Across the country, patients are experiencing challenges and delays in accessing services for diagnosis and treatment of ADHD. This picture is the same across mid and south Essex.
This is due to a combination of factors, including:
- increased numbers of patients seeking an assessment and being diagnosed;
- long waiting lists for diagnosis and treatment in specialist services;
- more patients are being prescribed medication and requiring ongoing monitoring in general practice where capacity is stretched;
- patients receiving different elements of NHS funded care from different providers, as well as privately-funded care;
- An ongoing national shortage of ADHD medications.
This creates a complex and challenging picture for healthcare providers who are working hard to ensure patients remain able to safely access ADHD medications and ongoing monitoring, whether that is within specialist care, or in their GP practice.
Changes to NHS GP prescribing of ADHD medications
Some GP practices are choosing to stop prescribing ADHD medications for their patients.
NHS Mid and South Essex has put in place new arrangements to ensure NHS patients remain able to access ADHD medications safely and without interruption. For patients who have accessed diagnosis or treatment privately, please refer to the FAQ below.
Alongside the new arrangements that have been put in place, we are continuing to work with GP practices, specialist care providers, and other system partners to plan, redesign and improve the pathways of care in mid and south Essex so that patients are supported to access the care they need in a way that is safe, equitable, and sustainable.
Please see below an FAQ about what will happen and how these changes may affect you if you are prescribed ADHD medication from your GP practice.
This page will be updated at regular intervals when details are confirmed.
Patient Frequently Asked Questions
ADHD medications require very careful monitoring and management, and GP practices want to make sure they have the necessary expertise and resources to keep people safe.
Where GPs take this on, they do so under a shared care agreement which is a formal local agreement that enables GPs to accept responsibility for the safe prescribing and monitoring of specialist medicines. Read more about shared care agreements here.
ADHD prescribing isn’t included within GPs’ core contract, it is an optional service that GP practices can choose to deliver. Some GP practices may opt to not sign up to this service or may decide to stop offering it as it falls outside of their core contract.
If a GP practice decides to stop delivering this service, then patients will be notified that responsibility for their prescribing is being transferred to an alternative provider and will be given a timeframe on when that would take place.
GP practices are under a lot of pressure.
Each practice needs to focus on providing the services that they must offer under the terms of their contract.
Some specialist medications are only safe for GPs to prescribe under a ‘Shared Care Agreement’ – which includes ADHD treatments. GPs do not have to prescribe shared care medications if they feel unable to do so or if they are not able to do this in a safe manner. ADHD prescribing and ongoing monitoring is not part of the core contract the NHS holds with GP practices. This is a core part of the requirements of ADHD specialist services.
On account of the pressures facing GP practices, the local medical committees (LMCs) in both Essex and Suffolk have recommended that GPs stop prescribing ADHD medications and return responsibility for this back to ADHD specialists.
This depends on who the patient’s ADHD specialist is, but the below will apply to both children and adults:
For some patients, their ADHD specialist will take back prescribing their ADHD medications and arrange any tests that might be needed.
For other patients, a new local ADHD service will take on prescribing their ADHD medications and arrange any tests that might be needed. This service is planned to go live in April 2025. Arrangements have been put in place to support patients where practices have withdrawn before then.
For patients that privately funded their ADHD assessment, different arrangements will apply. Following discussion with the patient, the GP practice will refer the patient back to their private provider, or into an NHS funded service.
More information about this is provided in the FAQ “I have privately funded an ADHD diagnosis and prescription for ADHD medication. My GP was managing the ongoing prescribing, but has advised me that they will no longer be doing this. What options do I have?”
Patients should wait to be contacted with information on these new arrangements.
Some GP practices have shared care agreements with specialist providers, which enable the GP to accept responsibility for the safe prescribing and monitoring of specialist medicines. More information about this can be found on Shared Care Agreements.
GP practices will be discussing the following options with patients who have received care from a private provider (not from an NHS funded service):
1. With the patient’s consent, they are referred back to privately funded specialist services for the ongoing prescribing and monitoring. The patient would be responsible for continuing payment for private treatment.
2. With the patient’s consent, they are referred to an NHS funded specialist provider.
For adults, this could be to Essex Partnership University NHS Foundation Trust (our local NHS Trust delivering ADHD services) or to a Right to Choose provider.
You may wish to seek further information on Right to Choose and the available providers via the Right to Choose ADHD UK Website. Please note that this is not an NHS website but provides useful information on service provision. If you wish to be referred under Right To Choose, you will need to look at services that provide the prescribing and monitoring of ADHD medication.
Whilst you access alternative services your GP practice may continue prescribing in the meantime. The decision to continue providing this service would be at their discretion, it is not part of the core contract the NHS holds with GP practices.
Other arrangements apply for patients under an NHS funded service. NHS Mid and South Essex ICB has established arrangements for “shared care” between NHS funded ADHD specialist service providers and GP practices. This arrangements apply to children and adult patients.
Patients need to be under the care of an NHS funded specialist service for this shared care agreement to apply. This specialist service will continue to monitor patients annually and provide advice to those prescribing medications should any queries arise.
