ADHD Referrals and Medication Position Statement

This practice is not funded to provide comprehensive NHS services for adults with ADHD.

NHS referrals for ADHD (children and adult)

Due to long waiting lists and overwhelming demand, from 5 February 2024, The Adult Service in Oxfordshire closed to new referrals.

However, those with symptoms severe enough to cause problems in their functioning may still request an NHS ADHD assessment using an approved private provider (see below) and will be assessed initially using a questionnaire:

NHS referrals for children and young people continue as normal for the present.

Private Providers and the Right-to-Choose Scheme

Due to this demand, the NHS has agreed that some private providers may provide ADHD assessments for NHS patients. These must be led by a consultant with a current NHS contract to provide the ADHD service, and able to provide ADHD treatments as well as assessments.

In order for a GP to refer responsibly to a specialist service they must ensure that the service is approved and meets certain quality standards.

Locally, the Buckinghamshire, Oxfordshire, Berkshire West Integrated Care Board has only approved and quality-checked the following providers for adult ADHD assessments.

• Psychiatry UK https://psychiatry-uk.com/
• Modality LLP https://www.modalitycommunityservices.com/
• Skylight Psychiatry https://www.skylightpsychiatry.co.uk/

The practice is therefore very happy to refer adults requesting a referral under the right- to-choose scheme to the above providers.
However, we have taken the difficult decision that we are unable to refer adults to alternative providers as we cannot guarantee the quality of the services.

No providers have been approved or quality-assured for children. Sadly we therefore do not feel able to safely refer children privately or under the right-to-choose scheme.

Please be aware that if this is suggested to you by an alternative agency, we will not be able to do so. Secondary Care services (such as CAMHS) can refer directly to the private provider if they feel this is appropriate.

Many private providers will also accept self-referrals for children but please do be aware that they may not offer the holistic input or ongoing reviews that are provided by the NHS CAMHS service.

Provision of medication

In order for medication to be issued safely, national guidance from the National Institute for Clinical Excellence expects long-term involvement of specialists in reviewing ADHD patients and their medical treatment. This is called a ‘shared care agreement’.

Unfortunately, the BOB-ICB are no longer providing funding for ongoing shared care agreements and will now only fund assessments for ADHD – NHS or the approved Right to Choose private providers.

Therefore the practice has taken the difficult decision that any new requests from specialists, both NHS and private, to prescribe ADHD medications to adult or child patients on a “shared care” basis will be declined UNTIL funding is available to support ongoing specialist reviews to enable valid shared care agreements in line with national guidance.

ADHD service providers can still carry out an assessment and diagnosis and provide prescriptions on an ongoing basis but may decline to do so.

If patients wish to start medications, all parts of the assessment (including pre-treatment tests and investigations) and ongoing prescriptions will need to be provided by the relevant NHS specialist or private provider.

As your NHS GP, we will not enter into “shared care” arrangements with private providers as this is against the NHS Principles of Separation between NHS and Private care, so if you undertake a private assessment you need to be aware that you will be responsible for all costs associated with that including consultation fees and medication costs.

Care of adults already receiving ADHD treatments remains under careful review. However we will be reviewing all existing patients with a view to reducing or stopping their medications where it is safe to do so unless proper local services are commissioned.

Further information and who to contact...

We firmly believe that patients should not be left without the care they need due to a lack of comprehensive NHS funding. Our local representatives have raised this issue with local funding and decision-making groups. If you also wish to raise this issue, you may want to contact the planned care team at BOB ICB, bobicb.plannedcare@nhs.net, and/or your MP