ADHD Shared Care Agreements: How Your GP Can Take Over Prescribing

A shared care agreement is an arrangement between a specialist and your NHS GP that allows your GP to prescribe your ADHD medication on the NHS, at standard prescription cost, after a specialist has diagnosed you and settled you on a stable dose. It is the answer to one of the most common questions we hear: “If I pay for a private assessment, will I be paying private prescription prices forever?” For most of our clients, the answer is no, more than 4,000 people assessed at The ADHD Centre are now supported through NHS GP Shared Care Agreements across the UK.

Key takeaways

• A shared care agreement lets your NHS GP prescribe your ADHD medication at standard NHS cost after a private diagnosis.
• It starts once titration is complete and your dose is stable, usually a few months after diagnosis.
• GP practices are not obliged to accept shared care, but a thorough specialist assessment makes acceptance far more likely.

This guide explains how shared care works, when it starts, and what your options are if your GP practice declines.

What a shared care agreement actually is

Under a shared care agreement, responsibility for your ongoing care is shared between two clinicians:

• The specialist: a Consultant Psychiatrist who makes the diagnosis, chooses the medication, adjusts the dose until it is right, and remains available for reviews and any future changes.
• Your GP: the clinician who issues your routine prescriptions on the NHS and carries out simple ongoing checks, such as blood pressure and pulse.

The arrangement is set out in writing, so both clinicians and you know exactly who does what. NICE guideline NG87, which governs how ADHD is diagnosed and managed in the UK, is built around exactly this model: specialist initiation, followed by continuation in primary care.

When shared care starts

Shared care is not requested on the day of your diagnosis. It begins after titration, the period, usually a few months, in which your Consultant Psychiatrist finds the medication and dose that works for you. GPs take on prescribing only once a patient is stable, because dose-finding requires specialist oversight.

The usual sequence looks like this:

1. Diagnosis following a private adult ADHD assessment with a Consultant Psychiatrist.
2. Titration, with regular reviews while your dose is adjusted and monitored.
3. Stability: you and your Consultant Psychiatrist agree the medication is working well at a consistent dose.
4. The shared care request: we write to your GP with your diagnosis, your medication history, the agreed dose, and the monitoring plan, and ask the practice to take over routine prescribing.

From that point, your repeat prescriptions come from your GP like any other NHS medicine, and you return to the specialist only for 6-monthly reviews or if something needs to change.

Will my GP accept shared care?

Usually, but not always, and it is important to be honest about this. GP practices are not obliged to enter into shared care agreements. Acceptance is at the practice’s discretion, and policies vary between practices and between areas.

What helps a request succeed:

• A thorough diagnostic assessment. GPs are far more comfortable accepting shared care when the diagnosis rests on a structured clinical assessment against DSM-5 criteria, carried out by a GMC-registered Consultant Psychiatrist, with a full diagnostic report.
• A completed titration with documented monitoring, so the practice is taking on a stable patient, not an unfinished process.
• A clear written agreement setting out what the specialist remains responsible for.

Because The ADHD Centre is regulated by the Care Quality Commission and every assessment is conducted by a Consultant Psychiatrist, our shared care requests meet the standard GP practices expect, which is why so many of our clients make this transition successfully.

What if my GP says no?

It is disappointing, but it is not the end of the road. If your practice declines shared care, you have options:

• Ask for the reason in writing. Some practices decline as blanket policy; others have a specific concern that can be addressed, for example, waiting until you have been stable for longer.
• Continue with private prescriptions in the meantime. Our repeat prescription service keeps your treatment uninterrupted while the position changes.
• Ask again later. Practices do revisit decisions, particularly once you have a longer record of stable treatment.
• Raise it with your Integrated Care Board (ICB). Local NHS policy on ADHD shared care is set at ICB level, and patients can ask their ICB what the local policy is.

What you should not do is stop your medication abruptly because of a prescribing dispute, speak to your Consultant Psychiatrist first, and see the NHS overview of ADHD in adults for general guidance on treatment.

What the written agreement actually covers

A shared care agreement is a working document, not a formality, and it is worth knowing what sits inside it. A typical ADHD shared care agreement sets out:

• The specialist’s responsibilities: confirming the diagnosis, setting and changing doses, carrying out an 6-monthly specialist review, and remaining available to the GP for advice.
• The GP’s responsibilities: issuing routine prescriptions, carrying out the agreed monitoring (usually blood pressure, pulse and weight at set intervals), and flagging anything unexpected back to the specialist.
• Your responsibilities: attending reviews, reporting side effects, and requesting repeats in good time.
• The circumstances that go back to the specialist. Some things always return to specialist hands: a dose change, a switch of medication, a significant side effect, pregnancy or planning a pregnancy, or a general deterioration. The agreement names these so nobody has to improvise.

This clarity is precisely why GPs value a well-drafted agreement, it defines the edges of what they are taking on, and guarantees the specialist has not walked away.

If you were diagnosed elsewhere and shared care never happened

We regularly hear from adults who were diagnosed (privately or through another service) but whose prescribing never made it to their GP, leaving them paying private prescription costs indefinitely or, worse, letting treatment lapse. If that is you, the position is recoverable: shared care can be arranged at any point where a specialist holds your care and your dose is stable. Contact our team and we will advise on the sensible route based on where your diagnosis and prescribing currently sit.

How much does it cost once shared care is in place?

Once your GP takes over, you pay the standard NHS prescription charge per item, or nothing, if you are in a group exempt from prescription charges. The costs of the assessment itself and the titration period are set out openly on our assessment costs page.

Frequently asked questions

How long after diagnosis can shared care start? Typically once titration is complete and your dose has been stable, often around three to six months after starting medication, though it varies with how quickly the right dose is found.

Is a private ADHD diagnosis valid for NHS shared care? Yes. A diagnosis made by a GMC-registered Consultant Psychiatrist is a clinical diagnosis, whether made privately or in the NHS. The practice’s decision is about prescribing responsibility, not about the validity of your diagnosis.

Does shared care cover all ADHD medications? Shared care agreements are used for the licensed ADHD medications a GP can safely continue, including stimulant and non-stimulant options. Your Consultant Psychiatrist will confirm what applies to your medication.

Can a shared care agreement be ended? Yes, either side can withdraw from a shared care agreement, and occasionally a practice does, for example after a policy change. If that happens, prescribing responsibility returns to the specialist, so your treatment continues; it does not affect your diagnosis in any way.

Do I still see the Consultant Psychiatrist once my GP prescribes? Yes, shared care means shared, not handed over entirely. You remain under specialist care for an 6-monthly review and any changes, while the routine month-to-month prescribing sits with your GP. Our process page shows how the whole pathway fits together.

Book an Adult ADHD Assessment

Shared care starts with a diagnosis your GP can trust. Our GMC-registered Consultant Psychiatrists provide comprehensive adult ADHD assessments following DSM-5 criteria and NICE guidelines, with a full diagnostic report and a personalised treatment plan. Appointments are usually available within the same week: from £695 online anywhere in the UK, or from £1,095 in person at our London and Manchester clinics.

Book an Adult ADHD Assessment online today, or call our team on 0203 966 1551 and we will help you choose the right option for you.