It has come to our attention the recent trend for patients to explore if they have a diagnosis of Adult ADHD.
We support patients contacting us to seek referral through available NHS pathways and we are also aware patients have elected to self refer to non NHS specialists for the initial advantage of quicker assessment, diagnosis and management but with the initial disadvantage of having to pay for the service outside of the NHS.
Further to the initial reviews by specialist services there is usually a request from a specialist for a GP to take over any prescribing for the long term. This is a discretionary matter as “shared care” in this area is not a contractual obligation.
While the specialist may take the view of assessment and management over a several months, the GP who will take over any prescribing needs to consider how safe the medication is over a matter of years or decades based on the long term working relationship we have with our patients.
We also cannot guarantee we can receive the necessary advice and guidance from a specialist within this area (and within an appropriate time frame) over the subsequent years, based on their department’s response and knowledge base as you, the patient, become older with other health concerns that could render the medications for adult ADHD unsafe.
There is also the further matter that such medications started by specialists may not be available in the community and we would need to seek advice on alternatives. That advice may not be forthcoming within a satisfactory time period from a specialist.
It is our belief that the long term safety of such medication has yet to be established and as a result of this, based on our non-specialist expertise in this area. We may not be able to maintain the prescribing of any medications started as a NHS prescription by a commissioned NHS provider and/ or from a private specialist. This matter can be reviewed over time, based on the long term maintenance of such medications, overseen by the specialist team.
We understand that this is disappointing, but we need to ensure all aspects of your care are taken into consideration from all stakeholders, be it the patient, GP and specialist services.
We also recommend whichever provider you see who started you on the medications to maintain the prescribing of the medications from specialist services. If you have been discharged from the specialist services we will consider weaning you off the medications as we cannot guarantee their long term safety, unless there is a clear plan for specialist follow up and long term specialist prescribing
Thank you for taking these details into consideration. The landscape on management of adult ADHD is always changing and we welcome any advice you can provide to enable further dialogue on this matter