My GP refused a Right to Choose referral. What now?

Most refusals can be sorted out at the practice. Find out the reason first, because what you do next depends on it.

Why GPs decline

There are two kinds of reason, and they are handled differently.

• A clinical reason. The GP doesn't think an assessment is appropriate yet. This is the GP's decision to make, but they should explain it.
• A provider or contract reason. For example, "we don't refer there" or "that provider isn't local". This is often a misunderstanding of the rules.

The rule on providers

Under NHS England patient choice guidance, you can choose any clinically appropriate provider that holds a qualifying NHS Standard Contract for the service with any Integrated Care Board (ICB) in England or with NHS England. The provider doesn't need a contract with your local ICB.

The right doesn't apply if you're already receiving care for the same condition after a referral, if you referred yourself, or if you're detained under the Mental Health Act or in prison or secure care.

What to do, in order

1. Ask for the reason in writing. Be polite and specific: is it clinical, or about the provider?
2. If it was about the provider, ask the provider which ICB holds its contract, and ask the practice to check this with your ICB.
3. If it was clinical, bring a clear one-page summary: your main difficulties, since when, where they cause problems, and evidence such as school reports or a family member's account. Ask to see another GP at the practice if you'd like a second view.
4. Complain to the practice using its complaints procedure, or complain to your ICB instead (find your ICB on nhs.uk). NHS complaints should normally be made within 12 months.
5. Go to the Ombudsman if you're unhappy with the final NHS response. The Parliamentary and Health Service Ombudsman is free.

What to say

"I'd like to understand the reason for the decision. If it's about the provider, my understanding is that a contract with any ICB in England qualifies under Right to Choose. Could the practice check this with the ICB?"

Related guides

• Right to Choose for an autism assessment
• Right to Choose for a child's ADHD or autism assessment
• Right to Choose caps in 2026/27: what they mean for you
• Right to Choose ADHD letter template for your GP