Annual reviews

Summary: Your ADHD medication needs a specialist review once a year to make sure it's still safe, effective, and right for you. Reviews are free for NHS patients and £140 for private patients – and if you need re-titration, this costs £420 for private patients. We'll invite you by email when your review is due and ask you to complete some short forms beforehand. 

• What annual reviews are

• Why annual reviews are needed

• What annual reviews involve

• FAQs 

An annual review is an appointment with a clinician to check that your ADHD medication is still safe, effective, and right for your needs. 

Your annual review is usually due 12 months after your last titration appointment. If you've had any extra appointments since then – or have a shared care agreement with your GP – it's 12 months from your most recent specialist contact. 

We'll email you when your review is coming up.

• NHS patients: free of charge

• Private patients: £140  

Annual reviews follow NICE guidance and help us make sure your medication is still working well, still safe, and still right for your current needs. We'll check how you're getting on, look for any side effects, and decide together whether anything needs to change. 

Without an up-to-date review, we can't keep safely prescribing your medication.

• NHS patients
  If your review isn't completed, we may not be able to keep prescribing. If you have a shared care agreement with your GP, that agreement depends on regular specialist reviews – without them, it may need to be stopped and we'll need to let your GP know.

• Private patients
  If your review shows that a full change of medication is needed, you'll need to go through re-titration before we can continue prescribing. Re-titration costs £420 and covers three 30-minute appointments with a prescriber, spaced four weeks apart, to make sure you're stable on your new medication. If you choose not to go ahead with your annual review (£140) or re-titration where required, we won't be able to keep prescribing safely and may unfortunately need to discharge you from our service. 

When we invite you, we'll ask you to fill in a short set of forms covering some basic physical health checks and a brief questionnaire about how you've been feeling (called “Patient-Reported Outcome Measures” or “PROM”). 

• Physical health – blood pressure, pulse, and weight

• Your medication – type, dose, how long you've been taking it, how well it's working, and whether you feel stable

• General health – other medications, sleep, appetite, mood, mental wellbeing, alcohol use, and lifestyle 

If your medication is working well and you're stable, your prescriptions will continue as normal. We'll send a summary to your GP – as part of your shared care agreement, or simply as good clinical practice if you don't have one. 

If any changes are needed, your clinician may arrange a follow-up. In some cases, a full re-titration may be recommended – this will always be explained and discussed with you. 

I'm happy on my current dose – is a review still necessary? 

Yes, even if everything feels settled. Annual reviews aren't just about adjusting doses – they're about making sure your medication remains safe and appropriate over time. NICE guidance recommends them for all patients on ADHD medication, and without one we're not able to keep prescribing safely. 

My GP has already done a review. Do I still need one with you? 

It's great that your GP is keeping an eye on things. However, as part of our shared care arrangement, we're also required to carry out and document our own specialist review. There may be some overlap, but our review includes specific monitoring that must be on record for us to keep supporting your care. 

This is an unexpected cost, do I have to pay? 
As a private registered patient, the cost of an annual review is £140. If your review shows that a full change of medication is needed, re-titration is an additional £420, covering three 30-minute appointments with a prescriber over 12 weeks. Both cover clinician time and report processing.