NHS clinicians are encouraged to follow NICE guidelines where possible. NICE guidelines are evidence based recommendations for health and care in England and Wales. NICE guidelines are developed with the help of health and care professionals, people who use services, and carers. They cover many aspects of a condition, including prevention, treatment, and education. NICE guidelines are subject to regular review and may be updated or withdrawn.
Private specialists are not required to follow NICE guidelines. Therefore the local NHS cannot be assured that patients seen by a private specialist have received the same assessment, diagnosis, treatment and care as they would have if they have been seen by a NHS specialist.
That is why assessment by an NHS clinician is required when a patient wishes to transfer from private care to NHS care.
Some GP practices may decide they can no longer safely continue to prescribe ADHD medications and provide the necessary ongoing medication monitoring, which is a service that falls outside of their core GP work.
In the event that your GP practice chooses to withdraw from this, the responsibility for prescribing your ADHD medication will be passed back to the specialist service where you received your initial diagnosis. This service will be responsible for providing the monitoring that you need (for example height, weight, blood pressure).
Your GP practice will share information with your specialist team to ensure a smooth handover, and patients should be contacted by their specialist team before this change happens.
If patients have privately funded care and wish to return to NHS care, they will need to be assessed by an NHS clinician, which can be done via GP referral to an NHS funded service.
Please be aware this would be classed as a new referral, and patients transferring from privately funded care will join the end of any existing waiting list for that service.
No patients can be given preferential treatment on the NHS waiting list. Therefore all new referrals are added to the end of a service’s waiting list, regardless of whether the patient accessed part of their care or diagnosis privately, or otherwise.
Further information for patients considering privately funded care is available on our Should I go private page.
There are many service providers available to patients under Right to Choose (RTC). Some of these providers offer private service, some offer NHS services, and some providers offer both private and NHS funded services.
You may wish to seek further information on RTC and the available providers via the Right to Choose ADHD UK Website. This website lists providers and indicates if they offer private or RTC services. Please note that this is not an NHS website but provides useful information on service provision. If you wish to be referred under RTC, you will need to look at services that provide the prescribing and monitoring of ADHD medication.
Referrals for Right to Choose (RTC) must come from a GP. Patients choosing a RTC provider should undertake their own research into available providers to ensure they are suitable.
Find out more about Right to Choose.
In many cases patients have the legal right to choose where they have their NHS treatment. The NHS is offering more and more options to enable patients to make choices that best suit their circumstances, giving them greater control of their care, and hopefully better results.
Referrals for Right to Choose (RTC) must come from a GP. Patients can choose a clinical team led by a consultant or named healthcare professional, if that service provides the treatment you require, and they have an NHS contract. Patients choosing a RTC provider should undertake their own research into available providers to ensure they are suitable.
Please refer to the Right to Choose FAQs for more information.
If a patient is diagnosed and prescribed medication by a provider (private or NHS) under the NHS Right to Choose Scheme and ongoing prescribing is requested from the patient’s GP practice, the decision whether to accept this is at the discretion of the patient’s GP practice.
If the patient’s GP does choose to take on the ongoing ADHD medication prescribing, the practice would enter into a shared care arrangement with the Right to Choose provider.
Find out more information about Shared Care agreements.
Find out more about Right to Choose.
If you are started on medication by a private provider, you can request on-going NHS prescribing by your GP, but this may not always be possible. Please refer to the NHS Mid and South Essex policy on defining the boundaries between NHS and privately funded healthcare.
The department of Health and Social Care has provided information about the national supply shortage of the medication prescribed to help manage ADHD symptoms.
Please find more information on the NHS Mid and South Essex website.
Pupils with ADHD may experience additional challenges when taking exams. Reasonable adjustments can be requested of the relevant educational institution or examination board to support pupils with ADHD.
The ADHD UK website has a template letter to use when requesting additional time or a separate examination room, and the Young Minds website has tips for managing exam pressures.
ADHD Support for additional exam time
Support for separate exam room
Exam Tips for Neurodivergent and Disabled Students | YoungMinds
Essex Partnership University Trust (EPUT) offers Attention Deficit Hyperactivity Disorder (ADHD) Services in Essex.
Visit the EPUT website for information about the different services, and the areas of Essex they cover.
There are four services that EPUT provide for neurodevelopmental conditions within Essex and they all differ slightly.
Families can look at the relevant authority local offer pages and/or NHS provider websites for additional advice and support.
There are lots of considerations that patients should take into account when considering whether to go private. NHS Mid and South Essex has published information for patients considering this: https://www.midandsouthessex.ics.nhs.uk/health/personalised-care/should-i-go-private/
We hope you have been able to find the information you needed on these FAQs.
Please note that NHS Mid and South Essex is unable to answer questions about individual patient’s circumstances, or offer clinical advice.
If you are unable to find an answer to your question on the FAQs here, please email your question to [email protected]
If you would like to raise a Complaint, please contact the NHS Mid and South Essex Complaints team on [email protected]