I did this - it runs the length of the back of the house.
You need drawings. People who can do drawings sometime advertise in the local newspaper. Alternatively you can get an architecy to do it for you.
You need to have some idea of where you want doors / windows etc. I found it useful to plan what the room would be used for, so I could then decide where doors, windows, radiators, power points etc should be sited.
You may or may not need planning permission. You could check with the local council. You will need building regulations so the work will be checked by the councils building inspector and a certificate of compliance will be issued when the work is complete and has passed inspection.
I let the builders deal with the buildings reg section within the council. They are used to doing this.
I kept the original outside wall and keyed the new extension into it. I already had patio doors so they came out and created the entrance to the extension. I put a back door, patio doors, window into the extension.
I didn't find it disruptibe - but I was at work all day/ Yes, the garden is out of bounds for the children while it's being built. Most of the building is done before they knock through into the existing house. It's disruptive when they have to take power from the existing house into he extension and also when the central heating is extended into the new room. Other than that it was OK.
If you're thinking about a rear extension have a think about doing a front porch at the same time. It would be cheap to do it while you have the builders on-site and they just need to increase the amount of materials and time. Much cheaper than having them do it separately at a later date.
You, or the builders, have to lift the existing patio. You, or the builders, could relay it after the extension is complete, depending on what materials it's constructed from.