Attention Deficit Hyperactivity Disorder (ADHD) Referrals and Medication

If you are concerned or suspect that you may have ADHD and would like to be referred to the NHS for an ADHD assessment, please see below the guidelines for adult and children ADHD referrals.

NHS ADHD Referral – Adult (18 years+)

Due to the unprecedented demand for ADHD diagnosis and treatment nationally and locally across all age groups, the Herts and West Essex Integrated Care Board have implemented an interim complexity threshold arrangement for Adult referrals.

This interim measure is intended to ensure that those patients most in need are prioritised and that those who can self-manage are supported to do so.

You will be referred to the local Primary Care Network ADHD/ASD Pathway Service, please see the following link for more information.

www.stortvalleyhealthcare.com/services/asd-adhd-pathway/

If the patient meets the referral criteria, these will be triaged by the Single Point of Access Team. Those not meeting this threshold will be referred back to their GP with self-help and signposting.

For adult ADHD referrals, please book a routine appointment with your named GP to discuss your symptoms and a potential onward referral. Prior to your appointment, please complete the ADHD checklist (link below) to include current symptoms and any evidence of onset ADHD symptoms in childhood, which should be brought to your GP appointment.

This will help the GP to have an understanding and assist them in raising a referral if deemed appropriate to Hertfordshire Partnership University NHS Foundation Trust (HPFT).

Herts and West Essex Integrated Care Board have created a document which contains a number of useful websites and self-help reading resources, available to you.

Adult ADHD, Patient Information and Self-Help Resources – HWEICB

www.stortvalleyhealthcare.com/services/asd-adhd-pathway/

 

NHS ADHD Referral – Children

If your GP feels it is appropriate, they may refer your child through the NHS for an ADHD assessment. For child ADHD referrals, supporting evidence of symptoms from both the parents and the school is required for the referral to be submitted. You will be contacted by the Waiting Well Service operated by Stort Valley & Villages Primary Care Network, please see link below for more information.

www.stortvalleyhealthcare.com/services/asd-adhd-pathway/

 

ADHD Diagnosis via NHS Pathway for Children and Adults

Due to demand the current waiting times are about three years for children and five years for adults.

If the NHS Mental Health Team confirm a diagnosis of ADHD, they would initiate treatment and might offer medication; initially this will need to be obtained directly from the NHS specialist consultant. Once the NHS Mental Health Team are confident the patient is stabilised on their medication, they may feel it is appropriate for the patient to obtain their medication from the GP Surgery.

In order for us to prescribe this type of medication, the Mental Health Team will need to send a Shared Care Agreement to your GP. This is an agreement with an NHS Consultant for the GP which stipulates any monitoring needed to continue to prescribe the ADHD medication safely.

Please note the GP is only able to continue prescribing and monitoring a patient if a Shared Care Agreement with an NHS provider is in place. This is due to guidelines set by Hertfordshire and West Essex Integrated Care Board (ICB).

Medication & Private Referrals 

Private ADHD Diagnosis

You may choose to be referred to a Private Provider for your ADHD assessment due to the long waiting times for an NHS appointment, or simply out of preference. In this instance, the prescribing and monitoring of any medication must continue under the care of the Private Provider.

We are only able to take over prescribing ADHD medication which has been started by an NHS service once we have an NHS Shared Care Agreement. This is due to guidelines set by the Herts and West Essex Integrated Care Board (HWEICB) who has no local policy with Private Providers. They state:

• A patient must be diagnosed with ADHD by an NHS specialist, who confirms that the prescribing of ADHD medicine is in line with NHS criteria.

If the patient wishes to transfer their ADHD treatment to the NHS, they will need to be referred to the NHS mental health specialist team for assessment and confirmation of their ADHD diagnosis. The NHS consultant will ascertain whether the NHS criteria for a prescription of ADHD medication has been met. However, due to the unprecedented demand for ADHD diagnosis and treatment nationally and locally across all age groups, the Herts and West Essex Integrated Care Board have implemented an interim complexity threshold arrangement for Adult referrals. We are not able to guarantee that a referral would be accepted by NHS services.

If this criterion is met, a Shared Care Agreement can be formed between the NHS consultant and the GP. Until this is established the clinical responsibility of prescribing and monitoring of the patient, and their medication should remain with the Private Provider.

NHS ‘Shared Care’ Medicines Prescribing after Initiation by a Private Provider

(NHS) Shared Care Agreement

A Shared Care Agreement is an agreement between the patient, the NHS specialist, and the NHS GP, enabling the care and treatment for a specific health condition to be shared between the hospital and your GP. This will only occur with your agreement and when your condition is stable or predictable.

A Shared Care Agreement contains information about your medicine, guidance on prescribing and monitoring and the responsibilities of the patient, the NHS specialist, and the NHS GP.

Please note there is no legal obligation nor mandatory requirement for a GP to enter into any Shared Care Agreement.

The Integrated Care Board does not support or recommend shared care agreements with private specialists for any medication. Shared care agreements may only be formed between NHS prescribers, this is because if the private part of the care is interrupted for any reason, the GP would then be isolated without a partner with whom they are sharing care. Within the NHS framework, there is a robust system of support for primary care providers, which is essential to ensure patients are safe and primary care clinicians have access to advice and guidance when prescribing specialist medications. This is also in line with the guidance published by the Department for Health and Social Care on private and NHS treatment: guidance for NHS patients who pay for additional private care at www.gov.uk/government/publications/nhs-patients-who-wish-to-pay-for-additional-private-care 

Information for Patients – Shared Care Agreements for Medicines

Patients should be aware that if they choose to seek an assessment and/or medication from a private provider, there may be additional costs to the patient for medication and follow up/monitoring appointments. 

Further information

For further information on guidance set by our Integrated Care Board, please contact the Pharmacy and Medicines Optimisation Team (PMOT) for South and West Hertfordshire, which is part of Hertfordshire and West Essex Integrated Care Board.

• Website: Contact us – Hertfordshire and West Essex NHS ICB
• Email: hweicbwe.patientfeedback@nhs.net
• Telephone: 01992 566122
• Postal address: NHS Hertfordshire and West Sussex Integrated Care Board, Charter House, Parkway, Welwyn Garden City, Hertfordshire, AL8 6JL