ADHD Referral Guidance for Adults

Attention Deficit HyperactivityDisorder (ADHD) is a condition that affects an individual's behaviour. People with ADHD may appear restless, have trouble concentrating, and act impulsively.Symptoms often become noticeable at an early age and may become more evident with changes in a child's environment, such as starting school.
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Sometimes, ADHD is not recognised during childhood and is diagnosed later in adulthood. While symptoms may improve with age, many adults diagnosed at a young age continue to experience difficulties.

If you believe you might have ADHD and are considering seeking a diagnosis, reflect on the following:

• When did these symptoms start?
• Where do the symptoms occur – at home, school, college, university, or work?
• Do the symptoms affect your day-to-day life – for example, making socialising difficult?
• Have there been any significant recent events in your life, such as a death or divorce?
• Is there a family history of ADHD?
• Do you have any other health conditions or symptoms?

In the UK, GPs cannot diagnose ADHD or initiate medication. If you suspect you have ADHD, you will need a referral to a mental health team for assessment by the community ADHD service.They require supporting evidence such as school reports and work assessments to proceed with the assessment. Without this evidence, they will not be able to assess you.

What is Shared Care?

Shared care is a collaborative arrangement between a specialist and a GP to manage a patient's treatment. This approach allows for the continued care of patients who need regular monitoring and medication management for conditions such as ADHD. The goal of shared care is to combine the expertise of specialists with the convenience and accessibility of primary care services, ensuring that patients receive comprehensive and coordinated care.

Components of Shared Care:

1. Diagnosis and Initial Treatment by a Specialist:

• The specialist, such as a psychiatrist or an ADHD clinic, conducts a thorough assessment and makes the initial diagnosis of ADHD.
• The specialist starts the patient on medication and monitors their response, making necessary adjustments until the patient is stable.

2. Transfer of Care to the GP:

• Once the patient is stable, the specialist and the GP agree to a formal shared care arrangement.
• This agreement outlines the responsibilities of both the specialist and the GP, including prescribing medications and monitoring the patient’s progress.
• It is a document that requires signatures from both the specialist and the GP.

3. Ongoing Monitoring and Adjustments:

• The GP continues to prescribe medication as per the shared care agreement.  
  
• The patient must have regular reviews with the ADHD clinic or specialist to ensure the treatment remains effective.  
• Any medication adjustments will be managed by your ADHD clinic, not by your GP.  
• The shared care agreement mandates ongoing reviews by your ADHD clinic including 6 monthly height, weight, blood pressure and pulse check.  
• If you do not continue reviews with your ADHD clinic, the shared care agreement will lapse, and your GP will not be able to prescribe ADHD medication.  
• If you have a shared care agreement from another NHS organisation within the United Kingdom, the GP will be able to provide ongoing care, provided your dose has been stable. If however your medication needs to be changed you will need to be referred to the local ADHD NHS service.

If seen by a private provider as an NHS patient, a shared care agreement is also required before the GP can take over prescribing.

If you are under a private psychiatrist and seek an NHS referral, please attach the assessment from the private UK-based psychiatrist.

For patients from outside the UK, medication must be obtained from their own specialist. To receive NHS prescriptions, a referral to an NHS ADHD clinic is needed, along with a shared care agreement before the GP can prescribe.

Transfer Acceptable Parameters:

Diagnosis has been made in the UK (private or NHS)
AND Medication has been started,
AND dose is stable,
AND the formal handover is made by the clinical provider.

Transfer Unacceptable Parameters:

Diagnosis made by a clinic abroad.
Handover made by the patient, not the clinical provider.
Diagnosis only, with no medication.