ADHD Information for adult patients

We understand that you have requested a referral for an assessment for ADHD.

Unfortunately, due to demand the local mental health service who carry out these assessments for adults are not able to take on any additional referrals unless there are other significant mental health issues. If you believe you come into this category then please let us know.

If you still want an assessment for ADHD then these are your options:

1. NHS Right to choose : diagnosis only.
2. NHS Right to choose: diagnosis and assessment for medication
3. Private: diagnosis only
4. Private : diagnosis: assessment for medication.
5. NHS Post diagnosis referral for medication.

It is really important to be aware that GPs can only issue medication for ADHD under a shared care agreement. This means that any initiation of medication, any change in dose, initial monitoring and annual follow up has to be provided by the specialist not the GP. We do not take on any shared care agreement with private providers due to the requirements needed and the ongoing cost to patients for that shared care.

Right to choose: please search online for currently available NHS right to choose providers. It is recommended that you find a provider that offers more than a single remote appointment and preferably with a doctor rather than another health care professional. Please inform us of the provider, their secure nhs email address and any paperwork they require. You will need to complete most of the paperwork yourselves.

If you think you may wish to have medication from this provider then it is important that you clarify with them that they are able to provide a full shared care service for the foreseeable future. If they stop providing shared care then you will have to stop the medication until a new shared care service is arranged and this can take several months. It is important that they are able to offer a quick response to medication queries especially in view of the supply issues with most adhd medication.

Private referrals: please make your own arrangements. Unless insurance is paying for the assessment etc you do not need a referral from the GP. Please note previous comment re medication and private providers.

If you already have a diagnosis and wish to be considered for medication only then we can refer you to the post diagnosis medication service, please be aware that the waiting time for this is currently at least 12-18 months and likely to get longer.

We also stress that we do not have to take on shared care agreements.

Each shared care agreement is made on an individual patient basis and it is not a given that they will always be accepted.

The Wessex LMC, although not our locality, has a very helpful explanation of this

“It is also important to remember that formal shared care arrangements, be they NHS or Private, are voluntary on the part of the GP and the GP should be mindful of their own clinical competence and workload capacity when considering agreeing to enter into such an arrangement. Workload requested for an individual patients will need to be considered in balance with the reasonable needs of the practice population and whether further workload can be absorbed by the practice team safely.

Specialist services should only transfer care to primary care if the GP agrees to do so. This step is often forgotten and taken for granted as a fait accompli by secondary care. It should not be. A practitioner’s requirement to work safely within their own competences should be respected to keep patients safe. Practice capacity to safely take on the associated workload of both prescribing and monitoring requirements should also be taken into account. These are both vital aspects of safe patient care.”

The BMA also says “Shared care protocols may be agreed locally. Hospitals must only initiate the care under the protocol where the individual GP has accepted clinical responsibility for the patient.”