ADHD Shared Care Agreements Explained

If you have been diagnosed with ADHD privately and started on medication, you have probably heard the phrase shared care agreement. Here is what it means and what to expect.

What is a shared care agreement?

A shared care agreement is an arrangement between a specialist (such as a psychiatrist) and your GP to share responsibility for your treatment.

Typically:

• the specialist makes the diagnosis, starts medication and adjusts the dose until it is stable
• the GP then agrees to take over prescribing and routine monitoring, such as blood pressure, pulse and weight
• the specialist stays available for advice and periodic reviews

The agreement sets out who is responsible for what, which checks are needed, and when care should go back to the specialist.

When is shared care requested?

Shared care is usually only proposed once:

1. you have a confirmed ADHD diagnosis
2. you have completed titration, meaning the right medicine and dose have been found
3. your treatment has been stable for a period of time

It is not normally requested at the first appointment.

Does my GP have to agree?

No. GPs are not obliged to accept a shared care request. It is their clinical and professional decision. Reasons a GP might decline include:

• local NHS policies about shared care with private providers
• not feeling confident monitoring a particular medicine
• workload or capacity in the practice
• wanting the diagnosis confirmed through an NHS pathway

Rules and practice vary between areas and GP surgeries, so it is worth asking your practice about their approach.

What happens if my GP declines?

If shared care is declined, you can usually continue private prescribing and follow-up with your psychiatrist, where clinically appropriate. You pay for private appointments, prescriptions and the medicine itself.

What are the benefits of shared care?

• Cost. Once your GP prescribes, you pay standard NHS prescription charges in England. NHS prescriptions are free in Scotland, Wales and Northern Ireland.
• Convenience. Prescriptions and monitoring are handled locally.
• Joined-up care. Your GP has a full picture of your health.

How does it work at Happy Clinic?

Happy Clinic can propose a shared care agreement to your NHS GP when treatment is stable and it is clinically appropriate. There is a dedicated shared care appointment. See the fees page for current prices. Shared care depends on your GP agreeing and cannot be guaranteed.

Tips for a smoother process

• Tell your GP early that you are being assessed privately.
• Consent to letters being shared with your GP.
• Attend all titration reviews and physical health checks.
• Keep a record of your blood pressure and pulse readings if asked.
• Ask your practice whether they accept shared care from private providers.

To find out more about ADHD care, read about adult ADHD assessments or what to expect from an assessment.

This article is general information and is not a substitute for personal medical advice. If you are in crisis, call 999, go to A&E, call NHS 111 or call Samaritans free on 116 123.