Why being registered with a GP in England matters

The pathway starts at a GP practice in England. Without that registration there is no referrer, and without a referrer the choice in regulation 39 never opens.

The short version

Regulation 38 limits an elective referral to a GP, a dentist or an optometrist. For ADHD that means your GP.
NHS South West London ICB states that anyone registered with a GP in England is legally entitled to access Right To Choose, and that providers still set their own criteria.
The NHS says its waiting-time rights apply only to services commissioned by the NHS in England.
This site makes no claim about how assessments are arranged in Scotland, Wales or Northern Ireland.

The entry condition to this pathway is quiet and absolute. Someone has to be able to refer you, and the regulation is specific about who that can be.

Who can refer

Regulation 38 defines an elective referral as referral by a general medical practitioner, a general dental practitioner or an optometrist, to a health service provider, for treatment that is not identified as being immediately required at the time of referral.

For an ADHD assessment that means a GP. No employer, school, university, therapist or private clinic sits inside that definition, which is the legal reason a referral from any of them does not open the choice, however well evidenced it is.

Registration, not residence

NHS South West London ICB frames the entitlement around registration: although anyone registered with a GP in England is legally entitled to access Right To Choose, each provider will have their own inclusion and exclusion criteria.

NHS West and North London ICB adds the geographic reach of the choice itself, describing it as letting adults or children choose an independent provider through the NHS from anywhere in England. So a patient registered in one part of England can be referred to a provider based in another.

Outside England

The NHS is explicit that the waiting-time rights it describes apply only to services commissioned by the NHS in England. Scotland, Wales and Northern Ireland run separate health services with their own arrangements.

This site does not describe those arrangements, because no source for them was checked when it was built, and guessing at another nation's pathway on a health page is exactly the kind of error that sends someone down a route that does not exist. If you are registered outside England, the reliable starting point is your own health service and your own GP practice.

If you are not registered anywhere

Registering with a GP practice is the first practical step, and it is worth doing before anything else, because every other part of this pathway runs through that relationship: the referral, the shared care question later, and the practice's knowledge of what the local commissioner currently expects.

Questions people ask about this

Does Right to Choose cover Scotland, Wales or Northern Ireland?

No. The duty falls on NHS commissioners in England, and the NHS states that the rights described in its England guidance apply to services commissioned by the NHS in England. The referral has to come from a GP practice in England, so registration is the entry point. How ADHD assessments are arranged by the separate health services elsewhere in the UK is something this site checked no source for and describes nowhere, so ask your own health service and your own GP practice.

Can a private psychiatrist refer me under Right to Choose?

No. Regulation 38 defines an elective referral as one made by a general medical practitioner, a general dental practitioner or an optometrist. A private clinician's assessment or letter can be useful evidence to bring to your GP, but it is not itself a referral that opens the choice.