To think £290 for my prescription is insane?!

[Justintimeee]

Posting here for traffic

I was diagnosed with ADHD 18 months ago and have been receiving monthly medication since.

I have been having follow up zoom calls with my psychiatrist every 6 weeks at a cost of £170. On top of that, to actually have the prescription written is £25 and the meds themselves are £95 so it is a huge cost for me.

The meds have completely turned my life around so I really do not want to go back to life without them.

The issue is, I can no longer afford to pay for the £170 follow ups so regularly. I have asked for a prescription but it has been refused if I don't book a follow up so I am at a loss... I had no idea they were mandatory for me to get medication when I have been diagnosed.

Do I just find another doctor? Is it the same everywhere? I have been refused shared care due to some NHS rules against accepting patients from private ADHD doctors so I don't know what to do.

I am in Essex if it helps.

That sounds so hard op. My sons mid teens and gets all of that free from CAMHS. Why can your doctor not just do all that? Can you refer yourself to the adult mental health team? My son only had appointments reguarly when they were sorting out the correct dosage.

I think this is just what private prescriptions cost unfortunately. My friend has ADHD and has struggled just like you to get the NHS to take on her prescriptions so she had to find them herself. I don’t know why the nhs won’t find adhd medication.

Between this and shortages I’ve been hesitant to medicate my ADHD but I’d pay that and more to “turn my life around”…can I ask how medication has helped you?

(sorry I can’t help with your question, I don’t know what scope their is to challenge on shared care)

Is the ruling about shared care new? My daughter had a private ADHD diagnosis in 2016 and after a handful of private prescriptions (until her dose was stabilised) was then transferred to nhs via the GP surgery. The waiting list for an NHS referral for an ADHD diagnosis was over 2 years so private was the only way to go really. She has recently changed medication via psychiatry uk who managed the titration but all prescriptions were nhs.

My DH had the same. His GP quite candidly said that most NHS doctors believe private doctors will diagnose anyone with ADHD who tells them they think they have it, so they won’t take the diagnosis on board and prescribe the medicine. Meanwhile, of course, DH is still on and endless waiting list for an NHS doctor to see him.

I had no idea that was the case. My GP referred me to private psychiatry and they diagnosed me and after I was settled on medication, back to GP and it's just a normal prescription charge for me.
Could you get referred again for NHS diagnosis

Yes it’s incredibly expensive.

If you can’t get shared care then the only way is to be assessed by the NHS. You could put yourself on the wait list and pay in the meantime.

That is terrible! The “private doctor” who diagnosed my daughter is a well respected consultant psychiatrist who does both nhs and private work. Would they equally disregard a diagnosis of a physical condition by a “private doctor”?

ADHD drugs can only be prescribed by GPs if there is a shared care agreement with a psychiatrist. It’s a contract stating the obligations of the consultant and the GP.

I’m a GP and where I work there is no shared care contract between GPs and private providers, so SC drugs initiated by private consultants can’t be prescribed by GPs. I think this is the case in most areas.

The current waiting time for NHS ADHD assessment is several years.

In many cases they do. They wouldn’t accept that I’d been diagnosed with endometriosis privately, for example, even though the doctor who diagnosed me also worked for the NHS (!). I ended up in the insane situation of having to get the same diagnosis from the same doctor wearing a different hat, after a significant wait.

OP I would suggest watching the Panorama documentary on private ADHD diagnoses and how they’re basically big money making scams. Be very careful, I know the wait is unbearable but a NHS diagnosis is more robust and they aren’t looking to make a monthly profit from you

surely getting the diagnosis privately takes a pressure off of the NHS so you would think they would be happy to not have that added pressure.

Do you think it’s fair that someone who can afford to pay for a private consul can get a diagnosis quicker, and have their meds paid for by the NHS, than someone on an NHS waiting list? It’s not fair. It’s a way of jumping the queue.

And the PP comparing it to a physical diagnosis - there often isn’t a cost of £100 in meds to the NHS every month.

Oh and also, adding to my previous point — the most obvious physical diagnosis in some ways, my missed miscarriage, had to be done twice by the same doctor! My consultant (working privately) diagnosed it and told me to go to the EPU for medical management, and they said they needed an NHS scan, so the same doctor had to scan me again as an NHS doctor. The interplay between NHS and private in the U.K. is deeply confusing.

When you also consider that the private provider’s main motivation or to make money it also puts patients who are desperate, in pain or deeply unhappy in a very vulnerable position - which can easily backfire on the NHS. For example if they have not been prescribed carefully, not least because they have no access to the patient’s NHS medical files so don’t know their history or if a prescription is safe.

@Allywill the problem is that many of these ‘private doctors’ are not doctors at all.
some are based abroad with no gmc licence, some are a 30 minute online ‘assessment’ and some are nurses/OTs who can’t prescribe and certainly should not be ‘instructing’ anyone else too.

unfortunately the safety, legality and responsibility of a prescription comes down to the person signing it. Not the person doing the adhd assessment.

without knowing the status and profession and that a rigourous assessment had been carried out a gp would not take over the prescribing without huge risk.

I feel for all those waiting on an nhs cahms or psychiatry appt - it’s shit. That shit service cannot be mopped up or even propped up at risk to the gp. Therefore it’s the same for all patients seen privately.

in our practice if you have seen a gmc registered psychiatrist privately and you have been titrated, reviewed and stabilised on meds we will take over prescribing, provided you have ongoing psych reviews either privately or nhs. This will mean remaining on private reviews whilst awaiting an nhs review.
we make it clear to patients the minute you stop that review, need a dose change or med change, we stop the script and it’s end of shared care.

Indeed @KarenNotAKaren

But right to choose is NOT the same as simply going private, it’s a system that is linked to the NHS from the beginning, and there are conditions.

Obviously some private psychiatrists are ethical, but some aren’t. Bottom line is the assessment process of getting a private diagnosis is on average less rigorous than the NHS assessment process.

That's incredibly arrogant of a GP to say that! (Especially as GPs are pretty badly thought of by their peers in the medical profession...)

Yes, that's how much the meds cost and you are locked in (mine were every 4 weeks and more expensive) I did get shared care immediately from my GP after a year or so of paying privately.

I deliberately chose to get a diagnosis from a psychiatrist who worked in a London teaching hospital as well as privately because I was aware of the stigma/discrimination/mocking that is all part of an ADHD diagnosis (especially if you are a middle -aged woman with a career/house/relationship/children etc) and was prepared for a fight to get shared care, was very relieved I didn't have.

As the shortage hit I've still had to go private because pharmacies are stockpiling for private patients rather than NHS - it's a nightmare getting hold of them with an NHS prescription at the moment & pharmacies seem to be at breaking point/not functioning as it is!.

@mumofone2019 youre still not getting it though. You might not have gone through right to choose, but you acquired shared care from the beginning. This is not the same as going private without any agreement from the NHS, then expecting the NHS to foot your medication bill.

We “went private without any agreement from the NHS” for our DS - the waiting list for our area was 3 years and he was facing exclusion. Two years later he is on shared care with the meds which the GP was fine with so it is certainly possible.
It’s basically a postcode lottery at the moment.