Shared Care, External ADHD Assessments & Safe Prescribing

The practice may take on prescribing only if ALL of the following criteria are met by the provider: 

1. The provider initiates and stabilises treatment
   • They prescribe the medication initially.
   • They complete titration.
   • They confirm a safe, stable dose.
2. The provider supplies a clear shared care agreement 
   This must outline:
   • monitoring
   • follow-up arrangements
   • responsibilities for dose changes
   • communication pathways
   • recall arrangements
3. The provider offers regular follow-up, including annual reviews
   • At least one specialist review per year
   • More frequently if clinically required
   • Clear documentation confirming ongoing suitability of medication
4. The provider remains clinically responsible
   • They accept the patient back promptly if concerns arise
   • They respond to GP queries
   • They manage complications or deterioration
5. The provider is not “diagnosis only”
   • Assessment-only services cannot be accepted for shared care
   • Prescribing requires that the provider offers treatment, titration, follow-up and monitoring

Some assessment services provide diagnosis only and do not offer medication or shared care.

Patients choosing an assessment-only provider should be aware:

• A diagnosis alone does not give access to treatment.
• If they later approach another provider for medication, that provider may not accept the original diagnosis.
• Treatment providers (NHS or Right to Choose) may require a full reassessment before prescribing.
• This may involve joining a new waiting list, which may be lengthy.

A rapid diagnostic assessment may therefore not shorten the overall time to treatment.
In some cases, it results in a longer delay.

The practice cannot influence whether another provider accepts or rejects an external diagnosis.

The practice cannot take on prescribing when:

• The diagnosing provider does not prescribe ADHD medication
• The provider does not offer titration
• No shared care agreement exists
• The provider does not offer annual reviews or monitoring
• The provider does not accept clinical responsibility
• The diagnosis is not accepted by the intended treatment provider
• The patient needs a full reassessment
• The circumstances make prescribing unsafe or outside General Medical Council guidance

Patients may continue to receive private prescriptions if they prefer.

We’re making sure any NHS prescriptions are provided safely and appropriately. Our priority is your safety.

GMC Good Practice in Prescribing (2021) states:

• “You must only prescribe when you have adequate knowledge of the patient’s health and are satisfied the prescription serves the patient’s needs.”
• “When sharing care, you must ensure appropriate monitoring and follow-up arrangements are in place.”
• “You are not obliged to prescribe medicines if you believe doing so would be unsafe or outside your competence.”

This protocol ensures full compliance with General Medical Council and The Medicines and Healthcare products Regulatory Agency standards.