Dear Patient,
There is currently a long waiting list for adults and children to be assessed for ADHD through normal NHS pathways. Certain private providers can be used for an NHS ADHD assessment under the “Right to Choose” pathway and for self-funding private patients. This may enable you to have an assessment sooner than the local NHS service. Unfortunately, many of these providers are unable to prescribe medications for ADHD or they may initiate medications and then request GPs to take over prescribing without any ongoing follow up from the specialist service. Under these circumstances, as a practice, we cannot take over responsibility for prescribing these medications as they are outside of our area of expertise and it is not safe for us to prescribe them without the relevant knowledge and training.
Sometimes private providers will request that we enter a “shared care agreement” with them. Sharing care with the private sector can carry higher risks than sharing care with the NHS and therefore decisions on this will be made on a case by case basis, and will always be discussed by at least two GPs. Decisions on monitoring and dose changes will be taken by the consultant. The decision to share care, or not to, will be based on review of the following factors:
• Whether the consultant is on the appropriate GMC specialist register, a member of the relevant Royal College and based in the UK.
• Whether the consultant holds, or has held in the recent past, a substantive NHS consultant post in the same specialty as the one in which they are now practising privately.
• How often the consultant proposes to review the patient. If private review stops then prescribing by the practice will no longer be safe and will have to stop, possibly with little or no notice. For patients who are on an NHS waiting list, sharing care with a private consultant would be an interim measure until care is taken over by the NHS.
• Communication between us and the consultant – we would expect access to email communication for any queries, with prompt replies.
• The nature of the prescribing – shared care is more likely to be possible if the drug is one which is licensed for the indication, would be given by an NHS consultant and for which there are no significant NHS guidelines or reports that recommend against its use.
• Whether we have received correspondence detailing a thorough clinical assessment and clear outcomes of this including evidence that diagnostic criteria have been met.
It is your choice whether you wait for an NHS appointment or seek help through a private provider (either through the right to choose pathway or by self-funding this). Please take into consideration the above information when making your decision. You may also want to show the private provider a copy of this letter so they can tell you whether they meet the above criteria before they offer you an appointment. Any correspondence we receive from the private consultant should contain the information detailed above if they are requesting to share care with us.
We appreciate that the current system of long waiting times for ADHD appointments is not acceptable and it is also frustrating for us to not have a way of accessing timely assessments and treatment for our patients. You may want to contact your local MP and make them aware of the difficulties you are having with this.
Leicester Terrace Health Care Centre