1 - Is your GP is willing to enter into a Shared Care Agreement? 
 
After an online ADHD Assessment, if you receive an ADHD diagnosis, then would you want to consider medication? If the answer is “Yes”, then you need to know if your GP is willing to enter into a “Shared Care Agreement”. The majority of people who have a private virtual ADHD Assessment, will also have a private medication assessment. ADHD medication is a specialist area of prescribing and most GPs are not trained to do the initial assessment and prescribing of ADHD medication. Therefore, you would need to see a private specialist prescriber who may be a psychiatrist, a mental health nurse or a pharmacist. They will work with you to agree on a medication which works well for you, at what dose and at what time of day you should take it. 
The National Institute of Care Excellence (NICE) states that, “After titration and dose stabilisation, prescribing and monitoring of ADHD medication should be carried out under Shared Care Protocol arrangements with primary care”. In other words, the specialist prescriber will recommend to the GP the medication you should take and the GP will then prescribe it each month and it will become an NHS prescription. The specialist prescriber and not the GP would then be responsible for monitoring and reviewing the medication as necessary. So, for example, if your physical health changed, then you would go back and have a review with your specialist prescriber. 
For this to happen, there needs to be a formal, written agreement between the specialist prescriber and your GP which is called a “Shared Care Agreement” (SCA). This sets out the position of each professional and what they have each agreed to do. This enables GPs “to accept responsibility for the safe prescribing and monitoring of specialist medicines… where this is suitable and in the patient's best interests”. 
 
However, GPs do not have to enter into a SCA. A GP practice may have a policy about whether or not they are willing to enter into SCAs and so this may not be a decision which is made by your individual GP. The GP practice may decide that they do not have the capacity to enter into a SCA because of other work commitments. Or they may decide not to enter into a SCA on clinical grounds, for example if they are not willing to work with the professional you want to see for your medication assessment. Sometimes a practice will have a list of specialist prescribers they are willing to work with and they will only enter into a SCA if you see someone on their list. 
If you might want medication if you receive an ADHD diagnosis, then it is very important that, before you book a Virtual Adult ADHD appointment with me, you contact your GP and ask, “If I receive an ADHD diagnosis, would you be willing to enter into a Shared Care Agreement with a private prescriber?” Otherwise, you might spend a lot of time and money on the assessment and then discover that you would have to pay permanently for private prescriptions each month which would be expensive. 
 
If you know that you would not want medication if you were diagnosed with ADHD, then there is no need to check with your GP about this. 
ADHD Adult Assessment 
 
If an adult, who thinks they may have ADHD, wants to ask for “reasonable adjustments” to be made by their employer, college or university, then they will need to have gone through an ADHD Assessment and received a formal diagnosis. 
Tagged as: ADHD
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