Attention Deficit Hyperactivity Disorder (ADHD) assessment – Referrals and Medication
As a practice we are committed to supporting patients with neurodevelopmental diagnoses, both children and adults.
This information is for those who patients who are concerned or suspect that they may have ADHD and would like to be referred to the NHS for an ADHD .
Attention Deficit Hyperactivity Disorder (ADHD) can affect many aspects of a person’s life. However, diagnosis is complex and GPs (General Practitioners) 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.
This guide will explain how the referral process works, how referrals are initiated and what you can expect if you are diagnosed. This information is based on national and local guidance, specifically NICE guidance.
The person who needs to initiate the referral will depend on the education age of the child:
Pre-School – The referral is to be discussed with the Childs Health Visitor or Early Years Setting – they can be contacted by calling: 01522 843000
School Age – The referral is undertaken by the school
Home Schooled Children – the referral is undertaken by the GP
Supporting evidence will be required regardless of who is initiating.
If the NHS Mental Health Team confirm a diagnosis of ADHD, they may initiate treatment and may offer medication; initially this will need to be obtained directly from the specialist consultant. Once the Mental Health Team are confident the patient is stabilised on their medication, they may feel it is appropriate for the patient to obtain their medication from the GP Surgery.
In order for us to prescribe this type of medication, the Mental Health Team will need to send a Shared Care Agreement to your GP. This is an agreement with an NHS Consultant for the GP which stipulates any monitoring needed to continue to prescribe the ADHD medication safely.
Please note, the GP is only able to continue prescribing and monitoring a patient if a Shared Care Agreement with an NHS provider is in place.
Due to the unprecedented demand for ADHD diagnosis and treatment nationally and locally across all age groups, all referrals are sent to the Single Point of Access Team to determine the clinical appropriateness for referral / assessment triage. Those not meeting this threshold will be referred back to their GP with self-help and signposting. If the referral is accepted, this will be forwarded to an approved provider. Currently the waiting time is approximately 16 weeks for initial assessment.
Which provider will assess me?
Lincolnshire ICB have commissioned several providers to support referrals. All providers who carry out NHS services must hold an NHS Standard contract which means they have passed the due diligence checks set by the NHS. Due to pace of change we are unable to provide you with a list of providers.
If the provider confirms a diagnosis of ADHD, they may initiate treatment and may offer medication; initially this will need to be obtained directly from the specialist consultant. Once they are confident you are stabilised on the medication, they may feel it is appropriate for you to obtain their medication from the GP Surgery.
In order for us to prescribe this type of medication, they will need to send us a Shared Care Agreement. This is an agreement with an NHS Consultant for the GP which stipulates any monitoring needed to continue to prescribe the ADHD medication safely.
Please note, we are only able to continue prescribing and monitoring a patient if a Shared Care Agreement with an NHS provider is in place.
Under NHS England’s Right to Choose legislation patients can exercise their right to see any appropriate health service provider. This provider can be anywhere in England, as long as the provider holds an NHS Standard contact detailed above.
Please let us know if you want to use a preferred provider, this information will be added onto the referral form, however, please be aware that all referrals will initially be sent to the Single Point of Access Team for triage and upon acceptance they will then consider the Right to Choose provider request.
Please note: If the provider of choice does not hold an NHS Standard Contract with Lincolnshire ICB due diligence checks will need to be carried out before the referral can be sent onto them, this may delay the referral.
Things to consider when choosing a Right to Choose Service:
It is important to understand that many of the Right to Choose services can offer diagnosis but are often unable to prescribe medication, even if deemed appropriate. This means that you may be able to obtain a diagnosis, but often you will need a further referral to a local NHS service should they recommend you need to start medication to control your symptoms.
Before a local service will take over your care, they may require you to complete their own assessment as not all assessments carried out by Right to Choose services are universally accepted and this may delay further treatment and follow up. Unfortunately, this is not something which can be easily avoided as most medications suggested for these conditions are ones that GPs do not prescribe without the support of a specialist clinic under a ‘Shared Care Agreement’. In line with most GP services our policy is not to enter into shared care agreements with any provider except the local NHS services.
You may choose to be referred to a Private Provider for your ADHD assessment due to the long waiting times for an NHS appointment, or simply out of preference. In this instance, the prescribing and monitoring of any medication must continue under the care of the Private Provider, and we will be able to prescribe ADHD medication or arrange monitoring on a Shared Care Agreement.
A shared care agreement allows GPs to prescribe specialist medications under the oversight of a specialist, who continues to review the patient’s treatment. Although there are established local shared care agreements with NHS specialists, these are not in place for private prescribers and so we do not accept shared care agreements with private specialists. This means that any medication requiring a shared care agreement that is initiated by a private clinician will need to be prescribed directly by that clinician.
Can I transfer from a private provider to NHS provider?
If following assessment, you wish to transfer your ADHD treatment to the NHS, you will need to be referred to the NHS mental health specialist team for assessment and confirmation of your ADHD diagnosis. The NHS consultant will ascertain whether the NHS criteria for a prescription of ADHD medication has been met.
If this criterion is met, a Shared Care Agreement can be formed between the NHS consultant and the GP. Until this is established the clinical responsibility of prescribing and monitoring of the patient, and their medication should remain with the Private Provider.
Please note there is no obligation nor mandatory requirement for a GP to enter into any Shared Care Agreement.
All referrals are sent to the Single Point of Access Team to determine the clinical appropriateness for referral / assessment triage. If the referral is not accepted, we will write to you to inform you of the decision and give you an opportunity to provide further evidence to support a resubmission. If the referral resubmission is rejected a further time, we will write to let you know, at this point we will signpost you to the organisations that may help you.
ADHD UK: A charity offering free advice and information on ADHD and Right to Choose referrals
ADHD Foundation: The UK’s leading neurodiversity charity, offering services for those who live with ADHD, Autism, Dyslexia, DCD, Dyscalculia, OCD, Tourette’s Syndrome and more
Attention deficit hyperactivity disorder (ADHD) - Living with - NHS