ADHD diagnosis and ongoing management including prescribing medications

There has been increasing awareness of and concern about accessing a proper diagnosis for ADHD. This includes making a management plan including prescribing medication.

As many of you will know ADHD NHS secondary services have very long queues.

General practice cannot diagnose ADHD. This needs to be done by a specialist psychiatrist after a thorough assessment.

General practice cannot monitor ADHD,  start ADHD medication or alter ADHD medication.

Some patients whose medication is stable contact us about whether we might be able to take over prescribing their medication. This document is aimed to help people understand what this involves

There are two options for ongoing management of ADHD medication

• The first is that the consultant psychiatrist continues to see the patient regularly arranges the prerequisite monitoring and prescribing for the patient. We would ask that from time to time they write to us to let us know what they are prescribing so we can note it down in our records. This is our preferred option.
• The second option is to consider whether some of the prescribing can be done by general practice. Parliament hill medical centre will consider doing this in certain situations

PHMC will consider a shared care arrangement in the following circumstances

1. If the practice is confident in the nature of the diagnostic process and the ongoing relationship between the person with ADHD and their specialist. This involves as a minimum the requirements of the person remains under the psychiatrist and consults with them twice a year.
2. The psychiatrist will be responsible for monitoring the ADHD including the effect of the medication and the physical health checks.
3. The psychiatrist will furnish the practice with a completed shared care agreement at the start and after each change of medication once the patient has been stabilised on the change of medication for three months.
4. The Patient will undertake to consult with the Psychiatrist and ensure that the physical health checks including weight/BP is provided to the psychiatrist. For the avoidance of doubt It will not be possible for the practice to forward patients bp/weight/blood results/ECG results to the psychiatrists. The patient will need to ensure that they can access those tests - including the results via the NHS app- and forward them to the ADHD team managing them.
5. The Psychiatrist will furnish the practice with regular update on the progress of the care they provide. For Patients who seek care in the private sector this may not be an automatic process and may need facilitating by the patient.

We have recently been increasingly asked to prescribe for people who have been assessed in the private sector for ADHD.

We do not automatically transfer scripts from the private sector to an NHS prescription.  1659541787-4054aeada6478c9a7f29221cfb39d2a0.pdf (gp-website-cdn-prod.s3.amazonaws.com)

We will consider transferring private prescriptions for ADHD medication to an NHS script under the circumstances delineated above. This may well take a not inconsiderable period of time to set up. Please do factor this into your plans/decisions regarding management of your condition

ADHD MEDICATION SHORTAGE 

There are challenges with the Global supply chain for ADHD medication. 

Please will you request your ADHD medication 7 days prior running out of your medication. We aim to issue repeat  prescriptions within 48 hours. 

Please go to the pharmacist to collect your medication soon thereafter.

If you are struggling at that point to get your normally prescribed ADHD medication from your pharmacist please contact the psychiatrist/ADHD team you are under. 

Please ask your psychiatrist to recommend and prescribe a different medication. If the psychiatrist is unable to issue the medication please ask them to contact the practice with their suggested replacement ASAP. We will aim to issue a new/changed medication in 72 hours.