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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

Original poster

to ask what shared care regarding ADHD actually means?

49 replies

ADHDnewbie · 27/09/2023 19:11

Very confused at the moment!
DD 13 years old is about to start Concerta XL
The private clinic is closing down soon due to retirement so whilst our GP has agreed shared care once he is stable ( approx 6 months time ) does this mean I now need to find another private DR / clinic to oversee the medication just to get the GP to write the prescription?

OP posts:
PhantomUnicorn · 27/09/2023 19:12

ask the clinic

HauntedPencil · 27/09/2023 19:13

The GP will prescribe after this point as long as the consultant confirms your child is table on the meds - my DS Still needs check ups though particularly as they can cause weight loss etc. so if you're a way off seeing an NHS consultant I think you'd still need to see someone privately?

AsYou82 · 27/09/2023 19:16

They will write the prescription stated by the consultant and monitor as appropriate but cannot titrate it or adjust the dose without specialist guidance/advice. So you will need another consultant to manage the stabilising phase until it’s settled on a suitable dose

Original poster
ADHDnewbie · 27/09/2023 19:21

Sorry she isn’t retiring until next summer so the whole trialling of the drugs / getting the dose correct etc will have all happened by this point and been paid for privately.

If she is then stable, will the GP take over shared care completely or will I need to find someone else / be referred through CAHMS which will take years just to “ oversee “ her medication is what I’m trying to figure out

I’m worried about the meds making a world of difference to her for 6 months and then not being able to get them as the DR retires and I need someone to guide the GP!

OP posts:
loobylou44 · 27/09/2023 19:22

How did you manage to get Shared care agreed? Our gp has just refused shared care for my daughters ADHD meds 🤬

Original poster
ADHDnewbie · 27/09/2023 19:24

I asked the GP before we got the medication prescription sorted via the private practise and she said yes to shared care one stable.
Im so sorry - how old is your daughter?

OP posts:
HauntedPencil · 27/09/2023 19:43

loobylou44 · 27/09/2023 19:22

How did you manage to get Shared care agreed? Our gp has just refused shared care for my daughters ADHD meds 🤬

My private consultant organised it for me, I'm sorry not every GP will take it on I don't think.

oldcottage · 27/09/2023 20:07

your GP will take it on then likely in time if he needs review of meds eg higher dose or switch of product then you’ll need another psychiatrist to make changes, then GP will take it on again.

When I switched from private to shared care my gp prescribed me generic meds and it made me feel dreadful so had to stop taking it, so psychiatrist did a letter to state it had to be concerta only and then gp has prescribed me with no issues for about a year now.

Original poster
ADHDnewbie · 27/09/2023 20:24

So if she starts on Concerta and there are no issues and is stable for a period of time then the GP can completely take it over without a psychiatrist at all?

im worried we won’t find one that will consult on the medication if it wasn’t their company who did the assessment as that’s what I’ve heard!

OP posts:
xyzandabc · 27/09/2023 20:29

I think you need to ask the clinic what they suggest you do. They must have lots of patients in the same boat. They may have an arrangement with other clinics??

We have shared care, the GP does the prescriptions but 6 monthly or annual reviews are done by the clinic and they tell the GP if the prescription needs to change

SugarPlumpFairy3 · 27/09/2023 20:34

Your GP should take over once the specialist is happy with the dose.

Your dd will still need 6 monthly checkups with the specialist to review her prescription and make any changes to her prescription - a GP cannot do this. They will then authorise your GP to prescribe any changes in medication/dose until the next 6 monthly review.

Original poster
ADHDnewbie · 27/09/2023 20:35

Yes I will ask but our appt isn’t for a month now to review so just wanted to see if anyone else has experience as all GPs seem to offer different things from nothing at all to the entire care ( as long as no change in prescription etc ) so it’s all quite confusing!

OP posts:
Littlefidget2 · 27/09/2023 21:24

It depends on what the shared care agreement says locally. But the whole point of a shared care agreement is that although thr GP agrees to prescribe, the patient should still have specialist reviews. Locally this means yearly reviews with your specialist, and the GP practice checking weight/ pulse/BP etc 3 monthly.

