Private Prescribing Policy for medications for ADHD with shared care agreements

ADHD Referrals, Diagnosis and Medication Policy

At Heathcot Medical Practice, we are committed to supporting patients with neurodevelopmental conditions, including Attention Deficit Hyperactivity Disorder, also known as ADHD.

We understand that ADHD can affect many areas of a person’s life, including education, work, relationships, and day-to-day functioning. We also recognise that NHS services are under significant pressure and that some patients may choose to seek assessment, diagnosis, or treatment through private providers.

This policy explains how Heathcot Medical Practice manages ADHD referrals, private diagnoses, medication requests, and shared care arrangements.

ADHD diagnosis

ADHD is a complex condition that requires assessment and diagnosis by an appropriately qualified specialist. This is usually a consultant psychiatrist, specialist ADHD clinician, or a recognised neurodevelopmental service.

GPs are not able to diagnose ADHD. If ADHD is suspected, a referral to a specialist service is required.

For adults in Surrey, NHS ADHD assessments are usually provided by Surrey and Borders Partnership NHS Foundation Trust. For children and young people, NHS neurodevelopmental assessments are usually provided through Mindworks Surrey.

ADHD medication

If ADHD is diagnosed, the specialist may recommend medication to help manage symptoms.

ADHD medication can be very effective for some patients, but it requires careful prescribing, dose adjustment, and ongoing monitoring. This is because some ADHD medications can affect blood pressure, pulse, appetite, weight, sleep, mood, and other aspects of physical and mental health.

Medication must be started and adjusted by the specialist. This process is often called titration. The specialist remains responsible for reviewing the patient’s ADHD symptoms, medication response, side effects, and physical health monitoring.

NHS shared care

Once a patient is stable on an established dose of ADHD medication, an NHS specialist may ask the GP practice to consider ongoing prescribing under a shared care agreement.

A shared care agreement is a formal arrangement between the specialist, the GP practice, and the patient. It must clearly set out who is responsible for prescribing, monitoring, reviews, and managing any concerns.

Heathcot Medical Practice will only consider shared care where:

• The diagnosis has been made by an appropriate NHS specialist or NHS-commissioned service

• The patient has been stabilised on medication by the specialist

• A formal shared care agreement has been provided

• The required monitoring arrangements are clear and safe

• The practice is satisfied that it is clinically appropriate to prescribe

Shared care is not automatic and remains at the discretion of the practice. Responsibility for specialist review, annual ADHD review, and medication advice remains with the specialist service.

Right to Choose referrals

Patients may be able to request an ADHD assessment through the NHS Right to Choose pathway. This allows eligible patients to ask to be referred to a provider that has an NHS contract to deliver ADHD assessment services.

Some patients choose this route because waiting times may be shorter than local NHS services.

Patients should carefully review the provider’s referral process, assessment pathway, medication arrangements, and follow-up provision before requesting a referral. Further information about Right to Choose providers is available from ADHD UK and the NHS.

Heathcot Medical Practice may need additional information from you in order to complete a Right to Choose referral. If we request information and do not receive a response within a reasonable timeframe, your referral request may be cancelled.

Private ADHD diagnosis and treatment

Some patients choose to have an ADHD assessment privately.

If you choose to see a private provider and they diagnose ADHD, please be aware that Heathcot Medical Practice will not automatically be able to prescribe ADHD medication or take over monitoring.

Private providers may have different processes for assessment, prescribing, titration, monitoring, and annual review. Before proceeding privately, patients should check the full cost of ongoing treatment, including:

• Initial assessment

• Follow-up appointments

• Medication titration

• Private prescriptions

• Physical health monitoring

• Annual reviews

• Any letters or documentation required for ongoing care

Heathcot Medical Practice does not routinely enter into shared care agreements with private providers. ADHD medication recommended by a private provider should usually continue to be prescribed and monitored by that private provider.

If you want NHS prescribing after a private diagnosis

If you have been diagnosed with ADHD privately and wish to receive NHS treatment or NHS prescribing, you will usually need to be referred to an appropriate NHS ADHD specialist service for review.

This referral will normally be subject to the usual NHS waiting times.

If the NHS specialist confirms the diagnosis, considers medication appropriate, stabilises treatment, and requests shared care, Heathcot Medical Practice may then consider whether it is safe and appropriate to prescribe under a formal shared care agreement.

Annual reviews and monitoring

Patients taking ADHD medication require ongoing monitoring. This may include:

• Blood pressure

• Pulse

• Weight

• Height in children and young people

• Appetite

• Sleep

• Mood

• Side effects

• Ongoing benefit from medication

An annual ADHD review should be completed by the specialist service. The GP practice is not a replacement for specialist ADHD review.

If monitoring is not completed, or if there are concerns about safety, side effects, or lack of specialist review, the practice may be unable to continue prescribing ADHD medication.

Further information

For further information about ADHD, please visit the NHS ADHD information page.

For information about Right to Choose ADHD referrals, please visit the ADHD UK Right to Choose guidance page.