What we can and cannot do as your GP
We understand that ADHD is increasingly recognised and that more patients are seeking assessment and treatment
- We do not diagnose ADHD in general practice
- We can refer you for an assessment. Diagnosis and treatment initiation must be carried out by a specialist
- We may prescribe medication under an appropriate Shared Care Agreement (if appropriate criteria are met)
- We request physical health measurements where needed, including weight, heart rate and blood pressure
How to access an ADHD assessment – Please read the section below on prescribing before proceeding
Option 1: NHS referral
– We can refer you to your local NHS ADHD service
– Waiting times are currently quite long
Option 2: Right to Choose
– You may choose an alternative NHS-funded provider
Option 3: Private assessment
– You may choose arrange a private ADHD assessment
ADHD Medical Prescribing
ADHD can be treated with specialist medicines (often controlled drugs or “CDs”) and must be initiated by a specialist.
What happens after diagnosis?
1. Specialist Confirms the diagnosis
2. Medication is started and adjusted (titration phase)
3. Once stable, a Shared Care Agreement will need to be put in in place between the specialist and your GP
Shared Care Agreements (SCA) – A Shared Care Agreement is an arrangement where:
– The specialist agrees to remain responsible for diagnosis, treatment and regular review
– The GP may take over prescribing based on the above conditions, with patients adhering to the physical health monitoring necessary. This usually happens after your medication is stable
Important points
– Shared care is recommended by national guidance once the patient and the medication dosing is stable
– However, it is not mandatory for GP practices to agree to prescribe ADHD medicines
When we will consider Shared Care
We will usually consider shared care if:
– Diagnosis is made by a qualified specialist (e.g. Consultant psychiatrist)
– Assessment meets national (NICE) standards
– Medication is stable for at least 3 months
– A clear treatment plan and monitoring protocol is provided
– The specialist agrees to provide support and reviews where needed
When we will not accept Shared Care
We will decline shared care if:
– The diagnosis or provider does not meet clinical standards
– Medication is not yet stabilised
– There is insufficient information or monitoring in place
– The specialist does not agree to provide support and access to reviews where needed
– The prescribing request falls outside local or national guidance
– We do not feel it is safe for the practice to prescribe
If we decline, the specialist remains responsible for prescribing and monitoring the medication.
Monitoring and follow-up
If shared care is agreed, we will:
– Issue regular prescriptions – Please note, these will not be placed on a standard repeat prescription if controlled drugs (CDs) are prescribed. The medication will be visible to our staff, but will have to be requested monthly by a patient
– Issue prescriptions for a maximum of 30 days in accordance with the legal requirements for controlled drugs (unless there are exceptional circumstances)
– Request, as appropriate, the following measurements:
+ Blood Pressure
+ Pulse
+ Weight
We will not make changes to the prescribed preparation or dose. This remains the responsibility of a specialist
You must:
– Attend regular reviews
– Continue follow-up with your specialist where appropriate
Important considerations before private assessment
Before arranging private care, please be aware:
– We are not obliged to prescribe following a private diagnosis
– Some patients may need to continue private prescriptions long-term (private prescriptions are substantially more expensive than the same prescription issued by an NHS service)
– Shared care depends on clinical information and capacity
Why policies vary between GP practices?
You may find different policies between practices. This is because:
– Shared care is voluntary for GPs
– ADHD medicines require careful monitoring and oversight
– Local NHS systems may have different guidance in place or capacity
What to do next
If you think you may have ADHD:
1. Complete the online triage request on our website
2. On receipt of the triage request, we will send you a questionnaire to complete, and following completion and return, arrange an onward referral. Please note that the choice of provider must comply with the Practice’s shared care arrangements; we will not be able to continue prescribing any of the initiated medicines.