ADHD Assessments - Right to Choose and Shared Care Prescribing
ADHD Assessments - Right to Choose and Shared Care Prescribing
Our Practice Policy on ADHD Medication Prescribing
Patients may receive an ADHD assessment and treatment through one of several routes:
- Local NHS specialist ADHD services.
- The NHS Right to Choose pathway.
- Independent (private) healthcare providers.
While all of these routes can provide access to ADHD assessment and diagnosis, they do not necessarily result in the same prescribing arrangements with GP practices.
Our practice is no longer able to enter into Shared Care Agreements for ADHD medications initiated by private providers or by providers delivering care through the NHS Right to Choose pathway.
What is a Shared Care Agreement?
A Shared Care Agreement is an arrangement in which a specialist clinician and a GP agree to share responsibility for prescribing and monitoring a patient's medication once treatment has been stabilised.
Participation in shared care is voluntary and GP practices are not contractually required to accept Shared Care Agreements. Any decision to do so must take account of local commissioning arrangements, specialist support available to the practice, and patient safety considerations.
What is the difference between Local NHS Services and Right to Choose Providers?
Local NHS ADHD services are commissioned by our local NHS system and have established pathways for communication, clinical governance, prescribing support, and ongoing specialist care.
Under the NHS Right to Choose scheme, patients can choose to be assessed and treated by an alternative provider that holds an NHS contract elsewhere in England. Although the assessment and treatment are NHS-funded, these providers are not part of our locally commissioned specialist service.
For this reason, our practice does not accept prescribing responsibility for ADHD medications initiated by Right to Choose or private providers.
What does this mean for patients?
If your ADHD medication has been started by:
- A private ADHD provider; or
- A provider accessed through the NHS Right to Choose pathway,
the specialist service that initiated treatment will remain responsible for:
- Prescribing ADHD medication.
- Carrying out medication reviews.
- Monitoring treatment effectiveness and side effects.
- Arranging any required physical health monitoring.
- Making changes to treatment where necessary.
The practice will therefore be unable to issue repeat prescriptions for ADHD medication on behalf of these providers.
Patients Considering a Private or Right to Choose Assessment
If you are considering an ADHD assessment through a private provider or the NHS Right to Choose pathway, we strongly recommend that you discuss ongoing prescribing arrangements with the provider before proceeding.
You should ensure that you understand:
- Who will provide your prescriptions following diagnosis.
- Whether there will be any charges for prescribing or follow-up care.
- What monitoring arrangements will be required.
- How long the provider will continue to prescribe medication if treatment is recommended.
Patients should not assume that their GP practice will be able to take over prescribing following diagnosis.
Patients Referred to Local NHS ADHD Services
Where patients are assessed and treated through locally commissioned NHS specialist ADHD services, prescribing arrangements will be considered in accordance with local shared care policies and practice procedures.
Acceptance of any Shared Care Agreement remains at the discretion of the practice and will be considered on a case-by-case basis.
Further Information
We appreciate that some patients may find this policy disappointing. The policy is intended to ensure that prescribing responsibilities remain clear and that patients receiving specialist ADHD medication continue to have access to the specialist oversight and monitoring required for safe treatment.
If you have questions about your ADHD care or prescribing arrangements, please contact your ADHD specialist provider in the first instance.