ADHD Prescribing at Northgate Health Centre

At Northgate Health Centre we seek to support all aspects of your care, and this will often involve prescribing medications recommended by a specialist, known as “shared care”. The practice has seen a significant rise in ADHD prescribing in recent years due to increasing diagnosis rates. Due to the absence of a locally commissioned service, we are having to interact with a number of  “NHS Right to Choose” and private providers. In this context to maintain safe prescribing for our growing ADHD population we have taken the decision to amend our prescribing approach. This is outlined below. Should you have any questions after reviewing this information please book a routine appointment with our practice pharmacist or your GP.

ADHD Shared Care with Private Providers is no longer supported

A core principle within the NHS is that NHS and private care needs to be kept separate to avoid the NHS subsidising private care. In addition, there are a large number of private providers competing for the care of ADHD patients. In this context entering into a safe reciprocal agreement with private providers has become increasingly difficult and we will no longer be able to support this.

(i) If you are  a new patient under the care of a private provider you will need to continue having your ADHD medication and monitoring  delivered by them. We recognise this is frustrating; however, we feel it is in the interests of all ADHD patient over the longer term.
(ii) If you are an existing patient under private shared care, we will write in due course to give to support you moving to NHS shared care as soon as possible. 

ADHD NHS Shared Care

Northgate Health Centre continues to support NHS shared care for ADHD patients. As there is no local service you can choose a provider from a different area under “NHS Right to Choose”. 

ADHD medication is a controlled drug (subject to tight restrictions including 30 day supply limit) that must be initiated by a specialist. Once stabilised on a therapeutic dose the specialist may write to the GP requesting that they enter into a “Shared Care Agreement”. This is a detailed agreement will be entered into between GP and specialist. 

A core requirement will be:

(i) Ongoing annual specialist review
(ii) Specialist available for advice
(iii) 3 or 6 monthly monitoring of heart rate, blood pressure, and weight

If either of these commitments are not met at any time then Northgate Health Centre will be unable to prescribe medication.

Specific Circumstances

We recognise that there are certain circumstances where a more flexible approach will be needed. These are outlined below

New Patients Registering from Abroad

If you are a new patient and your ADHD medication has been started abroad, whose care you remain under, we may be able to support ongoing prescribing. To do so we need comprehensive documentation consisting of at least 

(i) the initial assessment, headed and signed 
(ii) evidence of ongoing prescription
(iii) treatment to be inline with standard UK practice. 

Please ensure that you have a supply of your medication to cover the period where the appropriateness of prescribing is assessed by us. Unless you are only likely to be registered for less than 6months, we will require you to agree to NHS referral to enter into shared care.

ADHD Referrals and Shared Care for Under 18s

Northgate Health Centre will enter into shared care with CAMHS, the local service providing ADHD assessments for those under 18. Waiting times are regrettably long, in excess of 12 months at the time of writing. Referrals are generally made through the school who have a more detailed understanding through their regular contact with the child.

Detailed information is available on the Oxford Health website