This practice is not funded to provide comprehensive NHS services for adults with ADHD.

NHS referrals for ADHD (children and adult)

Due to long waiting lists and overwhelming demand, from 5 February 2024, The Adult Service in Oxfordshire closed to new referrals.

However, those with symptoms severe enough to cause problems in their functioning may still request an NHS ADHD assessment using an approved private provider (see below) and will be assessed initially using a questionnaire: 

NHS referrals for children and young people continue as normal for the present.

Private Providers and the Right-to-Choose Scheme

Due to this demand, the NHS has agreed that some private providers may provide ADHD assessments for NHS patients. These must be led by a consultant with a current NHS contract to provide the ADHD service, and able to provide ADHD treatments as well as assessments.

In order for a GP to refer responsibly to a specialist service they must ensure that the service is approved and meets certain quality standards.

Locally, the Buckinghamshire, Oxfordshire, Berkshire West Integrated Care Board has only approved and quality-checked the following providers for adult ADHD assessments. 

• Psychiatry UK https://psychiatry-uk.com/ 
• Skylight Psychiatry https://www.skylightpsychiatry.co.uk/ 

The practice is therefore very happy to refer adults requesting a referral under the right-to-choose scheme to the above providers.

We will also refer children to NHS right-to-choose services

However, we have taken the difficult decision that we are unable to refer to alternative private providers as we cannot guarantee the quality of the services. 

Please be aware that if this is suggested to you by an alternative agency, we will not be able to do so. Secondary Care services (such as CAMHS) can refer directly to the private provider if they feel this is appropriate. 

Many private providers will also accept self-referrals for children but please do be aware that they may not offer the holistic input or ongoing reviews that are provided by the NHS CAMHS service. We would also encourage you to work closely with your child’s school to enable appropriate educational support can be put in place as soon as possible.

Provision of medication 

In order for medication to be issued safely, national guidance expects long-term involvement of specialists in reviewing ADHD patients and their medical treatment. This is called a ‘shared care agreement’.

Unfortunately, the BOB-ICB will only fund assessments for ADHD – NHS or the approved right-to-choose private providers – rather than any ongoing shared care agreements.

Therefore the practice has taken the difficult decision that any new requests from specialists, both NHS and private, to prescribe ADHD medications to adult or child patients on a “shared care” basis will be declined UNLESS appropriate specialist oversight is in place. This must include an annual review with the specialist team. 

ADHD service providers can still carry out an assessment and diagnosis and provide prescriptions on an ongoing basis but may decline to do so. 

If patients wish to start medications, all parts of the assessment (including pre-treatment tests and investigations) and the initial prescriptions must be provided by the relevant NHS or right-to-choose private provider. Once a patient is established on a stable dose, the practice may provide prescriptions providing there is evidence of ongoing specialist involvement in care. 

Unfortunately we are aware of drug shortages. We will not be able to initiate new medications in primary care. These must be started and stabilised by the relevant specilist team in line with the Oxfordshire precribing formulary. Different formulations of the same drug will be considered on a case-by-case basis. 

As your NHS GP, we will not enter into “shared care” arrangements with non-NHS approved right-to-choose private providers. This is against the NHS Principles of Separation between NHS and private care. If you undertake a private assessment you need to be aware that you will be responsible for all costs associated with that including consultation fees and medication costs.

Care of adults already receiving ADHD treatments remains under careful review. However we will be reviewing all existing patients with a view to reducing or stopping their 

medications where it is safe to do so unless proper local services are commissioned. 

We await further guidance around this challenging area. 

Further information and who to contact…

We firmly believe that patients should not be left without the care they need due to a lack of comprehensive NHS funding. Our local representatives have raised this issue with local funding and decision-making groups. If you also wish to raise this issue, you may want to contact the planned care team at BOB ICB, bobicb.plannedcare@nhs.net, and/or your MP.