ADHD and Shared Care: Important Update for Patients

In recent years, awareness of adult ADHD has grown significantly, leading to a rise in people seeking assessments. Due to high demand, waiting times for NHS ADHD assessments can be extremely long, sometimes up to five years.

As a result, many patients choose to pursue private assessments to obtain a diagnosis more quickly. While this can help expedite care, it’s important to understand how this decision affects access to NHS prescriptions and ongoing support.

What is Shared Care?

Shared care refers to an arrangement where an NHS specialist and a GP work together to manage a patient’s treatment. This often involves the specialist initiating treatment and the GP taking over aspects such as prescribing and monitoring—if they agree to do so.

• A GP is not contractually obligated to enter into a shared care agreement.
• Shared care is only appropriate if a specialist continues to be involved in the patient's treatment.
• The GP must be satisfied that it's safe, appropriate, and supported by necessary systems and oversight.
• Shared care must not result in a complete transfer of responsibility to the GP without specialist involvement.

Some private providers have presented these agreements as "shared care" while fully shifting the prescribing burden to the GP - without the necessary expert support or oversight.

Our Policy on Shared Care with Private Providers

Following guidance from NHS Resolutions, the MDU, the BMA, and our LMC, we have been advised that:

We are not insured to prescribe ADHD medication under shared care agreements with private providers.

As a result, Clapham Park Group Practice will no longer be entering into shared care agreements with private providers for ADHD treatment.

This guidance has required us to make a difficult but necessary decision to immediately stop prescribing ADHD medications for patients under shared care agreements initiated by private providers. We understand this may feel sudden or distressing for some, and we sincerely apologise for the disruption this may cause to your care.

However, we must prioritise safe prescribing. It is important that our clinicians prescribe within the scope of their indemnified practice, and within the scope of our NHS contract.

Please be reassured that you are still able to access treatment through your private provider, who remains responsible for prescribing and monitoring. If you wish to transition to NHS care, please request an NHS referral while continuing to receive care privately in the interim. This approach ensures that you remain supported while working toward NHS care integration.

We are truly sorry for the inconvenience and impact this may have. However, we must follow the advice provided to us by our expert partners, as this ensures we can provide a safe and sustainable service to our patients.

Why Has This Decision Been Made?

• Insurance and liability: NHS Resolutions has confirmed that ADHD prescribing in these situations falls outside the scope of NHS services and is not covered under CNSGP.
• Professional safety: Prescribing without proper shared care arrangements and monitoring puts patients at risk, especially with controlled medications.
• Regulatory guidance: BMA guidance advises against shared care with private providers to preserve the integrity of NHS care.

If You Choose Private ADHD Care

If you choose to pursue ADHD diagnosis or treatment privately:

• We will not be able to prescribe medication or provide monitoring.
• All prescriptions and reviews must be managed by your private provider.
• Please consider the full cost of private care, including medications and regular specialist reviews.

ADHD medication should be reviewed annually by a specialist. If your private provider cannot ensure this, consider requesting a referral to NHS services.

Transitioning to NHS Care

If you'd like to transition your ADHD care to the NHS, we can help facilitate this. Please complete our referral request form:

ADHD Referral Request Form

You can also explore NHS Right to Choose options with potentially shorter waiting times via ADHD UK. Indicate your preferred provider when filling out the referral form.

It is important to note that many NHS organisations do not accept private diagnoses as a basis for ongoing treatment. In most cases, the NHS provider may decide to reassess you entirely before beginning NHS care. We appreciate that this can be frustrating, but it is outside our control. Our advice is to focus on starting the referral process promptly so that progress can begin toward fully integrated NHS care.

Once under NHS specialist care, and if medication is initiated, we can consider entering a shared care agreement with the NHS provider.

Interim Support

If you are currently receiving private ADHD care, please consult your private psychiatrist for medication and support. We are unable to assist with these matters, as they fall outside our scope of practice and expertise.