.

Local NHS waiting lists run 2–6 years in most areas. Right to Choose providers are usually weeks to months. Same NHS. Same £0. The difference is knowing the sentence to say.

Are you eligible?

• Registered with an NHS GP in England
• Living in England at referral, assessment and treatment
• Your GP agrees an assessment is clinically appropriate
• Your chosen provider holds a current NHS Standard Contract

That's it. No means test. No postcode rule.

The thing that catches everyone out

You cannot refer yourself. It has to come from your GP. Every provider, no exceptions.

Which means the whole game is making it as easy as possible for a tired GP to say yes. You do the paperwork. They sign.

How to do it

1. Pick your provider first — and check the waiting time before you fall in love

Providers holding NHS contracts for adult ADHD as of mid-2026 include Psychiatry-UK, ADHD 360, ProblemShared and Healios, among others. But contracted lists differ by ICB — a provider available five miles away might not be available to you. Check the provider's own site for which ICBs they hold contracts with, and their current waiting time. Both change constantly.

2. Download their referral pack

Most publish a GP referral form and a covering letter. Fill in your half before you go near an appointment.

3. Do the ASRS

The Adult ADHD Self-Report Scale. Free online, standard screening tool, and it turns "I think I might have ADHD" into a document. Bring it.

4. Book an appointment about ADHD

Not tacked onto something else. Say when booking what it's for, so you get the time.

5. Turn up with

• The completed ASRS
• The provider's referral form and covering letter
• Specific examples — work, relationships, the admin pile, the thing you didn't do for eight months
• School reports if you have them
• Already diagnosed privately? Your assessment report and titration record

6. Say this

You are not asking for a favour. You're telling them which box to tick.

7. Confirm it's actually gone

Referrals usually go via the NHS e-Referral Service. Ask the practice to confirm when it's sent. Expect to hear from the provider within about a month.

When they say no

Here's the part worth reading twice.

A valid refusal: a specific, documented clinical reason why an assessment isn't appropriate for you, or why that particular provider is unsuitable for you personally.

Not a valid refusal:

• "We don't do that here"
• "Our ICB doesn't allow it"
• "We only refer to [local service]"
• Anything about budgets

Your GP cannot refuse because of a blanket practice policy or ICB budget guidance. Guidance to GPs is not law. Your right is.

So do this

Ask for the refusal in writing, including the specific clinical or contractual basis. Most refusals die right here, because "we don't do that" is embarrassing to write down and sign.

Ask which policy they're relying on. If the answer is ICB guidance rather than a clinical judgement about you, that's the crack.

Then escalate, in order:

1. Practice manager — in writing
2. Formal complaint to your ICB. Use the exact phrase "patient choice complaint". It's not decoration — it triggers an obligation to respond on patient choice grounds specifically, rather than filing you under general grumbling.
3. NHS England. Email england.contactus@nhs.net, subject line "patient choice complaint — Right to Choose — [ICB name]", attaching your GP's refusal and the ICB response.
4. Your MP. ICBs are extremely sensitive to political attention.
5. Register with a different practice. Not a defeat. Practices vary wildly and people do this constantly.

Cite these three and watch the tone change: the NHS Constitution, SI 2023/635, and paragraph SC6.18 of the NHS Standard Contract — which requires commissioners not to take action that prevents or deters you from exercising choice.

The legal framework is solid. The enforcement is underfunded. Which means persistence in writing works more often than not — not because you'll win a court case, but because nobody wants regulatory scrutiny over one referral.

If you're already diagnosed privately

Ask about titration-only referrals. Some Right to Choose providers accept referrals for medication titration where you already have a private diagnosis — much faster than a full re-assessment. Policies vary, so ask your GP to check with the provider first.

Keep everything. Your private report and titration history are evidence for whoever picks you up next.

And the reason this route matters at all: GPs accept shared care from Right to Choose providers far more readily than private ones, because the assessment was NHS-funded. You're not proving your diagnosis is good enough. You're removing the objection entirely.

One honest warning

Sources

• NHS Constitution; Patient Choice Regulations 2023 (SI 2023/635)
• NHS Standard Contract 2024/25 and 2025/26, paragraph SC6.18
• Health and Care Act 2022 (ICB structure, 42 ICBs from 1 July 2022)
• Provider Right to Choose pages — check current waiting times and ICB coverage directly

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