Shared Care for ADHD: How to Get Your GP to Prescribe

Shared care is an arrangement where a specialist initiates treatment and then transfers ongoing prescribing responsibility to the patient's NHS GP. It is a well-established model in UK healthcare and is the standard pathway for managing ADHD medication after a private diagnosis.

Why shared care matters

Private ADHD medication prescriptions can be expensive over the long term. A private prescription for lisdexamfetamine, for example, can cost £80-120 per month. Shared care allows patients to access their ADHD medication on an NHS prescription (currently £9.90 per item, or free for those with a prepayment certificate), significantly reducing costs.

Beyond cost, shared care also means your ADHD treatment is integrated into your NHS records, your GP is aware of your diagnosis and treatment, and you have a consistent point of contact for ongoing management.

How to request shared care: a step-by-step guide

Step 1: After your private ADHD assessment, if medication is recommended, your private clinician will send a detailed shared care letter to your GP. This letter should include your diagnosis and the clinical evidence supporting it, the recommended medication, starting dose, and titration plan, monitoring requirements (blood pressure, heart rate, weight), and contact details for the specialist.

Step 2: Your GP receives the letter and reviews the request. They may contact your specialist with questions.

Step 3: Your GP accepts or declines shared care. If they accept, they take over prescribing. If they decline, you continue to receive prescriptions from your private clinician.

What if my GP refuses?

GPs are not legally obliged to accept shared care arrangements, and some decline. The most common reasons include unfamiliarity with ADHD medication, local ICB policy not supporting shared care from private providers, or concerns about monitoring requirements.

If your GP refuses, you have several options:

• Ask for the refusal in writing and the specific reason
• Ask your GP to refer you to the NHS ADHD service for ongoing management (this may involve a wait)
• Contact your local Integrated Care Board (ICB) to ask about their shared care policy
• Ask your GP to at least monitor your blood pressure and weight while you continue with private prescriptions
• Seek a second opinion from another GP within the practice

ICB policies and shared care

Integrated Care Boards (ICBs) -- the NHS bodies responsible for commissioning healthcare in each area of England -- have varying policies on shared care for ADHD. Some ICBs have formal shared care guidelines that GPs are expected to follow. Others leave the decision entirely to individual GPs.

If your GP is citing ICB policy as the reason for refusing, ask to see the specific policy document. In some cases, GPs are unaware that their ICB does support shared care for ADHD.

What our clinical reports include

At ADHD Assessment UK, our clinical reports are specifically designed to support shared care requests. We provide a comprehensive diagnostic report with clear clinical reasoning, a structured shared care letter addressed to your GP, specific medication and dose recommendations, monitoring requirements, and our contact details for GP queries. This level of detail gives GPs the information they need to make a confident decision about accepting shared care.

Shared care and NHS prescriptions

Once shared care is accepted, your GP will prescribe your ADHD medication on a standard NHS prescription. As ADHD medication is a controlled drug, prescriptions are issued monthly and cannot be post-dated or collected early. You will need to collect your prescription in person or arrange for a nominated person to collect it on your behalf.

Prepayment certificates

If you take regular medication, a Prescription Prepayment Certificate (PPC) can significantly reduce your costs. A PPC covers all your NHS prescriptions for a fixed fee (currently £111.60 per year or £31.25 per quarter), regardless of how many items you need. For anyone taking ADHD medication plus other regular medications, a PPC almost always saves money.