Right to Choose isn't a loophole or a workaround. It's a legal right written into the NHS Act 2006 that most GPs won't tell you about. If your local waiting list exceeds 18 weeks, you can choose any NHS-funded provider. Nobody can refuse you.
Patients have a legal right to choose any willing NHS-funded provider for their first outpatient appointment in any specialty, as long as waiting times are longer than 18 weeks and the patient meets the clinical referral criteria.
Source: legislation.gov.uk
Your local NHS ADHD service's waiting list almost certainly exceeds 18 weeks. This makes you automatically eligible for Right to Choose. You don't need to prove hardship or special circumstances.
Source: NHS waiting times guide
Your GP's job is to send the referral to the provider you name. They cannot refuse to send it on the grounds that the provider is out of area or that you should see your local service.
Once you've named a provider, your GP must send the referral to that provider. They cannot unilaterally change it or send it to the local service instead.
Your ICB (local NHS commissioning body) has a duty to fund Right to Choose assessments. A few ICBs have tried to restrict it; this is unlawful unless they can prove they have no capacity.
An ICB (Integrated Care Board) is your local NHS body responsible for planning and funding healthcare in your area. There are 42 ICBs across England, and they control the budget for Right to Choose referrals. While most ICBs process Right to Choose requests without issue, a small number have attempted to restrict or pause it for ADHD. Here's what you need to know.
Attempted a formal pause on Right to Choose for ADHD in 2023-2024, citing capacity concerns. This was challenged and remains controversial. Current status: accepting Right to Choose referrals, but with reported delays.
Implemented a temporary pause on Right to Choose ADHD referrals in 2024. The rationale was service capacity, but this decision has been questioned by ADHD advocacy groups as potentially unlawful.
Reported capacity issues and bottlenecks in processing Right to Choose referrals. Referrals are accepted but may face longer processing times.
Use this template to request your Right to Choose referral from your GP. Customize it with your details and your chosen provider.
Date: [Today's Date]
To: [Your GP Name]
[Practice Name]
[Practice Address]
Re: Right to Choose ADHD Assessment Referral - [Your Name] (DOB: [Your DOB])
Dear [GP Name],
I am writing to formally request an NHS referral for ADHD assessment under my Right to Choose, as guaranteed by Section 75 of the NHS Act 2006.
Key details:
I understand that Right to Choose allows me to be assessed by any willing NHS-funded provider, and I have chosen this provider based on their ADHD expertise and availability.
Please confirm that you will send my referral to [Provider Name] within 2 weeks. Should you wish to discuss this request, I am happy to attend a consultation.
I would appreciate your response within 5 working days.
Yours sincerely,
[Your Name]
[Your Address]
[Your Contact Details]
A small number of GPs may resist your Right to Choose request. If this happens, there are clear escalation routes.
Ask your GP to explain their reasoning in writing. The only valid reasons to refuse are: (1) the provider you named is not willing, (2) they cannot assess you, or (3) you don't meet the clinical criteria for assessment. "You should use our local service" is not a valid reason.
Escalate to your practice manager or the practice's complaints officer. Explain that you are requesting a legal right under the NHS Act 2006 and that the GP's refusal may breach NHS patient rights.
PALS is the independent NHS patient advocacy service. File a formal query about your Right to Choose access. They can escalate to the practice and ICB on your behalf and investigate potential rights breaches.
Write to your Member of Parliament with details of your case. MPs have direct access to NHS England. Political pressure often unlocks bottlenecks that patient complaints alone cannot.
File a formal complaint under the NHS Complaints Procedure to the practice, then to your ICB if unresolved. Reference Section 75 of the NHS Act 2006 and the NHS Constitution. If the practice is refusing a legal right, formal complaints create legal documentation and accountability.
Now that you know your rights, the next step is finding the right NHS-funded ADHD provider for you.