Hertfordshire and Essex ICB have advised that we are no longer able to offer NHS referrals to services offering Adult ADHD diagnosis. If you wish to pursue this diagnosis you are able to access services via the “Right to Choose” Pathway.
You will need to choose your service provider from the services listed on the ADHD UK website. This site also offers comprehensive advice on the right to choose pathway and information and location of the providers offering the assessments. You will need to complete the forms for your selected provider and then submit them to the practice.
However in many cases this referral will only cover the initial consultation, and will not include ongoing support from the provider or medication provided on prescription by the practice.
Where a private specialist has initiated and reviewed treatment, with any of the Attention Deficit Hyperactivity Disorder (ADHD) medications, and considers the patient to be stable on treatment, Herts and West Essex ICB (our NHS board) do not recommend prescribing to be transferred directly into primary care. This is due to diagnosis and management not necessarily following approved NHS ADHD pathways/criteria. There is also a requirement for an NHS specialist to undertake an assessment to confirm the diagnosis and review that the prescribing is in line with NHS criteria.
Herts and West Essex ICB only support shared care agreements between an NHS specialist and NHS GP. Shared care between a private consultant and an NHS GP is not supported. If the private part of care is interrupted (e.g., patient unwilling or unable to pay) then the GP is left isolated without the support of a specialist. GP’s cannot take on shared care with private providers.
| Shared Care requires the provider to : * Monitor effectiveness of medication and adverse effects, taking into account the monitoring required for the specific ADHD medication. * Titrate initial dose against symptoms and side-effects over 4 – 6 weeks until dose optimisation has been reached and the patient’s condition is stable. * Record symptoms and side-effects at each dose change. The patient’s progress should be reviewed regularly. Maintaining close clinical contact by means of a telephone review may be beneficial for some patients. * Communicate with the GP a summary of the clinical review, including results of monitoring undertaken, changes to treatment / dose changes. * Issue shared care information to GP, inviting GP to enter shared care at/after week 12 when patient is stabilised on treatment. i.e., drug tolerated, dose stabilised and monitoring parameters are satisfactory. * Continue to issue prescriptions for the patient after treatment initiation until such time as the patient’s GP agrees to the shared care arrangement. SHARED CARE MUST FORMALLY BE ACCEPTED BY THE GP |
Please see the the ICB patient guidance below for more information.
https://www.hweclinicalguidance.nhs.uk/all-clinical-areas-documents/search-results/shared-care/
Additional information
Please watch this video here from Dr Sophie on Adult ADHD, including diagnosis, self help, NHS referral waiting times and why choosing to go private may not be beneficial.
Adult ADHD patient information and resources letter here
