Attention Deficit Hyperactivity Disorder (ADHD) Referrals and Medication
As a practice we are committed to supporting patients with neurodevelopmental diagnoses, both children and adults.
We are mindful that pressures on NHS services have increased in recent years, and that often patients seek private diagnosis and treatment as a result. This policy sets out the practice’s policy on acknowledging diagnosis and taking over treatment where requested.
This document is based on national and local guidance, specifically NICE guidance.
Attention Deficit Hyperactivity Disorder (ADHD) can affect many aspects of a person’s life. However, diagnosis is complex and requires a specialist, usually a consultant psychiatrist to do this.
GPs are not able to make a diagnosis of ADHD and a referral is needed to an ADHD specialist. If an ADHD diagnosis is subsequently made by the specialist, they may choose to offer medications to help manage the symptoms. These medications are potentially dangerous and therefore require careful monitoring.
The Adult NHS ADHD service in Manchester is provided by Greater Manchester Mental Health. Once a diagnosis is made, the specialist is responsible for initiating medications, making any adjustments until the dose has been stabilised. The specialist will also remain responsible for arranging an annual review which includes a review of your ADHD symptoms, your medication and a physical assessment. Once an established dose of the appropriate medication has been established, we may take on responsibility for on-going prescribing and monitoring under a shared care agreement with the NHS service specialist, however responsibility for prescribing and monitoring remains with the specialist.
Alternatively patients can exercise their ‘right to choose’ and ask to be referred to a private provider who has an existing contract to provide NHS services. This may be because the wait times are shorter. Details of right of choose providers can be found at https://adhduk.co.uk/right-to-choose
You need to be aware that should you choose to be referred to a private provider under Right To Choose, and a diagnosis is made, we will not be in a position to prescribe ADHD medication or arrange monitoring. This is because the private providers may not be able to offer the same follow-up or monitoring as NHS specialists. As a practice, we will not enter into a shared care agreement with a private provider. Getting the ADHD medication must all be done through the private provider and you should check on the costs of ongoing treatment including prescribing and yearly reviews. Please note some providers will not accept a referral without an agreement for the practice to take on a shared care agreement.
Private providers each have their own referral process and you should refer to their websites for more information. We may need information from you in order to complete a referral to a private provider on your behalf. Failure to respond to a request for information about your referral in a timely manner, will result in your referral request being cancelled.
If a patient who has been diagnosed by a private service wishes to receive their ADHD treatment on the NHS from their GP, they will still need to be referred to an NHS mental health specialist for an assessment. This referral will still need to go through the NHS waiting list.
If the NHS mental health specialist feels the patient meets NHS criteria to start ADHD medication, a shared care agreement may then be agreed between the NHS specialist and GP.
For further information on ADHD please visit the NHS website - https://www.nhs.uk/conditions/attention-deficit-hyperactivity-disorder-adhd/
For an update on the situation in Greater Manchester please see the communications from our own ICB- https://gmintegratedcare.org.uk/adult-adhd-services/