In Southwark, there is limited provision for Adult ADHD services with our local NHS mental health trust. Independent providers are usually used by the NHS for assessment for Adult ADHD under the right to choose scheme.

1. If you asking seeking an Adult ADHD assessment please complete the adult ADHD questionnaire: self-report scale (ASRS-V1.1)

https://add.org/wp-content/uploads/2015/03/adhd-questionnaire-ASRS111.pdf

You can either send us the form via email (please call us for our email address) or drop a copy to the reception team who will scan on your records.

2. You will then be sent by text a booking link for a routine telephone consultation with one of our clinicians to discuss your symptoms and your options for referral for an assessment.
3. You will have 2 choices to either seek a referral on the NHS right to choose system or you can consult a private service provider directly yourself.
4. If you are seeking a NHS referral we will pass this to the South East London Adult ADHD referrals triage service who will review the referral and contact either contact you to discuss your options or inform us directly if they do not accept the referral. We can no longer make a direct referral under right to choose to a provider of your choice; if you wish to use NHS right to choose, we have to refer to the triage service and they will discuss next steps with you.
5. Once assessed by an ADHD provider, if they deemed you would meet the criteria for medication then they will discuss options with you including potential risks and side effects. It is standard practice that the provider will initiate and monitor the medication until you are on a stable dose (usually over a 3-month period).
6. The provider may then ask us as your GP practice to take over the prescribing of these medications under a written shared agreement. This involves a 6-monthly check of your heart rate, blood pressure, weight and height and at least an annual review by an ADHD specialist.
7. Please note the practice reserves the right to decide whether we will take over prescribing. It should NOT be assumed that will automatically be agreed by us.
8. Please note that adult ADHD medications are controlled drugs and are rated amber 3 on the South East London prescribing formulary which means that all patients on these medications must have a shared care agreement. Therefore, you must remain under the care of both the practice and the ADHD provider whilst taking these medications.
9. We will only accept shared care prescribing on the following criteria:

• a. The diagnosis has been made by a GMC registered Psychiatrist (UK based Medical Doctor specialised in Psychiatry)
• b. The ADHD provider will continue to offer at least an annual review of the medication and your health by a GMC registered Psychiatrist
• c. The ADHD provider will remain available for both direct contact by yourself and for us for clinical advice and reviews for any medication side effects, medication dose adjustments and medication shortages
• d. A written shared care agreement plan is provided to us

10. The above criteria must be met on whether you consult a private ADHD provider or on the NHS right to choose pathway. It will be your responsibility to check on these requirements beforehand. We will not agree to shared care prescribing if these conditions are not met.
11. If we do not agree to take on shared prescribing, then you will need to decide if you purchase the medications via your ADHD provider directly.
12. If you have recently registered with the practice and wish for us to take over your current prescribing for ADHD medications, please book a routine appointment.
13. You will need to demonstrate the conditions of shared care prescribing including a written agreement is in place. If this is not the case or your were diagnosed in another country then you will need to seek a UK based ADHD provider to put this in place.
14. By agreeing to shared care prescribing with the practice you must follow the recommendations of the agreement. The practice will support you with the 3 to 6-month monitoring of your heart rate, blood pressure, weight and height. We have practice pods that you can use at all sites without an appointment, or you can book an appointment with our Nursing team.
15. If you are delayed in the physical monitoring requirements, we will send you a reminder by text and give you a grace period of one month. If you continue to not have this done then we will no longer continue prescribing for you as you have not followed the shared care prescribing agreement.
16. If you are delayed in your ADHD review with an ADHD provider (usually annual for stable patients) then we will text you a reminder to have this done and give you a grace period of 6 weeks. It is your responsibility to arrange this. If this is not done, then we will no longer continue prescribing for you as you have not followed the shared care prescribing agreement.
17. If you are having all your care privately with an ADHD provider and we are not involved in shared care prescribing we will still support you with having the physical checks of heart rate the 3 to 6-month monitoring of your heart rate, blood pressure, weight and height. You can still use our practice pods or see our Nursing team as your ADHD provider will need these measurements.
18. If you are having all your care privately with an ADHD provider and can no longer afford to fund this yourself then we will explore with you if it is possible to link you in with a NHS right to choose provider for shared care prescribing. We are unclear at this time if the new South East London triage ADHD service will accept such referral cases. In the meantime, you will need to decide if continue to your current arrangements privately or stop your medications.

Please note the following Service Exclusion Criteria

• Patients with acute mental health needs and require access to an emergency mental health service.
• Patients currently receiving treatment in secondary mental health services.
• Patients who have an existing ADHD assessment in progress or have been accepted on a waiting list for this service for 18 weeks or less.
• Patients who have previously received an assessment for ADHD.
• Patients with a moderate or severe learning disability.
• Patients who may require an assessment for Autism (ASD).
• Patients with an ongoing substance misuse/alcohol dependency issue.