Adults and Children
At Lonsdale Medical Centre, patient safety is our highest priority.
ADHD medication requires specialist assessment, careful initiation and titration, appropriate physical monitoring and ongoing review. Our policy follows NICE guidance and relevant NHS prescribing and shared-care guidance.
Our Policy
We may prescribe ADHD medication under a shared-care arrangement where:
- ADHD has been formally assessed and diagnosed by an appropriately qualified specialist with expertise in ADHD.
- Medication has been initiated and titrated by the specialist and the patient is established and stable on treatment.
- We have received a written Shared Care Agreement or formal shared-care request setting out the diagnosis, treatment, monitoring requirements and respective responsibilities of the specialist and the practice.
- Appropriate baseline investigations and monitoring information have been provided.
- There is a clear route for the practice to obtain timely advice from the specialist if concerns arise.
- The patient remains under ongoing specialist care, including medication review at least annually.
- The practice has reviewed the individual case and agreed that it is clinically appropriate and safe for us to accept the proposed shared-care responsibilities.
Shared care is not automatic. Each request is considered individually and must be formally accepted by the practice before we take over prescribing.
Until we have confirmed that shared care has been accepted, responsibility for prescribing and monitoring remains with the initiating specialist.
Private ADHD Care
Patients are free to choose private ADHD assessment and treatment.
Where ADHD has been diagnosed and treatment initiated privately, we may consider a request for shared care on a case-by-case basis once treatment has been appropriately titrated and stabilised.
Acceptance will depend on us being satisfied with the specialist assessment, treatment and monitoring arrangements and receiving an appropriate written shared-care proposal. The medication must also be appropriate for prescribing within NHS and local prescribing guidance.
If shared care is accepted, the patient must remain under the care of the specialist for the elements of treatment requiring specialist expertise, including appropriate ongoing medication review. Where this specialist care is provided privately, the patient remains responsible for any associated private fees.
If we are unable to accept a private shared-care arrangement, the private specialist remains responsible for prescribing. We can discuss appropriate NHS referral options with the patient.
What Is Shared Care?
Shared care means that the specialist and GP each retain responsibility for agreed parts of the patient’s treatment.
Typically:
- The specialist assesses and diagnoses ADHD.
- The specialist initiates medication and adjusts treatment until it is stable.
- Once shared care has been formally accepted, the practice issues repeat prescriptions and undertakes the monitoring specifically agreed with the specialist.
- The specialist continues to provide specialist oversight and review and remains available to advise the practice.
- Changes requiring specialist expertise are referred back to the specialist.
Shared care is not a complete transfer of responsibility from the specialist to the GP.
Children and Young People
For patients under 18, we will consider shared care where:
- Diagnosis has been confirmed by an appropriate specialist ADHD service.
- Medication has been initiated and titrated by the specialist and treatment is stable.
- A written Shared Care Agreement has been received and accepted by the practice.
- Appropriate arrangements are in place for ongoing physical monitoring.
- The child or young person remains under appropriate specialist follow-up and medication review.
Monitoring will be undertaken in accordance with NICE guidance, the medication being prescribed and the agreed shared-care arrangements, and may include height, weight, blood pressure, pulse, effectiveness of treatment and adverse effects.
If required monitoring or specialist review does not take place, we may need to pause shared-care prescribing and refer the patient back to their specialist.
Adults
For adults, we will consider shared care where:
- ADHD has been appropriately assessed and diagnosed by a specialist with appropriate expertise.
- Medication has been initiated and titrated by the specialist and treatment is stable.
- A written Shared Care Agreement or formal shared-care request has been received and accepted by the practice.
- Appropriate monitoring arrangements are in place.
- The patient remains under ongoing specialist oversight, including medication review at least annually.
These principles apply whether the specialist care has been provided through an NHS service, an NHS-commissioned provider (including Right to Choose), or a private specialist service. However, every shared-care request is considered individually and acceptance remains at the clinical discretion of the practice.
NHS Referral Options
If you would prefer your ADHD care to be provided through NHS-funded services, we can discuss the referral options available to you.
These may include:
- Referral to the appropriate local NHS ADHD service.
- Where applicable, referral to an NHS-funded provider under the Right to Choose pathway.
Right to Choose providers differ in the assessment, prescribing and follow-up services they offer. We therefore recommend discussing this with us before choosing a provider, particularly if medication may be required.
Please book an appointment to discuss this.
Further Information
For more information about ADHD, visit:
https://www.nhs.uk/conditions/attention-deficit-hyperactivity-disorder-adhd
For adults, this symptom checklist may also be helpful:
We have adopted this policy to support safe prescribing, appropriate specialist oversight and consistent decision-making for all patients.
If you have questions about this policy, please contact our Practice Manager via reception or via the website .