ADHD Treatment: What You Need to Know

Policy for patients – ADHD Diagnosis and treatment including shared care processes.

Introduction

If you have ADHD or suspect you might, this summary outlines how our Practice will work with you and other healthcare specialists to provide the best care possible. We are committed to offering the best possible care for our patients with ADHD. If you have any questions or concerns, please don’t hesitate to contact us.

Initial Steps

For Adults over 18:

  1. Consultation: To begin, we will ask you to contact us via the get Help For Any Problem form on the website. You will then be asked to complete an Online Adult Screening Tool and return the results to the Practice. If needed a referral will then be made to NHS ADHD Manchester Commissioned provider. On some occasions you may be invited in for a further telephone or face to face conversation before the referral is made. If you struggle to access this platform please contact the surgery by calling or popping in to speak to our admin team who will be happy to help.
  2. Referral: If needed, you’ll be referred to a specialist for further evaluation and treatment. Currently the wait time for ADHD referrals on the NHS is very long between 2 and 7 years. You have the option of choosing a private provider, which you will have to pay for, but please note that we cannot vouch for the quality of care provided by private specialists and we will not be able to enter into “Shared Care Agreements” with them (see below). A shared care agreement is something that has to be in place for you receive ADHD medication on the NHS.

For those under 18:

We advise parents that are wanting an ADHD diagnosis for their child to go via their SENCo lead at school as they know the child better than the GP and a referral to an NHS service is unlikely to be successful without evidence of sustained support from school.

NHS Right to Choose

  1. For any patient to be eligible for right to choose they need to have been on Manchester’s commissioned pathway waiting list for a minimum of 40 weeks. There is a commissioned service with GMMH and referrals can be made by the GP via the Mental Health Gateway.
  2. If at that point the patient still wishes to pursue a referral via Right to Choose and the GP is of the view it is clinically appropriate the following has to be in place:
    • The identified provider hold a Standard NHS contract with an ICB in England;
    • They are registered with CQC;
    • They provide the full pathway, i.e. assessment / treatment / titration onto medication if indicated to be clinically appropriate;
    • The practice agrees an approach regarding shared care before a referral is made.

Shared Care Agreement

Note: We only enter into shared care agreements with NHS specialists (i.e. not private specialists) or those providers that have been commissioned on behalf of the NHS.

  1. Start of Medication: If medication is prescribed, the specialist will handle the initiation phase until your treatment is stable, which usually involves a three-month review.
  2. Ongoing Care: After stabilisation, the responsibility for prescribing your medication might shift to your GP under what’s known as a “shared care agreement.” The GP may decide to accept this shared care agreement or may request that the specialist continue to prescribe the medication.
  3. Annual Reviews: The specialist will need to conduct an annual review of your treatment, and you may need to attend a GP appointment for physical checks like blood pressure, pulse rate, and weight.

Important Notes:

  • The Practice will need to make sure that all protocols have been followed. Your GP will only prescribe medication if these conditions are met.
  • Missed Appointments: If you fail to attend your scheduled check-ups with your specialist or GP, your prescription may be stopped for your safety, this is because ADHD medication are controlled drugs and things such as your weight and blood pressure affect the safety of prescribing them.

Private Providers and NHS “Right to Choose” Providers Requesting Tests

The Practice will not carry out tests that private providers want you to have, any tests that private providers need to be done must be completed by them. The Right to Choose providers are also commissioned to do things like physical checks and blood tests and therefore this is also something that they should provide. If they are an online/remote provider you will need to discuss this fully with them on how to proceed.

Private Providers Providing Treatment and Medication

The Practice will only enter into shared care agreements with NHS specialists (i.e. not private specialists) or those providers that have been commissioned on behalf of the NHS. If you have started treatment with a private provider, you will either need to:

  • approach the Practice to request a referral to an NHS specialist, or
  • continue to receive your treatment directly from your private provider indefinitely.

Please note that there may be a significant delay in having your diagnosis reviewed by the NHS team and them agreeing to participate in a shared care agreement. During this time, you will need to continue to receive your treatment directly from your private provider. The Practice is not able or obliged in any way to provide a “bridging” prescription.

Moving Your ADHD Care to Surrey Lodge Group Practice

  1. Transferring from Another UK General Practice Surgery
    • Your medical records should transfer electronically to us within days, but this isn’t always the case please ensure you have a good supply of your medication from your old / last GP Practice before leaving them or the area.
    • Upon registering with us, please send us a copy of your shared care agreement or ask your last GP Practice to send us a copy of your shared care agreement – this can be emailed to us or in paper form.
  2. Shared Care Agreement
    • If you are under the care of an in-person NHS mental health team, provided the standards are met during the initial checks, we’ll proceed with establishing a Shared Care Agreement with this provider, ensuring your treatment continues.
    • If you are under the care of a private specialist, we will not be able to enter into a shared care agreement. You can ask us to refer you to an in-person NHS mental health team, but while waiting to see them, you will need to obtain your treatment from your private specialist directly.
  3. Intervening Prescriptions
    • During the transition phase, it might be necessary for you to obtain your prescriptions from your consultant until the Shared Care Agreement is in place.
  4. Transferring from Overseas
    • Medication Supply
      • It’s crucial that you bring a sufficient supply of your medication to last while we conduct our initial checks and connect you to a UK Consultant, either privately or via the NHS.
    • Initial Registration
      • Contact us and register as soon as you arrive in the UK. This will enable us to initiate the necessary procedures to ensure continuity of your ADHD treatment.
    • Establishing a Shared Care Agreement
      • The process to establish a Shared Care Agreement can take several weeks. During this period, we will not be able to prescribe ADHD medication for you.
    • Engagement with UK consultant
      • We’ll assist in connecting you to a UK consultant to evaluate your treatment plan and ensure it aligns with UK healthcare standards. This step is crucial for establishing a Shared Care Agreement and ensuring a smooth transition of care. The wait times advised above will apply to your referral, so it is important that you have enough medication when you enter the UK to cover your first few months.