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.

Yes it’s possible but the point is, it’s a punt.

And it’s getting harder and harder to get shared care with a private psychiatrist. Even when you do, if you want to change the prescription you have to pay for a consul and for consuls to monitor any titration and review. A GP won’t and can’t do that.

My adult ds only had been frequent appts until they got his dosage right. After that the appts are far less frequent. The medication had also been life changing for him.

I hate to tell you this but £95 is cheap for meds, im £350 for meds alone (not including prescribing/ reviews etc), £220 for 6 monthly review. Cant afford it any more and I'm watching my whole life crumble round about me while my GP says that I need to be reviewed by mental health before they will prescribe. GP surgery up the road will prescribe before private diagnosis is reviewed so I've spent about £10k while others pay nothing at all, despite being diagnosed at the same time by the same private clinic. GP rolls his eyes every time its mentioned and they've managed to miss I've been anemic for at least a year because every time I try and get help for the symptoms its blamed on the adhd meds.

My partner was advised to choose the private assessment carefully to ensure that the nhs would be happy to take shared care. He went with an nhs ADHD consultant who did private consultations in the evening. It could be cost effective in the long run to get a second diagnosis and set up shared care this way?

My private psych is also NHS and I've been declined shared care three times. Its madness, getting me off the waiting list would mean someone else could be seen sooner

These cost seem standard OP. I had a similar problem for another mental health condition, and I switched from a traditional GP to one of the virtual NHS GPs.

They were willing to put in place a shared care agreement and have altered my dosage as per my psychiatrists instructions before but as above they do expect to see reviews from my psychiatrist periodically. In my case if they haven’t received a letter in around 4 months one of the pharmacists will get in touch to ask for one. I’ve really liked having a virtual GP because I can see the same GP and pharmacist every time. It makes it much easier to deal with medication because they’re already familiar so are less hesitant to trust my psychiatrist.

I agree with the pp above, it is a hugely unfair system and my heart really goes out to anybody who needs help and can’t afford to go private. Trying to get NHS, help was one of the worst experiences of my life.

If we take the issue around whether the private doctors are appropriately qualified out of the equation and just look at it from purely ethical grounds then surely if those who can afford the private assessment all decide to pay to do so it alleviates the pressure on the system enabling those who can't afford to pay to also access the assessment more quickly? I think that is the point that's being made? That the huge waiting list is for the assesment and after that it's just the prescription which should be relatively easy to continue on a repeat prescription. I don't see the issue with people paying for private treatment if they can afford to do so unless I'm missing something?

Different gps may also have different approaches. Some will have gps who are more confident and experienced to work with private assessments. I was told some gps won’t touch it but others will.

Keep the meds but give up the therapy sessions?

I think OP is saying the private doctor won't prescribe the meds without the therapy sessions

@Justintimeee You should be able to get your GP to prescribe it once you are settled on a dose.

If they do need you to be diagnosed by the NHS, if you can provide the paperwork showing you've been diagnosed then they will somewhat fasttrack you (though it still isn't fast.)

It seems wrong if the NHS won't take over your prescribing once you no longer need it prescribed by your consultant.

They do usually need to have you on the right dose for you before a GP can take over, though.

I'm disabled and unable to work and I often pay for private help/medical stuff for various things with my PIP, although I'm on a low income. It's worth prioritising to me even though it means less money for other stuff. At times I had private consultants/assessments, EMDR etc and couldn't afford much else, but it was worth it.

I'm lucky enough not to have many outgoings though.

I wouldn't want to carry on permanently as you are OP- hope something gets sorted out for you soon x

You don't have to discuss and agree with the NHS that you're going to go private for something. I've never heard of that being a requirement or anything, because it's not.

The OP isn’t having therapy sessions. The psychiatrist sessions are medication reviews if that makes sense. The psychiatrist won’t prescribe the medication without these reviews.

@SoapyBubblesLittleTroubles It's late and maybe I've missed something but couldn't you just join the other GP surgery? It sounds like your current one aren't treating you the best anyway.
Or don't the other one have room?

I think it depends on the private organisation. There have been several recent documentaries about private clinics diagnosing everyone with ADHD and medicating them. So GPs were hit with a flurry of new ADHD diagnoses requesting shared care for people who may or may not have ADHD. Quite dangerous.

Try going through a reputable organisation like Psychiatry UK. I can't see shared care being rejected from them.

@RiderofRohan I get what you mean as it happened to me at the hands of a private shrink, but a private psychiatrist is still a psychiatrist of course.

But this isn't enough for them to dictate to other doctors what to prescribe. The legal and moral responsibility lies with the prescriber, so the GP in the case of a shared agreement. They need to know that the private organisation has safe policies that are following up to date guidance. Many of these organisations are just working for maximum profit.

So someone I know whose child has a private assessment, they were diagnosed by a nurse, not a doctor. I think the NHS should be able to accept a private diagnosis if it’s come from a doctor who works for the NHS too. I wonder if they have different criteria, is there a universal criteria for diagnosis? I think your only choice is to get on the list for NHS diagnosis anyway. Until then I think you only have 2 choices, keep paying or don’t take meds until you get NHS diagnosis

And this is why there's some truth to the statement above from the GP about some private doctors diagnosing anyone who asks with ADHD. Look how much that clinic/doctor is making off of you. Would they be able to make that from you if they didn't diagnose you ADHD?

I'm not saying you don't have it, just that there are absolutely ulterior motives at play here and in a lot of private Healthcare.

I knew this would be about adhd meds. It’s scandalous really but how on earth could the nhs take on everyone who’s received a private diagnosis in recent years? How is it possible? Especially as some private diagnosis are very dodgy (not all). The medication is Essentially amphetamines and really not without risk so it’s right to have regulars follow ups and check ups. Your provider actually sounds like they are being responsible there. I don’t know what the solution is other than better nhs funding for all ND assessments and a decrease in demand.

Exactly, you can understand the issue they have

I disagree psychiatrists who work for the NHS should also be able to diagnose and gain (via the NHS) preferential treatment for those who are willing and able to pay for a diagnosis.

I believe that not least because, to my mind, when the (NHS trained/employed) psychiatrist is privately diagnosing someone with the funds to pay, it means the same psychiatrist is not simultaneously available to diagnose* those on the *NHS wait list.

What it means is those who can pay will be fast-tracked onto NHS drugs budgets and ongoing monitoring schedules much more quickly than those who can't pay for diagnosis.

There will be no hierarchy of needs. Just an ability to pay to access NHS 'approved' psychiatrists and, by default, automatic access to NHS budgets and continuing monitoring of needs.

Psychiatrists who operate solely in the private sector should be very closely monitored in terms of qualifications/registration etc., with shared care available only after diagnosis/ongoing monitoring by a psychiatrist employed by the NHS.

My view is if you want to jump the queue for diagnosis, fire ahead. However, I believe by doing so you need to be prepared to deal with the complete cost rather than only the elements that allow you to be fast-tracked onto NHS budgets/monitoring ahead of others who cannot afford to pay the initial fees.