Will My GP Accept a Private ADHD Diagnosis? The Shared Care Problem

You've paid for a private ADHD assessment. You've been diagnosed. The psychiatrist has recommended medication and written to your GP. You assume the hard part is over. For many people, it isn't. The shared care problem is the most common source of frustration for privately-diagnosed ADHD adults in the UK, and it's something you need to understand before you choose a provider.

What Shared Care Means

ADHD medication (stimulants such as methylphenidate and lisdexamfetamine, or non-stimulants like atomoxetine) must be initiated by a specialist. Once you're on a stable dose, the ongoing prescribing and monitoring can be transferred to your GP through a 'shared care agreement.' This is the standard NHS model: the specialist starts the medication and the GP continues it.

Shared care benefits everyone. The specialist handles the complex initial phase (titration), and the GP manages the routine prescribing and monitoring. You get your medication through NHS prescriptions at standard cost (currently £9.90 per item in England, or free if you have a prepayment certificate).

Why GPs Refuse Shared Care

Here's the problem: GPs are not obligated to enter shared care agreements. ADHD prescribing is not part of the core NHS contract with GP practices. A GP can legally decline to prescribe ADHD medication, even if a specialist has recommended it.

Common reasons for refusal include: the GP practice has a blanket policy against shared care with private providers; the GP doesn't feel confident managing ADHD medication; the private provider isn't recognised by the local Integrated Care Board (ICB); or the GP questions the validity of the private diagnosis itself.

Some ICBs have published specific guidance on which private providers they will and won't accept shared care with. If your provider isn't on the approved list, your GP may be told not to accept the shared care request, regardless of the clinical quality of your assessment.

How to Avoid the Shared Care Trap

1. 1

   Ask your GP practice about their shared care policy before you pay for assessment. Call the surgery and ask directly: 'Do you accept shared care agreements for ADHD medication from private providers? Are there specific providers you will or won't work with?' Get this in writing if possible.

2. 2

   Choose a provider your GP will work with. If your GP practice has an approved list, use a provider on it. If they work with Right to Choose providers, consider that route instead (it's NHS-funded and shared care is typically smoother). Our clinic directory flags which providers have strong shared care track records.

3. 3

   Check your local ICB guidance. Many ICBs publish prescribing policies that list accepted private providers. Search '[your ICB name] ADHD prescribing policy' or call them directly.

4. 4

   Ask your private provider about their shared care success rate. Reputable providers will be upfront about how often GPs accept their shared care requests. If a provider can't answer this question, that's a red flag.

5. 5

   Get everything in writing. Once diagnosed, make sure your provider sends a detailed shared care request to your GP that meets local formulary requirements. A vague letter makes it easy for the GP to say no. A thorough shared care protocol with clear monitoring instructions makes it harder to refuse.

What If Shared Care Is Refused After Diagnosis?

If you've already been diagnosed privately and your GP won't enter shared care, you have several options. First, ask for the refusal in writing, including the specific reasons. Then consider whether another GP at the same practice might take a different view. You can also request that your GP refers you to the local NHS ADHD service for a 'validation' of your private diagnosis, which some ICBs accept as a pathway to NHS prescribing.

As a last resort, some areas allow you to request an NHS re-assessment, which, if it confirms the private diagnosis, would put you on the standard NHS prescribing pathway. This adds delay, but it resolves the shared care impasse permanently.

The Bigger Picture

The shared care problem is a systemic issue, not a personal one. It exists because ADHD services have been under-resourced for decades, GP training on ADHD remains limited, and the interface between private and NHS care has never been properly standardised. The ADHD Taskforce has recommended improvements, but change will be slow.

In the meantime, the best protection is research before you spend. Ten minutes checking your GP's shared care policy could save you thousands of pounds in ongoing private prescription costs.

Sources

Derby Medical Centre: Prescribing policy for ADHD shared care · Mid and South Essex ICS: ADHD prescribing FAQs · ADHD UK: Right to Choose · NHS England: Independent ADHD Taskforce Part 1 · NICE Guideline NG87