Disclaimer – Private Provider ADHD Assessment, Prescription Medication and Monitoring
We acknowledge the concerns raised in relation to ADHD diagnosis, shared care arrangements, and access to ongoing prescriptions. We recognise the impact that this situation may have, including where financial or health pressures are involved.
Vernon Street Medical Centre does not currently enter into Shared Care Agreements for ADHD medication. ADHD shared care is not a commissioned service under our NHS contract and therefore falls outside the scope of NHS-funded primary care services. Participation in such arrangements remains at the discretion of individual GP practices.
Due to current capacity constraints, prescribing governance requirements, and the non-commissioned nature of this work, we are unable to take on ADHD shared care at this time. This position is applied consistently to all patients and is not based on individual circumstances, including the route of diagnosis (such as Right to Choose) or completion of titration.
We appreciate that patients may be advised during the diagnostic or titration process that shared care can be requested. However, such arrangements are not automatic and remain subject to agreement by the patient’s registered GP practice.
Where a Shared Care Agreement is not in place, responsibility for prescribing and clinical monitoring remains with the initiating specialist provider. We would therefore advise that the patient continues to liaise with their specialist regarding ongoing prescriptions and management of their treatment.
While we are unable to alter our current position on shared care, patients may wish to explore whether alternative GP practices are accepting ADHD shared care arrangements, or discuss options further with their specialist provider.
If there are ongoing concerns, these can be raised through the NHS complaints process, including escalation to NHS England.
We hope that this has clarified our position regarding referral to ADHD services and the prescribing of any recommended medication.
What should I do if I think I have ADHD?
If you think you have ADHD, please book a consultation with one of our clinicians. They will tell you what to do next. If you are under 18 and in school, your school will need to fill out some forms. For adults, there can be a 3 to 5 year waiting list because many people need help.
What happens after I see the specialist?
After you see a specialist, they will talk to you about starting medication. The specialist will help you find the right dose. Once your dose is stable, your GP can take over prescribing the medication. This is done after a shared care agreement between the GP and the specialist.
What is a shared care agreement?
A shared care agreement is a document that says who is responsible for your care. It includes details about monitoring and prescribing your medication. Your GP will prescribe your ADHD drugs as long as your blood pressure, weight, and heart rate are normal. You must also attend your yearly review with the specialist. If you miss your review or have problems with your blood pressure, heart rate, or medication side effects, you need to see your specialist. GPs are not ADHD specialists, so they will ask the specialist for help if needed.
What should I do if my medication is out of stock?
There is a shortage of some ADHD medications like methylphenidate, lisdexamfetamine, and guanfacine. This means medication supplies can be unpredictable and vary from pharmacy to pharmacy. If your pharmacy does not have your medication, try other pharmacies. Sometimes we can switch you to a different brand, but not all brands are interchangeable. We cannot check pharmacy stock, so it is your responsibility to find your medication.
ADHD medication types
ADHD medication comes in different types: fast-acting and slow-acting. Here are some common medications:
Fast acting (Immediate release)
- Methylphenidate Hydrochloride: Acts straight away. Often starts at 5mg doses.
Mixed slow and fast acting preparations (Often known as modified release)
- Delmosart: 30% fast acting, 70% long acting.
- Medikinet: 50% long acting, 50% short acting. Note: Once you are on a certain medication mix, it’s best not to switch.
| Modified release Methylphenidate | Brands also compatible |
| 30:70 drug split, most commonly known as Concerta XL (dosed as 18mg, 27mg, 36mg, 54mg) | Concerta XL (max dose licensed 108mg) Affenid XLDelmosart (max dose licensed 54mg) Xaggitin (max dose licensed 54mg) Xendiate Matoride (max dose licensed 54mg) |
| 50:50 drug split Most commonly known as Medikinet (Dosed as 10mg, 20mg etc) | Medikinet XL (max dose licensed 90mg children, 100mg adults) Equasym XLMeflynate XL Metyrol XL |
| Immediate release methylphenidate (fast acting) | |
| Most commonly known as Methylphenidate hydrochloride | Medikinet 5mg tablets, Ritalin or Tranquilyn |
Why do you prescribe by brand?
Methylphenidate is a controlled drug with specific rules from the Home Office. You can only get a 28 day supply at once and must prove your identity to collect the prescription.