We understand that many families seeking support for ADHD face long waiting times for assessment and treatment. We know this can be incredibly challenging, and we recognise why many parents choose to access assessment and treatment through an independent provider or an NHS Right to Choose service.
We also understand that, once a child has been diagnosed and started on medication, families often ask their GP practice to take over prescribing through a shared care agreement. This is usually because NHS prescriptions are much less expensive than obtaining medication directly from an independent provider.
Why are we unable to accept new shared care agreements for children and young people?
Shared care is a voluntary arrangement where a specialist asks a GP practice to take over prescribing once treatment has become stable. Before agreeing to shared care, a practice must be satisfied that it has the capacity, specialist support and governance arrangements needed to do so safely.
ADHD medication is a specialist treatment. It requires careful monitoring and regular review, including checks of blood pressure, pulse, height, weight, appetite, mood and any side effects.
Monitoring children and young people is particularly complex and requires specialist paediatric or ADHD expertise. Decisions about medication doses, growth, development and ongoing treatment need regular specialist input.
At present, Wilmslow Health Centre does not have the clinical capacity or specialist support needed to safely take on new shared care arrangements for children and young people under 18 receiving ADHD treatment through independent or NHS Right to Choose providers. For this reason, we are unable to accept any new paediatric ADHD shared care agreements.
Responsibility for prescribing and monitoring therefore remains with the specialist service that started treatment.
ADHD shared care for adults (18 years and over)
We currently continue to accept new ADHD shared care arrangements for adults aged 18 and over where appropriate information and specialist support are available and where we are satisfied with the monitoring arrangements in place.
This is because there are established arrangements in place to support the monitoring and review of adult patients, allowing us to participate in shared care safely.
However, as ADHD services continue to evolve locally and nationally, these arrangements remain under review and may be subject to change in the future.
Why is this happening?
We appreciate that this situation may feel unfair for families, and we agree that the current system is not ideal.
At present, there is no locally commissioned NHS ADHD service for children that provides the specialist support needed for GPs to safely take over prescribing from independent or Right to Choose providers. This means that specialist monitoring, follow-up and clinical responsibility remain with those providers.
Unfortunately, GP practices have not been given the additional funding, specialist support or staffing required to undertake this work safely. The information, monitoring arrangements and ongoing support provided by different services can also vary considerably, making it difficult to ensure a consistent and safe standard of care.
This is a system issue rather than a reflection on any child, family or individual provider.
We are actively raising these concerns with NHS Cheshire and Merseyside Integrated Care Board (ICB) and other NHS organisations. We are asking them to develop alternative arrangements that provide better support for families and create a fairer, safer pathway for ongoing ADHD care.
Frequently Asked Questions
Why has the practice made this decision?
After reviewing the prescribing responsibilities, monitoring requirements and specialist oversight involved in ADHD treatment, we concluded that we cannot safely and consistently take on new paediatric ADHD shared care arrangements outside our local NHS specialist pathway.
This decision is based on patient safety, clinical capacity and the absence of a commissioned local service to provide the specialist support required.
Does this mean my child cannot have ADHD medication?
No.
Your child can continue to receive ADHD medication from the specialist service that diagnosed them and started treatment. Responsibility for prescribing and monitoring remains with that service unless a formal shared care agreement has been accepted by the practice.
Why can’t my GP just prescribe the medication?
ADHD medication is not simply a repeat prescription. It requires ongoing specialist oversight, regular monitoring and sometimes changes to treatment.
GPs can only safely prescribe these medications under shared care when there are clear arrangements in place for specialist review and support. At present, those arrangements do not exist for new paediatric ADHD shared care outside the local NHS pathway.
Does this affect my child if we already have shared care with the practice?
Not immediately.
We are reviewing existing arrangements individually to ensure appropriate specialist monitoring remains in place. A review does not automatically mean prescribing will stop, and we will contact you directly if any changes are required.
Is shared care automatic?
No.
Shared care is a voluntary arrangement that requires agreement from both the specialist and the GP practice. National guidance makes clear that GP practices should only enter into shared care arrangements when they believe they can do so safely and with appropriate support.
Why do some GP practices have different arrangements?
Shared care is voluntary, and practices may reach different decisions based on local services, clinical capacity and available specialist support.
Some neighbouring practices do not accept ADHD shared care for either adults or children. Our approach reflects our assessment of what we can safely provide for our patient population at this time.
What happens if my child transfers into a local NHS ADHD service?
Where a child’s ADHD care is transferred to a local NHS specialist service with established shared care arrangements, we may be able to participate in shared care in the usual way.
This would be considered on an individual basis once the specialist service has taken over responsibility for ongoing care.
What can I do if I disagree with this decision?
We understand this decision may be disappointing.
The underlying issue is the lack of a commissioned local NHS ADHD service for children and young people and the absence of funded arrangements to support GP practices in taking on this work.
If you would like to raise concerns about local ADHD service provision, you may wish to contact NHS Cheshire and Merseyside Integrated Care Board (ICB), your local Member of Parliament, or the specialist service caring for your child.
