We understand that you may have questions about ADHD medication, whether you are considering starting medication, are currently waiting for treatment, are already taking medication, or are supporting a family member or someone you care for.
Please use the frequently asked questions below to find the information most relevant to you.
Shared care means a specialist ADHD service and a GP practice work together to support someone with ADHD medication.
How does ADHD medication usually start?
- A specialist service usually starts the medication
- They adjust the dose slowly to find what works best
- This is called titration
What happens when the medication is stable?
- The specialist may ask a GP practice to take over prescribing
- This is called a shared care agreement
Why might shared care happen?
A GP practice may agree if:
- They have clear information from the specialist and ongoing support
- They know how to monitor the medication
- They feel able to prescribe safely
Why might shared care not happen?
A GP practice may not agree if:
- The medication is still being adjusted
- The information is not clear•
- There is no clear monitoring plan
- They do not feel able to prescribe safely
What if shared care is not agreed?
- This does not mean care will stop
- The specialist service will keep prescribing and monitoring the medication
What about private assessments?
- A private diagnosis is not always accepted by the NHS
- NHS services may need their own assessment first
- A GP practice does not have to prescribe medication recommended by a private provider.
- If shared care is not agreed, medication may need to be paid for privately
What should you be told?
You and your family should be told:
- Who is prescribing your medication
- What happens next
- Who to contact if you have questions
Shared care means a specialist service and a GP practice agree to share responsibility for ADHD medication. This usually happens once medication has been started by the specialist service and the dose is stable.
A GP practice may agree to shared care when they have clear information from the specialist, understand what monitoring is needed, and feel able to prescribe safely.
A GP practice may decline shared care if the information is not clear, if the medication is not yet stable, if monitoring arrangements are not in place, or if the practice does not feel able to take on prescribing safely.
If there is no shared care agreement in place, the specialist service that started the medication remains responsible for prescribing and monitoring.
Yes. If ADHD medication is clinically appropriate, people assessed through the NHS Right to Choose pathway can still access ADHD medication through NHS-funded care.
Medication is usually started and adjusted by the specialist service that completes the assessment. This is sometimes called titration. It means finding the right medication and dose safely.
Once medication is stable, the specialist service may ask for prescribing to be shared with primary care through a shared care agreement. Shared care means the specialist service and primary care work together, with clear information about prescribing, monitoring and who to contact if advice is needed.
If there is no shared care agreement in place, the specialist service that started the medication remains responsible for prescribing and monitoring.
If ADHD medication is recommended, the specialist provider that completed the assessment is usually responsible for starting medication and adjusting the dose safely. This is called titration.
What happens next depends on where the young person is in the medication process. If medication has not started yet, the provider should explain who will start it and what the next steps are.
If medication has already started and the young person is still in titration, this should not stop just because they turn 18. The provider that started titration should continue to support this safely until medication is stable, unless there is a clear and agreed plan for another service to take over.
Once medication is stable, the provider should explain the ongoing prescribing arrangements. This may include shared care with primary care, or support from an adult ADHD pathway, depending on local arrangements and the provider involved.
The young person and their family should be told who is responsible for prescribing, what happens next and who to contact with questions.
If a patient already has an ADHD diagnosis and is seeking NHS-funded prescribing, shared care, or to restart treatment, this may be considered ongoing management, where the Right to Choose does not always apply. However, if a new referral to a specialist ADHD service is required (for example, for medication titration or reassessment), patients may still be able to exercise their Right to Choose, provided eligibility criteria are met. Shared care arrangements remain subject to GP agreement and are not a legal right.
You will not be discharged from your provider while you are receiving treatment, and any reviews of medication will continue.
Private assessment can speed up diagnosis, but NHS-funded treatment is not guaranteed afterward.
A private diagnosis is not automatically accepted by the NHS. NHS clinicians may require an NHS assessment before starting treatment, even if you have a private report. This is because the NHS clinician takes legal responsibility for prescribing and ongoing care. Some GPs will accept a private diagnosis under a Shared Care Agreement, but this is at their discretion, and not guaranteed.
Private providers may offer diagnosis only, leaving medication titration and monitoring to the NHS. NHS services, including GPs, are not required to prescribe medication recommended by private providers. This decision will always be based on clinical judgement and NHS prescribing guidelines. If the GP declines Shared Care, you may need to pay privately for prescriptions and follow-up care, which can be costly. NHS guidance states that private and NHS care should remain clearly separate — NHS resources cannot subsidise private care.
