ADHD Referral Guidance for Adults

If you believe you may have ADHD, please book an appointment with a GP to discuss your symptoms.

When considering referral, we may ask about:

• When your symptoms began 
• How symptoms affect your daily life 
• Whether symptoms occur in different settings (home, work, school, university) 
• Any previous mental health history 
• Family history of ADHD or related conditions 
• Supporting evidence such as school reports or workplace concerns 

ADHD assessments are carried out by specialist services and not by GPs directly.

At Island Health, our usual referral pathway is through the local Community Mental Health Team (CMHT). The CMHT will triage referrals and direct appropriate patients into the specialist ADHD assessment pathway.

The specialist service requires supporting evidence in order to proceed with assessment. This may include:

• School reports 
• Educational psychology reports 
• Workplace assessments or occupational health reports 
• Information from family members or carers 

Without sufficient supporting evidence, the specialist ADHD service may be unable to proceed with assessment.

Patients should also be aware that current NHS waiting times for ADHD assessment through the local CMHT pathway are approximately 36 months.

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Patients in England may have a legal right to choose their provider for NHS outpatient services, including ADHD assessment services, where clinically appropriate. This is commonly referred to as NHS Right to Choose. (wessexlmcs.com)

Referral options may include:

• Local NHS ADHD services via the CMHT pathway 
• NHS-funded Right to Choose providers 
• Private assessment providers 

The GP will consider whether referral is clinically appropriate and discuss available options with you.

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What is Shared Care?

Shared care is an arrangement between a specialist clinician and a GP where responsibility for certain aspects of treatment, such as prescribing medication, is transferred to primary care once a patient is stable.

Shared care is voluntary and can only proceed where the GP is satisfied that:

• The arrangement is clinically appropriate 
• Adequate specialist support and monitoring are in place 
• The provider is appropriately qualified and working within UK best practice guidance 
• Clear communication and prescribing responsibilities are established 

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How ADHD Shared Care Usually Works

1. Specialist Assessment and Initiation

The ADHD specialist service:

• Completes the assessment and diagnosis 
• Starts medication where appropriate 
• Monitors response to treatment 
• Adjusts medication until the dose is stable 

2. Consideration of Shared Care

Once treatment is stable, the specialist may request a shared care agreement with the GP.

The practice will review:

• The quality and completeness of the assessment 
• Whether monitoring arrangements meet NHS and local prescribing guidance 
• Whether the provider can continue specialist oversight 
• Whether the GP feels clinically competent and appropriately supported to prescribe safely 

Acceptance of shared care is not automatic and remains at the discretion of the GP practice.

3. Ongoing Monitoring

Where shared care is agreed:

• The GP may issue repeat prescriptions 
• The specialist remains responsible for ongoing specialist review 
• Medication changes remain the responsibility of the specialist service 
• Patients must continue attending specialist follow-up appointments 

Regular monitoring may include:

• Blood pressure 
• Pulse check
• Weight 
• Height (where appropriate) 

If specialist follow-up stops, shared care may no longer be appropriate and prescribing may need to return to the specialist provider.

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Many Right to Choose providers are independent organisations delivering NHS-funded services under NHS contracts. 

The practice will consider shared care requests from NHS Right to Choose providers on an individual clinical basis, taking into account:

• The provider’s NHS commissioning status 
• Quality of communication and documentation 
• Availability of ongoing specialist support 
• Compliance with UK prescribing and monitoring standards

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Patients may choose to access ADHD assessment and treatment through a private provider. However, Island Health GP Practice will no longer enter into shared care arrangements for adult ADHD treatment initiated privately.

Patients receiving treatment from a private provider will remain responsible for obtaining prescriptions, monitoring, and ongoing specialist reviews through their private service.

The practice will continue to consider shared care arrangements with NHS services and NHS Right to Choose providers where appropriate specialist oversight, monitoring, and clinical governance arrangements are in place.

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

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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.

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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.

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