Shared care

Summary: Once your medication is stable, your GP can take over prescribing through “shared care”. If your GP refuses, there are steps you can take to challenge this, and we’ll offer support in the meantime. 

• What shared care is

• How to set up shared care

• If your GP refuses shared care

• Your options if shared care isn't possible FAQs 

This article only applies to patients diagnosed with ADHD, or ADHD together with other conditions like autism – where treatment is often different. 

Shared care is an arrangement between us and your GP to manage your ADHD treatment together. Once you’ve completed titration and your medication has been stable for 8 weeks or more, you can request a shared care agreement with your GP. Your GP will then take over prescribing and day-to-day management of your medication, while we monitor your treatment every year in an annual review.

• If your GP agrees to shared care, you'll pay the NHS prescription rate for your medication – currently £9.90 per item, or free if you're eligible. Your annual review with us is free for NHS Right to Choose patients and £140 for private patients.

• Shared care tends to work well for everyone – it means better clinical oversight, lower costs for you, and less pressure on specialist services. 

Once your medication is stable, you can request to move to a shared care agreement  with your GP as part of our titration service. We'd recommend checking with your GP surgery beforehand to make sure they're open to this – it can save a lot of time later on. 

Once you have made your request, you don't need to do anything else. We'll handle the agreement and let you know once it's in place. 

Some GPs do decline shared care agreements. If that happens, there are a few things you can do:

• Speak to your GP or practice manager You can explain that we’re an NHS-accredited provider registered with the Care Quality Commission (CQC). Sometimes that conversation is all it takes.

• Consider submitting a formal complaint to your GP practice It can sometimes help the practice review their decision.

• Contact your Integrated Care Board (ICB) ICBs oversee healthcare in your area and may be able to offer guidance or influence local policies on shared care.

• Consider changing GP If shared care can’t be agreed, you may wish to register with a different GP practice that supports shared care arrangements for ADHD treatment. Unfortunately, we can’t help you change GP practices and this might not always be a straightforward or available option. 

Because we don't have access to your full medical history in the way your GP does, we may ask you to sign a waiver before we can prescribe without GP oversight. We take this responsibility seriously and carry out strict safety checks before prescribing.  

One of our patients has also shared a template letter that has helped some people successfully challenge their GP's decision to refuse shared care. While we can't take credit for the letter, it may be worth trying – please see here for a supporting letter. 

If your GP has referred you to us for assessment but won't agree to a shared care arrangement for medication, don't worry – we won't turn you away. We'll continue prescribing beyond your initial titration period, so you're not left without support. 

You'll pay the standard NHS prescription charge (£9.90) at our partner pharmacy, unless you’re exempt from paying. Annual reviews are included at no extra cost, and additional appointments may also be available to you. 

Each prescription costs a £20 admin fee (paid directly to us) plus your medication cost, which is typically £75–£160/month (paid to the pharmacy). Appointments and annual reviews are £140 each. 

Do I have to set up shared care? 

You will if you’re on Right to Choose. If you’re a private patient, this is completely your choice. If you'd prefer to continue with a private prescription through us, that's absolutely fine. Shared care is simply the most cost-effective option for most patients once titration is complete. 

What if my GP refuses shared care? 

There are several steps you can take – see the "If your GP refuses shared care" section above. If shared care isn't possible, we can continue prescribing privately, and NHS Right to Choose patients should continue to be covered at NHS rates. 

Will I still need to see you if my GP takes over prescribing? 

Yes. You'll have an annual review with us each year to make sure your prescription is still right for you. This is free for NHS Right to Choose patients and £140 for private patients. 

Can I still be referred if my GP doesn’t agree to shared care? 

Yes. We currently accept referrals regardless of whether your GP provides shared care agreements.