Important Information

Changes to ADHD Medication Prescribing and Monitoring

Dear Patients,

We are committed to providing you with the highest standard of care and ensuring your safety and well-being. 

We have had to make the difficult decision to implement a policy regarding “Shared Care Agreements” requests from private providers.  

Why Are We Making This Change?

Shared care is a term used within the NHS to describe the situation where a specialist doctor wishes to pass some of the patient’s care, such as prescription of medication, over to their general practitioner (GP). This is something that can be requested but the guidance for all medications is that this may only be done if the GP agrees. The GP will need to consider a number of factors to decide if this is safe.

Formal shared care arrangements, be they NHS or Private, are voluntary on the part of the GP and the GP should be mindful of their own clinical competence and workload capacity when considering agreeing to enter into such an arrangement.

Due to several factors, our practice will no longer be accepting Shared Care requests for ADHD medications from private providers. Here are the key reasons for this decision:

1. Clinical Expertise and Safety Concerns:

• ADHD medications require specialist knowledge for safe prescribing and monitoring. Our GPs do not have the necessary expertise to manage these medications independently.
• When accepting a diagnosis and shared care agreements with private providers, the GP must be satisfied that the provider is appropriately accredited, practicing in line with UK best practice and will prescribe and monitor patients in line with locally agreed pathways. Unfortunately, with the proliferation of private ADHD providers, it is not practically possible for us to ensure that each provider meets these criteria. 
• Local NHS ADHD services often decline to acknowledge diagnoses made by alternative providers and are unwilling to take over prescribing or monitoring for patients with ADHD previously receiving their care in the private sector without undertaking their own diagnostic assessment, so this can potentially put the GP and yourself in an impossible situation should you decide that you are unable to continue with private follow up (or should the private provider cease to provide care).

2. Capacity and Workload:

• We are aware that there are multiple issues that are affecting patient NHS hospital waiting times and that ICBs (Integrated Care Boards) and our secondary care colleagues are working hard to address these. It is recognised that General Practice is also struggling to meet patient needs. GPs need to be mindful of focussing on undertaking essential services to patients first and foremost before agreeing to take on extra work on top of this. They should not be asked to work beyond their competencies or over safety limits in order to cover long waiting times for other services or commissioning gaps.
• The increasing demand on General Practice has made it challenging to accommodate shared care arrangements without compromising the care of other patients, especially where there are the added complications mentioned above.

3. Lack of Support and Resources:

• Shared care arrangements often lack the necessary support and resources for GPs to manage ADHD medications safely.
• Without adequate support, there is a risk of miscommunication and potential harm to patients.

What Does This Mean for You?

If you are already receiving ADHD medication from us through a shared care arrangement, this provision will not change for the time being. 

For any new or future requests for shared care, here is what you need to know:

• Your ADHD medication and monitoring will need to be provided and managed by your private provider.  As and when we receive requests to enter “shared care agreements” with private providers, we will inform them that we will not be able to accept this agreement.  We recommend contacting your private provider to discuss your ongoing care.
• If clinically appropriate, your GP will be happy to refer you to the NHS ADHD services as an alternative option for you, so please arrange an appointment with your GP if you would like to discuss this option.

Thank you for your understanding and cooperation.

Warm regards,

The Hadleigh Practice

Published: Oct 3, 2024