How to Ask Your GP for a Right to Choose Referral for ADHD & Autism

If you suspect your child may be autistic, have ADHD, or both, the conversation with your GP can feel like the biggest hurdle of the whole journey. Many parents tell us they rehearsed what to say in the car park, worried they'd be brushed off, or simply didn't know that "Right to Choose" was something they were allowed to ask for.

Here's the reassuring part: Right to Choose isn't a favour your GP grants you. It's a legal right, and asking for it doesn't have to be a battle. This guide walks you through exactly what to prepare, what to say in the room, and what to do if things don't go smoothly, so you can walk into that appointment feeling ready rather than anxious.

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What is Right to Choose, in plain English?

Right to Choose (sometimes shortened to RTC) is part of the NHS Constitution and the NHS Choice Framework. It means that once your GP agrees a referral for a specialist assessment is clinically appropriate, you; not the GP, not the practice, and not your local Integrated Care Board (ICB), get to decide which NHS-contracted provider carries out that assessment.

For families waiting on stretched local autism and ADHD services, this matters enormously. Instead of being tied to your area's community paediatrics team, with waits that can stretch past two years in some parts of the country, you can ask to be referred to any provider holding an NHS standard contract, including independent services like Paloma Health, wherever you live in England.

A few things worth knowing upfront:

• Right to Choose applies once your GP agrees an assessment is clinically necessary. It doesn't override their clinical judgement about whether a referral is needed at all.
• It is a genuine legal entitlement under the NHS Choice Framework, not a local policy that individual practices can opt in or out of.
• Your GP is the only person who can make this referral. Schools, nurseries, and other professionals can support your case with evidence, but they cannot refer on your behalf.
• There's no extra cost to your family. Right to Choose providers are NHS-funded, in exactly the same way as your local service would be.

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Before the appointment: how to prepare

A little preparation goes a long way in a 10-minute GP slot. Most parents find the appointment goes far more smoothly when they walk in with the following ready to go.

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1. Complete a screening questionnaire.

These aren't diagnostic, but they give your GP objective, standardised evidence to support a referral rather than relying solely on a verbal description. Useful options include the AQ-10 for autism traits, the CAT-Q for autistic masking or camouflaging (particularly relevant for girls and gender-diverse children, who are more often missed or diagnosed late), and the SNAP-IV for ADHD traits.

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2. Build a short evidence pack.

School reports, SENCO notes, nursery observations, or any previous assessments all help build a clear picture. If your child is home-schooled, a report from another adult outside the home who knows them well in a social setting can serve the same purpose.

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3. Write down the "why."

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Specific, concrete examples carry far more weight than general concerns. Rather than "he struggles socially," try noting down real situations: difficulty following a conversation with peers at lunchtime, meltdowns after unexpected changes to routine, sensory distress at the hairdresser, or losing focus mid-task even on things they enjoy. Think across settings; home, school, and extracurricular activities, since GPs and assessors alike are looking for evidence that difficulties show up in more than one environment.

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4. Know the name of the provider you want.

If you're considering Paloma Health, it helps to know which pathway suits your child's age before the appointment (more on this below), so you can be specific rather than vague.

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What to say in the appointment

You don't need special legal language to assert your rights, but a few clear phrases make it easy for your GP to say yes. Start by describing your concerns using your evidence pack, then be direct about the referral you're asking for:

"I'd like to request a referral for an autism/ADHD assessment. I'm exercising my Right to Choose to be referred to Paloma Health, an NHS Right to Choose provider."

If your GP seems unsure whether they can refer outside your local area, it can help to gently remind them of the legal basis:

"Under the NHS Choice Framework and the NHS Constitution, I have the right to choose any provider holding an NHS standard contract with any ICB in England, for elective and mental health referrals. That choice isn't limited to a local approved list."

Before you leave, run through a quick checklist:

• Ask your GP to confirm which pathway they're referring you to (for example, remote, or a hybrid pathway with an in-person appointment).
• Double-check your child's name, date of birth, and address are correct in whatever referral form or system your GP is using.
• Ask them to confirm, there and then, that the referral has been submitted.

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Which Paloma Health pathway is right for your child?

