Attention Deficit hyperactivity Disorder (ADHD) is a complex medical condition for which some people are offered medication as form of treatment. As per national guidance, this requires long term involvement of a specialist in terms of the regular review of patients and their medical treatment.
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 specialist is responsible for starting the medications, making any dose adjustments, and arranging a yearly review which includes a physical assessment.
Unfortunately, at this moment in time, GP surgeries are not funded or contracted by the NHS to provide this much needed comprehensive service for people diagnosed with ADHD.
There is also some concern amongst clinicians that ADHD is being incorrectly diagnosed and
stimulant medications being started inappropriately before exploring social, psychological, and behavioural intervention.
Having discussed the challenges associated with prescribing amongst all the clinicians here at our surgery, we have decided that we will only provide prescriptions for ADHD medications where the NHS ADHD service, or contracted NHS ADHD service have accepted our shared care agreement (see below), which has been formulated to maintain prescribing safety. Without their acceptance of this agreement we will not be able to provide ongoing prescriptions, and the responsibility of prescribing be upon the person/service who has made the assessment and diagnosis.
We will also be making this policy clear to providers of ADHD services whenever we make a referral on behalf of a patient so that they are clearly aware.
There is currently a long waiting list for NHS ADHD referrals. Understandably, this is very frustrating, and some patients are looking at other options for diagnosis, such as being referred to a private provider. Please be aware that should you choose to follow this route and a diagnosis is made, you may wish to look into the costs of ongoing treatment including prescribing and yearly reviews.