Are most GP's stopping shared care for ADHD?

[Milmoe]

I am thinking about seeking a private ADHD diagnosis so that I can get some help. I am almost certain I have this condition and I want to get help before I completely waste any potential that I have. I did ask my GP about it some time ago but they were quite dismissive.

I have heard about people being able to pay for a private diagnosis then they are able to get shared care via their GP's for their medication long term. However I am also hearing now that lots of GP's are now doing a blanket refusal on shared care for ADHD and are even ending shared care agreements that have stood for years.

I can barely afford the diagnosis and would not be able to pay £100's monthly for my medication so if there is no chance of shared care via my GP then their would be little point in seeking a diagnosis except for perhaps being able to access some in work modifications.

I just feel so hopeless, the medication for ADHD seems like my last hope of a normal life but it seems I will never be able to actually access it even if I was diagnosed.

But my daughter was diagnosed but the leading NHS ADHD psychiatrist of the trust so are they accusing the trust of not following guidelines and policies?

But it’s not a widespread policy at all. NHS ADHD services and departments are not going to be stopped. Some have had to close wait lists, the department is still running.

I now realise it was you I was referring to when I said that people on this thread are experiencing the risk they cant get meds. You spoke of your daughter not being able to get her meds. Surely that is a service to her that is going to be stopped? You sound like you're contradicting

Whether its widespread is a moot point, if its happening in your area, its very likely happening to other areas, potentially affecting thousands of people.

No, it'll be a blanket decision which you'd expect was off the back of another service getting actual funding to provide the prescribing duties.

No you said

“Adult adhd services are potentially stopping being funded by the NHS altogether as part of the cuts.“

ADHd services do diagnosis, titration, prescription, psychotherapy and alternative ADHD treatments .

Nowhere has it been said that these services are going to potentially stop being funded by the nhs altogether.

Sorry could you elaborate a bit more. Are you saying they are arguing that NHS ADHD services are paid to do the monitoring after prescription so should do it as opposed to concerns re monitoring being done properly as has been suggested on this thread .It was a generic letter which showed zero examining of individual cases, zero reasons and was really poor?

I didnt say that, you're quoting the wrong post.

The nhs don’t have enough psychs to deal with the demand so have outsourced to psychiatry uk via the right to choose system, once sorted and stable you’ll be passed back to gp via shared care, and like PP say it’s literally a repeat prescription and yearly BP check, hardly difficult for them!

What they won’t accept is diagnosis from many online sources, most of whom don’t hold the appropriate qualifications to be able to diagnose! It’s very difficult to find a reputable private company that the NHS will accept a diagnosis from.

Do you know about what happens to diagnoses that are made as children via private companies, once those children get to adulthood, would there be problems?

We have huge numbers of these at work

Yep you’re right, apologies. It was from somebody else beginning with S.

My point was, you yourself are experiencing a risk that your daughter cant get her meds, funded or not, services stopping or not, that is likely to be replicated a across the country. The implications of this are huge.

It really depends where you are and who is providing your diagnosis. DS who is 22 has a shared care agreement for his medication but spoke to his GP before starting the diagnosis process to ask if he went to X clinic for his assessment would they considered shared care? They said yes, because X clinic used consultant psychiatrists working in the NHS for their diagnosis and the process was the same as it would be in the NHS. Other clinics offering online diagnosis or assessment by a psychologist or similar they would not enter into a shared care agreement with.

This has all happened within the last year, we're in Glasgow.

No it’s a very different scenario than is being suggested by yourself and the other poster .

ADHD services and everything they do that I listed are not being stopped. NHS patients are still going to get their meds just via the ADHD dep that diagnosed them in our case and others diagnosed by the NHS -the NHS. Nobody has suggested she isn’t going to get them, our GP is liaising with her consultant to ensure there is no disruption. Whether her GP should be doing that is arguable.

Yep but some GPs are now not doing shared care with NHS diagnosed patients. If that happens he’ll still get them but via his consultant and have his yearly monitoring(BP)done there which is unnecessary extra hassle,particularly unhelpful when you have adhd.

Our whole family has adhd, I’m just about to go to shared care with my gp, having started medication this year. I want to
get youngest assessed (16) and spoke to gp regarding shared care after a private diagnosis. The gp said they are happy to do shared care as long as the prescribing consultant carries out annual checks.

ADHD meds are crazy expensive too, I understand why GPs (which are businesses) are reluctant to prescribe.

GPs don’t pay for prescriptions. Many medications and conditions are expensive. Crisis MH care, hospitalisation and self medication which adhd meds in many cases averts are hugely expensive

I would think the main issue with any private diagnosis is that there is no quality checking that diagnosis. So many online ADHD scam diagnoses out there.

Shared care in general is problematic. It is effectively ‘jumping the waiting list’ and then pushing the burden for onward care on the NHS. That’s not an equitable system.

@WhereAreTheWildThingsNowi agree it’s a racist, classist, ableist system.

I've been on medication for years, the same medication, shared care agreement, and all of a sudden it's stopped so now having to go back private. I won't be able to afford the medication privately so assuming I will just have to stop meds altogether. I do totally understand gps are concerned about the huge increase in private diagnosis but surely it should be decided on a case by case basis and not a blanket ban on practices refusing all shared care agreements for adhd prescribing. It honestly makes me feel like a drug seeker, having to try and argue with my practice about needing my prescription, I've been on it for years and no issues raised, now all of a sudden nope we can't prescribe. I actually struggle to function without them and will be at risk of losing my job.

Your wording is wrong here a GP will be prescribing the medication not issuing it. If anything goes wrong they will prescribed it. The problem with private providers is GPs have no guarantee of their ongoing support as if the private clinic closes down or the patient decides not to pay anymore they are stuck being responsible for a medication that is managed by specialists.

NHS right to choose is different but some GP surgery may have disproportionate numbers of shared care and they may feel it is not something they feel they can do safely or is a good use of their stretched resources.

Remember it can take several months and different medication to get the correct dosage and right medication, this is all done with your private physiatrist/phycologist. You normally need a review every year and again your need to pay your original physiatrist

I have heard that many GPs are stopping it because of the workload involved in preparing prescriptions. Crazy that they're essentially trying to dissuade people getting a private adhd assessment when the NHS waiting lists are so long!

Our GP wouldn't commit. Basically said the decision will be made by the local mental health team. As a result I've applied for DLA for my son to cover the monthly medication cost - otherwise I wouldn't have done so. So many of these decisions are so very short sighted where public finances are concerned.

But this is how it should be. DLA is meant to support the costs that come with having a disability. So it doesn’t ‘cost’ society any more. Less in fact as you are not getting DLA and the medication on the NHS. Really you should have an NHS diagnosis*

• see previous comment re queue jumping

They are also stopping shared care with nhs patients so nhs adhd services are going to having a double whammy with longer wait lists and the psychs being tied up with more prescribing/ monitoring so less time to deal with the longer wait lists- it’s madness.