Advance Directive Cost UK

An ADRT Itself Is Free to Create

There is no registration fee, no filing cost, and no statutory charge for creating an Advance Decision to Refuse Treatment in England. Unlike a Lasting Power of Attorney — which costs £92 per document to register with the Office of the Public Guardian — an ADRT does not need to be registered with any government body.

You can write an ADRT on a blank piece of paper, sign it, have it witnessed, and it is legally valid under the Mental Capacity Act 2005 provided it meets the statutory requirements.

The costs people encounter are not for the document itself. They are for help getting the document right.

What a Solicitor Charges

Solicitors who offer advance directive services typically charge between £150 and £600 for an ADRT, depending on complexity and whether it is bundled with other planning documents.

At the lower end, you get a templated ADRT adapted to your basic preferences — treatment refusals filled in from a standard questionnaire, the life-at-risk clause inserted, proper witnessing arranged.

At the higher end, you get a bespoke drafting process that involves a consultation about your specific medical conditions, coordination with your clinical team to ensure the treatment refusals are clinically precise, and integration with your LPA and estate planning documents.

Most solicitors will offer an ADRT as part of a package alongside LPAs and a will. Package pricing typically runs £500 to £1,500 for a complete planning suite (ADRT + both types of LPA + will review), which can represent better value than commissioning each document separately.

When You Do Not Need a Solicitor

The ADRT form is not legally complex in the way that a trust deed or commercial contract is. The structure is straightforward: identify yourself, state which treatments you refuse, describe the clinical circumstances, include the life-at-risk clause if you are refusing life-sustaining treatment, sign it, have it witnessed.

You do not need a solicitor if:

• You are a healthy adult making a standard ADRT (refusing CPR, refusing ventilation in a terminal condition)
• Your treatment preferences are straightforward and do not involve complex clinical scenarios
• You are comfortable using a free template from Compassion in Dying or My Decisions and having your GP review it for clinical accuracy
• You have no significant family disputes that might lead to the document being challenged

A GP review is not a legal requirement, but it serves a practical function: the GP can confirm that your treatment refusals are described in clinically meaningful terms, and they can flag the document on your electronic patient record at the same time.

When a Solicitor Adds Genuine Value

Professional drafting becomes worth the cost when:

• You have a progressive cognitive condition. A solicitor can arrange for a formal capacity assessment at the time of signing, creating documentary evidence that you had capacity — which makes the ADRT much harder to challenge later.
• Your treatment refusals are clinically complex. If you have multiple conditions and need to specify different treatment refusals for different clinical scenarios, a solicitor working with your medical team can draft precise language that withstands clinical scrutiny.
• Family members are likely to dispute your wishes. A solicitor-drafted ADRT with a formal capacity assessment, witnessed signing, and a clear paper trail carries more evidential weight if challenged in the Court of Protection.
• You are also creating LPAs. Bundling the ADRT with LPA preparation ensures the documents are properly coordinated — particularly the precedence rules (whichever document was created most recently takes priority if they conflict).

The Hidden Cost: Getting It Wrong

The real expense is not the document — it is the consequence of an invalid one. An ADRT that uses vague language, omits the life-at-risk clause for life-sustaining treatment refusals, or lacks a witness signature is not merely imperfect. It is unenforceable.

When an ADRT fails, the backup is either the family's unstructured advocacy (which has no legal standing beyond being consulted) or a Court of Protection application — which costs several thousand pounds and takes months.

The Full Cost Picture

The practical minimum for complete advance planning in England — an ADRT plus both types of LPA, done without a solicitor — is £184 in OPG registration fees. Add a solicitor and the total runs £500 to £1,500.

Our England Advance Directive guide sits between the free template and the full solicitor service: a structured drafting framework with clinical phrasing templates, the LPA signing protocol, and the GP registration process — designed to get both documents right without paying £500+ for professional drafting.

See more England guides →