ADHD - GP refuses shared care

[sunnyday2025]

I am desperate to get to get my 20 year old an ADHD assessment. She has a history of self harm which is getting worse and displaying typical behaviours.

I appreciate via Right to Choose can still take forever so am prepared to pay for a private assessment. BUT our surgery and in fact most of the region refuses shared care.
so am I left with either having to wait at least several months for an assessment or go private and pay indefinitely for med prescriptions?

Am I missing something? It just seems so wrong.

All NHS will refuse shared care because of the the cost. I’m on a wait list for ADHD meds it’s 18 months and I will then have to pay privately. It’s a huge huge problem.

It’s very wrong. I was diagnosed 4 years ago and have to pay for the prescription to be issued and the medication every month. The reviewing psychiatrist keeps telling me the GP should accept shared care but I just get told “there is no provision for it in this area”

If you’re missing something OP, so am I, because I can’t see a way around it. Bloody infuriating.

Sorry to hear you’re in the same boat. Can I ask how much you have to pay?

Where are you based? My DD is 18 and has just moved to NHS shared care after a private diagnosis and 8 months of private prescriptions. We are in Greater Manchester. So it is possible, I guess location dependant.

GPs in our area no longer accept shared care because private providers were not reliable and did not really share the care. Writing a one off letter is not really sharing care.

The medications are not within a GPs remit to prescribe so they need to have easy access to a specialist the whole time that the prescription is being issued in case the patient has queries they can’t answer or side effects they can’t manage.

In our area a lot of people were paying for an assessment, titrations and letter to the GP but then the private provider would not answer when questions arise later on or required paying to answer questions and the patient might refuse to / not be able to pay so the GP was stuck with irate people on meds they could not manage.

It’s a decision for each individual practice so will vary by area

It's not even just the meds, it's the fact that the private diagnoses are so unreliable.

I am an NHS psychiatrist and we are having people reach the top of out waiting list now, who have a private diagnosis of ADHD who are expecting us to take over their prescription, and we feel the diagnosis is completely wrong. A lot of these companies are single diagnosis clinics, and it seems when all you have is a hammer, everything looks like a nail, as the saying goes.

We are then in the difficult position of having to refuse to take over care because we disagree with the diagnosis, which leaves us with very irate patients and a whole pile of complaints. It's a very difficult situation.

I really don't blame GPs for refusing shared care with these companies

It depends on the org. Psychiatry UK and ADHD 360 are good and used often via Right to Choose. But they now have long waiting lists of almost a year for diagnosis and then almost another year for titration (trialling meds and finding the right dosage).

Once you get past that, the GP prescribes and you pay for an annual review with the psychiatrist.

The GP won't do anything related to the meds and will stop prescribing if there are unresolved issues.

If you go full private, you pay for the prescription which is about £15 a month and the cost of meds. It really depends what type of meds you land on. When I was titrating I was paying maybe £25 a month for short and long acting methylphenidate but other types (forget the names....Concerta maybe) which are also popular can be around £50 - £70 a month I think. Sometimes you have two types, a long acting one and a short acting top up.

It's not just private - I know of people whose GPs won't even share care with NHS specialists, which I think is a scandal.

It's a problem with private providers when it comes to HRT as well.

I had a relative prescribed topical HRT and she was lucky that a sympathetic NHS GP agreed to take over the prescription as it was about £40 a tube privately.