We are an NHS Right to Choose provider offering NICE-compliant autism and ADHD assessments for children and young people across England, at no cost to your family.

Autism assessments are available for children from their 2nd birthday to their 18th, across a remote pathway (ages 8–18), a hybrid pathway with an in-person observation in Exeter (ages 5–18, or 2–4 following assessment by a community paediatrician), and a hybrid pathway with an in-person observation in Norwich (ages 6–18).

ADHD assessments are available remotely for children and young people from their 8th birthday to their 18th.

Combined ADHD and autism assessments are available for children from their 8th birthday to their 18th, across a remote pathway, or a hybrid pathway with an in-person observation in Exeter or in Norwich.

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What to do if your GP refuses

Most GPs are supportive once they understand Right to Choose is a legal entitlement rather than a special request. But if you do meet resistance, it usually comes down to a misunderstanding rather than a genuine barrier, and there's a clear path through it.

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Step 1: Ask for the reason in writing.

If your GP declines during the consultation, ask them directly: "Can you provide the clinical reason for this refusal in writing, for my records?" This isn't confrontational, it simply ensures there's a clear record of why a referral considered clinically appropriate isn't being actioned.

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Step 2: Clarify the pathway.

Some GPs mistakenly treat Right to Choose requests like an Individual Funding Request (IFR), which involves a separate approval process for treatments outside standard commissioning. It isn't the same thing. Right to Choose referrals to an NHS-contracted provider don't require special funding approval. It can help to note that some ICBs incorrectly tell GPs that choice is limited to a local approved list, it isn't. Any provider with an NHS standard contract in England, including Paloma Health, is a valid choice.

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Step 3: Request a follow-up with the Practice Manager.

If your GP remains hesitant, ask for a short follow-up appointment or phone call with the Practice Manager to talk through the legal basis for the referral. Often, a conversation at this level resolves things quickly.

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Step 4: Contact PALS.

If the practice still won't process the referral, get in touch with your local ICB's Patient Advice and Liaison Service (PALS). Let them know your legal right to choice is being restricted. PALS exists specifically to help resolve issues like this between patients and GP practices.

Throughout this process, it's worth remembering: you're not asking for a favour, and you're not being difficult. You're asking your GP to follow a process the NHS has already set out.

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Already waiting on another NHS provider? You may still be able to switch

If your child is currently on a waiting list with a different NHS autism or ADHD service and you've been waiting longer than 18 weeks (or been told the wait will exceed that), you have a legal right to change provider. Speak to your GP about transferring the existing referral rather than starting again from scratch.

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Frequently asked questions

Does a Right to Choose referral cost anything? No. Right to Choose providers are NHS-funded, so there's no cost to your family, in the same way your local NHS service would be free at the point of use.

Can my child's school make the referral instead? No. Only your NHS GP can make a Right to Choose referral. Schools and nurseries can provide valuable supporting evidence, but they cannot refer on your behalf.

What if I'm not sure whether my child needs an autism or ADHD assessment? That's a good question to raise directly with your GP, who can help guide which assessment (or both) is appropriate. Organisations like the National Autistic Society and ADHD UK also offer accessible introductions to what each condition can look like.

How long will we wait for an appointment once the referral is made? Wait times vary by pathway and by where you live, since some NHS ICBs currently apply local funding restrictions. As a guide, Our current wait times range from around 4 weeks for ADHD assessments to 6-8 weeks for autism assessments, depending on the pathway. We keep published, up-to-date wait times for each pathway on our website.

What happens after the referral is submitted? You'll usually receive email confirmation once the provider has received your GP's referral. From there, you and your child's school will typically be asked to complete some questionnaires, before an assessment appointment is booked.

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You know your child best

Asking for a Right to Choose referral can feel daunting, especially if you're already stretched thin from advocating for your child at school or at home. But it is your right, the process is well established, and most GPs will support it once they understand what's being asked.

If you'd like support preparing for your GP appointment, We provide a free downloadable Right to Choose guide and a customisable GP letter template for both autism and ADHD referrals, alongside age-appropriate screening tools like the AQ-10, CAT-Q, and SNAP-IV.

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