Your GP should refer you

GPs cannot diagnose ADHD or autism, that requires a specialist assessment. What they can and should do is refer you to the appropriate service when you present with symptoms affecting your daily life.

A GP refusing to refer you is not the same as a GP saying you do not have ADHD or autism. They are not qualified to make that judgement. A referral is a step toward an assessment, not a diagnosis, and a refusal to refer is a decision to prevent you from reaching that assessment.

That said, GPs do have clinical discretion, and not every refusal is unreasonable. What matters is whether they have given you a clear and legitimate clinical reason, and what you can do if they have not.

Step 1: Ask for their reasons in writing

Ask your GP to put in writing why they are declining to refer you. This does two things:

It creates a formal record of their decision
It often prompts reconsideration, a GP who knows their reasoning will be documented may think more carefully before refusing

You can do this by asking at the appointment, following up with a written request to the practice, or writing a letter to the practice manager. Keep a copy of everything.

Step 2: Ask another GP at the same practice

You are not obliged to see the same GP for every appointment. Ask to speak to a different GP at your practice, one who may have more experience with neurodevelopmental conditions or a different view on the referral threshold.

This is a straightforward step and often resolves the situation without any escalation.

Step 3: Put your referral request in writing

Write to your practice to formally request a referral. A written request:

Creates a paper trail that the practice must respond to
Is taken more seriously than a verbal request
Makes it harder to dismiss without explanation

Keep your letter factual: describe your symptoms, how they affect your daily life, and that you are requesting a referral to the appropriate specialist service. Do not make it confrontational, the goal is a referral, not a complaint.

Step 4: Contact the Patient Advice and Support Service (PASS)

PASS (Patient Advice and Support Service) is a free, independent service delivered by Citizens Advice Scotland that helps people understand and exercise their rights within NHS Scotland. They can:

Advise you on your rights around GP referrals
Help you understand what options are available in your area
Support you in writing formal requests or complaints if needed

They are impartial, they work for you, not the NHS, and the service is entirely free.

Step 5: Make a formal complaint

If your GP has refused to refer you without adequate clinical reason, and the steps above have not resolved it, you can make a formal complaint through your health board. Every Scottish health board has a complaints process.

A complaint does not have to be adversarial. You can frame it as a request for review of a clinical decision. Health boards are required to investigate complaints and respond formally.

You can also escalate to:

The Scottish Public Services Ombudsman (SPSO), if you are not satisfied with how your health board handles your complaint
NHS inform, Scotland's official health information service, which can guide you to the right complaint pathway

Step 6: Consider a private assessment

If you have tried the above and cannot access an NHS referral, or if the waiting time after referral is too long to manage, a private assessment is an option.

A private diagnosis is valid in Scotland. It can be used to access shared care (NHS prescribing of medication) and other support. Our Compare providers tool lets you filter private providers in Scotland by what they assess, their costs, HIS registration status, and their track record on shared care with Scottish GPs.

Compare private providers → · Guide to going private →

Common reasons GPs give, and what to know

"There is not enough evidence." You do not need to prove you have ADHD before being referred for assessment, that is what the assessment is for. Present clear, specific examples of how your symptoms affect your daily life. If you have completed a validated screener, take the results with you.

"You are coping fine." Appearing to function does not mean you are not struggling, many people with ADHD develop significant coping strategies that mask the underlying difficulty. Explain the cost of that coping: exhaustion, anxiety, the effort involved in tasks others find straightforward.

"ADHD is a childhood condition." It is not. ADHD is recognised in adults in both major diagnostic frameworks (DSM-5 and ICD-11) and by NHS Scotland's own clinical guidance. Many people receive a diagnosis in adulthood for the first time.

"We don't have a service for that here." Some health boards have limited provision, particularly for adults. However, that does not mean no referral pathway exists, ask specifically what is available, and if necessary, what alternatives your GP can offer.

If you are in crisis

If you are struggling significantly while waiting for assessment, tell your GP. If your mental health is being seriously affected, you may be able to access support through CAMHS (for children and young people), adult mental health services, or crisis services, separately from an ADHD or autism assessment.

Support and resources →

My GP won't refer me for assessment