"Everyone's a bit ADHD these days."— what you've probably been told
ADHD (adult assessment)
NHS guideline NG87 covers recognition, diagnosis and management of ADHD in children, young people and adults. Adult patients have a legal right under NHS Patient Choice Guidance (NHS England, 19 December 2023) to ask their GP to refer them to any NHS-contracted provider for assessment — this is the NHS Right to Choose pathway.
The wait: Adult NHS waits for assessment are commonly multi-year across many ICBs.
Many adults are refused referral or told the local NHS service is the only option. NG87 sets the clinical threshold for referral, and the NHS Patient Choice Guidance is explicit that approval by a commissioner in advance is not required for an elective referral where a patient exercises their legal right to choice.
- An NHS Right to Choose referral via the e-Referral Service to the patient's chosen NHS-contracted provider, in line with NHS Patient Choice Guidance (2023)
- An NG87-aligned referral threshold assessment, not a refusal on cost or commissioning grounds
- Confirmation in writing of the GP's position on shared care after diagnosis (noting shared care is GP-discretionary, not guaranteed)
Can my GP refuse to refer me to a Right to Choose provider?
Not on cost or local-contract grounds. The NHS Patient Choice Guidance (2023) is explicit that prior commissioner approval is not required where a patient exercises a legal right to choice. The GP can decline on clinical-appropriateness grounds — the letter asks for any refusal to be put in writing.
Will my GP prescribe ADHD medication after a Right to Choose diagnosis?
Shared care after diagnosis is GP-discretionary. The letter asks the GP to confirm their position in writing so the patient knows where they stand before paying for any private bridge.
What's usually said in the room
"Everyone's a bit ADHD these days."
What the guideline actually says
Many adults are refused referral or told the local NHS service is the only option. NG87 sets the clinical threshold for referral, and the NHS Patient Choice Guidance is explicit that approval by a commissioner in advance is not required for an elective referral where a patient exercises their legal right to choice.
Source: Attention deficit hyperactivity disorder: diagnosis and management (NG87)
Outcomes from people with ADHD (adult assessment)
One short email each Sunday — anonymised stories from people who got their GP to take them seriously.