Shared Care Explained

In ADHD care, shared care may sometimes be considered after medication has been initiated, adjusted and the patient is clinically stable.

Shared care is not automatic and a GP is not required to accept a shared-care arrangement.

What happens before shared care?

Where ADHD medication is clinically appropriate, treatment is normally initiated and titrated by an appropriately qualified specialist.

During titration, the clinician may adjust medication and monitor:

• Symptom response
• Side effects
• Blood pressure
• Pulse
• Weight and other relevant physical-health measures
• Overall tolerability and clinical response

The aim is to identify an effective and well-tolerated treatment plan.

What happens when treatment is stable?

Once a patient is considered stable, the specialist may consider whether shared care is appropriate.

A shared-care request may then be sent to the patient’s GP.

The request normally provides relevant clinical information and explains the proposed responsibilities of the GP and specialist.

Does my GP have to accept shared care?

No.

Shared care requires agreement from the GP practice. A GP can decide that they are unable or unwilling to accept responsibility for prescribing under a shared-care arrangement.

Patients should therefore not assume that receiving an ADHD diagnosis or starting medication guarantees that their GP will subsequently prescribe it.

What happens if shared care is accepted?

The precise arrangement depends on the applicable shared-care protocol and agreement.

Typically, the GP may take responsibility for ongoing repeat prescribing and specified routine monitoring while the specialist remains responsible for specialist review and advice.

Patients still require appropriate clinical monitoring and periodic review.

What if my GP declines?

If a GP declines shared care, this does not invalidate an ADHD diagnosis or mean that treatment must necessarily stop.

The specialist medication provider should explain what alternative prescribing arrangements are available and any associated costs.

It is sensible to understand these arrangements before beginning private ADHD medication treatment.

Precision Neuro Clinic’s current medication pathway

Precision Neuro Clinic currently provides ADHD diagnostic assessments but does not directly prescribe ADHD medication.

Following an ADHD diagnosis with Precision Neuro Clinic, patients who wish to explore medication can discuss our onward referral pathway.

With the patient’s consent and where appropriate, Precision Neuro Clinic can refer relevant clinical information to Phoenix Mental Health Services, an independent specialist provider.

Phoenix Mental Health Services undertakes its own clinical review and determines independently whether ADHD medication is clinically appropriate and safe.

Where medication is considered appropriate, Phoenix may provide medication initiation, titration, monitoring and ongoing prescribing under its own clinical governance arrangements.

Treatment and medication-service fees are arranged directly between the patient and Phoenix Mental Health Services.

Is medication required after an ADHD diagnosis?

No.

Medication is one possible ADHD treatment option and is not appropriate or desired by everyone.

The decision should be individualised and based on clinical circumstances, preferences, potential benefits, possible risks and other available approaches.

Planning ahead

If shared care is important to you, you may wish to speak with your GP practice before beginning private medication treatment to understand its approach to private ADHD shared-care requests.

Policies and individual clinical decisions can vary between GP practices.

A specialist medication provider should also explain what happens if shared care is not accepted so that you understand the longer-term prescribing arrangements before proceeding.