Original poster
ADHDnewbie · 27/09/2023 22:31

I understand that but if the specialist then retires what happens?!

OP posts:
Hankunamatata · 27/09/2023 23:44

Mine are under nhs. My gp will only write a prescription after adhd consultant sends a letter stating medication and dose.

Hankunamatata · 27/09/2023 23:45

Your going to need to find a new private adhd consultant or ask nhs to be transferred onto their list - some trusts will and some wont

Littlefish · 28/09/2023 00:01

I agree with others. You will need to have a private psychiatrist involved in your dc's care. Without one, the GP will not be able to prescribe the ADHD meds.

QueenPB · 28/09/2023 03:16

You find another private consultant or get referred to the NHS for yearly monitoring

POTC · 28/09/2023 03:40

I've had this arrangement for my narcolepsy medication (same med is used for adhd) for over 20 years. I have to have a yearly review with my consultant, they send a letter to my GP saying they have reviewed, GP continues prescribing exactly as per the letter. If for any reason the review letter doesn't reach GP it flags up as needing a medication review and I can't get my meds until consultant writes to them.

Madcatwoman123 · 28/09/2023 04:20

My daughter has ADHD medication and we are lucky that we do have access to the local adult ADHD NHS service. Her GP does shared care but even as an adult it is limiting as to what they can do.

My worry for you is that there can be shortages of medications still post-Covid and we struggle with ADHD medication. My daughter was prescribed a branded version of Atomoxetine which is just not available. Just getting the prescription changed to be the generic medication so that our pharmacy could fulfil it was a nightmare. It isn't just getting stable on a drug which is an issue but also factors like supply which may demand you have a private specialist who can advise the GP. Your current specialist really needs to provide advice on a new provider

Original poster
ADHDnewbie · 28/09/2023 06:57

Thank you - it’s confusing as I arranged a doctors appt to discuss all of this before we even met the private doctor to discuss medication and GP said happy to do prescriptions, general checks once stable on it - approx 6 months time she said.
I took that to mean that If the dose is completely stable and no changes required, she would be happy to prescribe without a psychiatrist overseeing as I told her about the clinic closing.
So stressful as a lot of private clinics won’t oversee without the assessment coming from them so my DD could end up having a great 6 months then and having to stop 😢

OP posts:
redguitar123 · 28/09/2023 07:02

ADHDnewbie · 27/09/2023 19:11

Very confused at the moment!
DD 13 years old is about to start Concerta XL
The private clinic is closing down soon due to retirement so whilst our GP has agreed shared care once he is stable ( approx 6 months time ) does this mean I now need to find another private DR / clinic to oversee the medication just to get the GP to write the prescription?

Yes exactly this, need to be under long term regular consultant review

redguitar123 · 28/09/2023 07:02

loobylou44 · 27/09/2023 19:22

How did you manage to get Shared care agreed? Our gp has just refused shared care for my daughters ADHD meds 🤬

It's an individual practice decision

redguitar123 · 28/09/2023 07:03

ADHDnewbie · 27/09/2023 20:24

So if she starts on Concerta and there are no issues and is stable for a period of time then the GP can completely take it over without a psychiatrist at all?

im worried we won’t find one that will consult on the medication if it wasn’t their company who did the assessment as that’s what I’ve heard!

No. Shared care is shared with a consultant so you willneed at least annual consultant review lifelong

redguitar123 · 28/09/2023 07:04

ADHDnewbie · 28/09/2023 06:57

Thank you - it’s confusing as I arranged a doctors appt to discuss all of this before we even met the private doctor to discuss medication and GP said happy to do prescriptions, general checks once stable on it - approx 6 months time she said.
I took that to mean that If the dose is completely stable and no changes required, she would be happy to prescribe without a psychiatrist overseeing as I told her about the clinic closing.
So stressful as a lot of private clinics won’t oversee without the assessment coming from them so my DD could end up having a great 6 months then and having to stop 😢

I would move now and get a consultant who can see her long term to do the titrating etc