Navigating Shared Care Agreements for the Treatment of ADHD

If you are beginning on your journey towards an ADHD assessment or you have already walked the path, you will likely know the difficulties, and hurdles that you face. Long NHS waiting lists, expensive private services of varying quality, and limited care and support after your diagnosis. 

For some people, staying with a private ADHD clinic for a long period to ensure the most accurate and supportive treatment and maintenance, isn’t feasible. It can be costly, so many look to other alternatives, one being a Shared Care Agreement (SCA). 

What is a Shared Care Agreement (SCA) and How Does it Work?

A Shared Care Agreement is an agreement between you, your ADHD psychiatrist, and your GP, whereby the care and treatment you receive for ADHD are shared between your psychiatrist and your GP. This is obtained through an agreement with you once your ADHD medication is stabilised and optimised.

Shared care agreements are not a legal requirement from your GP, but more of a professional courtesy. However, NICE guidance issued in 2018 states “After titration and dose stabilisation, prescribing and monitoring of ADHD medication should be carried out under Shared Care Protocol arrangements with primary care” for adult diagnosis and ADHD management.  

A Shared Care Agreement allows your GP to take over prescribing your medications and basic monitoring of your physical health as directed by your ADHD psychiatrist. Your psychiatrist will remain responsible for reviewing your care at annual intervals as well as at times where you experience physical or mental health complications which may be related to ADHD or the medication you take to manage the symptoms of ADHD. It is possible to transfer your care more fully to NHS services however this would require a transfer to a specialist NHS ADHD service, or for children, this could be your local Child and Adolescent Mental Health Service (CAMHS).  

How Could You Benefit from an SCA?

An SCA should ideally be the best of both worlds when it comes to ADHD. The waiting list for an ADHD assessment on the NHS is currently around 3 years. Some people, like parents of school children who need access to care ASAP, simply can't wait that long. By gaining a Shared Care Agreement the patient can benefit from a swifter process of gaining an ADHD assessment and diagnosis if clinically indicated, as well as a detailed plan around their treatment and medications if needed.

Once this stage has been reached, it is then possible for the patient to request that their care be passed onto their GP, so that costs are reduced in terms of reviews, maintenance appointments, and prescription costs. The NHS is also far more accessible for the majority, with most GPs being in the nearest town or city, and so travel costs are drastically reduced.

Can an SCA be Refused?

Unfortunately, all GPs can refuse to take on a Shared Care Agreement as it is not a legal requirement, and some often feel the responsibility is a burden on top of their already heavy workload. If this is the case, then the patient will get passed back to their psychiatrist and private ADHD clinic that made the initial ADHD assessment. In this situation, medication prescriptions will continue to be issued by the private ADHD clinic, rather than by the NHS, which of course can be more costly.

What to do if Your GP Refuses Your Transfer of Care.

It can be stressful to learn that your GP won’t accept responsibility for your ADHD prescriptions,  however, there are steps you can take that may help in the transfer of your care.

• Arrange a face-to-face meeting with your GP – prepare what you want to say in advance and talk through how ADHD affects your day-to-day life as well as how the cost of managing your ADHD impacts your finances. Also, talk to your GP about how having access to ADHD medication through NHS prescriptions will impact you personally.

• Understand the NICE guidelines – “The NHS should not withdraw NHS Care because a patient chooses to buy private care, nor should patients who access private care be placed at an advantage or disadvantage in relation to the NHS care they receive. The NHS should continue to provide free-of-charge care that the patient would have been entitled to had they not chosen to have additional private care. Where the same diagnostic, monitoring, or other procedure is needed for both the NHS and private elements of care, the NHS should provide this free of charge and share the results with the private provider.” It is advisable to read the NICE guidelines in full beforehand but it’s possible to explain this to your GP and ask how their refusal aligns with  NHS guidance on private care.

• NHS pathway referral – if your diagnosis is refused by your GP, you can ask them if they can refer you through the NHS pathway and take on shared care while you are waiting.

• Change GP – if you are having a lot of difficulties, it is possible to change GP surgery, however, make sure that the GP you are changing to will accept your SCA before making the swap. 

Focusing on Now and Beyond: A Private ADHD Clinic in Manchester.

At Beyond, we focus on more than just gaining your ADHD assessment and diagnosis. We understand that ADHD impacts across the lifespan.  We strive to provide the best quality care and genuine support now and in years to come, building strong foundations for you to manage your ADHD symptoms with a secure network of people behind you from our private ADHD clinic in Manchester.

If you are struggling with a shared care agreement with your GP, we offer an ongoing care pathway to ensure your medication is received on time and annual reviews are made to discuss your progress.

If you would like to speak to one of our friendly team in our ADHD clinic about our process, contact us today.