Adult ADHD Services

Posted on December 3rd, 2024

Unfortunately, due to increasing pressures and demand for appointments, mental health services in Buckinghamshire are no longer able to provide comprehensive NHS services for adults with a diagnosis of ADHD.  Please review the following options available to you.

ADHD NHS Adult Referrals

Unfortunately, local NHS services are under such extreme pressure, they have closed to new referrals. Unprecedented demand has outstripped its funded capacity.

1. Buckinghamshire Adult ADHD Service

Patients seeking a new referral to ADHD services for diagnosis and treatment of potential ADHD, may be eligible to choose from an alternative consultant psychiatrist led, approved provider under the NHS Right to Choose. They will need to demonstrate that their symptoms are severe enough to cause problems in their functioning and will need to complete an Adult ADHD Self Report Scale

2. Adult-ADHD-Self-Report-Scale

If you meet their referral criteria we can discuss a referral to these services in a routine GP appointment, but please be aware they also have long waits, and due to the nature of their service many may not meet the standard required for us to share care with (diagnosis not made by a consultant psychiatrist, no medical prescribers, no annual review offered).

We would prefer and are campaigning for NHS commissioners to fund a local service, providing high quality care from expert specialists with safe ongoing reviews and prescribing.

This is not the fault of us as primary care provider. This is a commissioning problem, and we believe that patients should not be left without the specialist care they need due to a lack of comprehensive NHS funding. Our Local Medical Committee representatives have raised this issue with local funding and decision-making groups. If you wish to raise this issue, we suggest you direct your concerns to the ‘planned care team’ at BOB ICB bobicb.plannedcare@nhs.net

You may also want to raise this issue with your MP.

Child and Adolescent ADHD Services

Child and adolescent NHS ADHD services in Buckinghamshire are currently open to new referrals, but there are lengthy waiting lists to be seen.  Where appropriate, we will consider sharing care with Buckinghamshire CAMHS under a NHS shared care agreement for children and adolescents diagnosed with ADHD, as long as they abide by the conditions set out in the agreed NHS shared care policy.

NHS Buckinghamshire Shared Care Protocol Children and Adolescents

When they are discharged from CAMHS aged 18 this shared care agreement comes to an end. At this point the named CAMHS consultant will be responsible for transferring their ongoing care, if still required, to adult services.

We will no longer be able to share care with private providers for children and adolescents with ADHD. We will be making this clear to providers at the point of referral.

If you or your child has had a diagnosis of ADHD and wish to transfer your care to the NHS, your private consultant is able to refer you directly to the NHS service to be placed on the waiting list.

Why are we and other GP practices not able to share care with the private sector?

This is to ensure you receive safe clinical care and monitoring, delivered by suitably qualified and trained specialist consultant led teams who are funded, resourced and indemnified to do so. The article below is taken from our ICB Statement of Position on prescribing for ADHD in primary care following private consultations.

BOB (Bucks, Oxon, Berks) ICB Position Statement on Prescribing for ADHD in Primary Care following Private Consultation

An increasing number of patients and families are seeking private treatment for ADHD. Patients who have been privately diagnosed and treated for ADHD might request that further treatment/medication be provided within the NHS.

BOB ICB has no local policy in place that allows shared care between non-NHS commissioned private providers and NHS prescribers. This should not be confused with patients who have been referred, under ‘right to choose’, to private providers who have been commissioned by the NHS where separate arrangements may apply. The medication used in ADHD is prescribed locally under shared care agreements in place between NHS providers.

Patients and their families should have their expectations managed from the outset and it should be explained that they will be unlikely to access medicines on the NHS following private treatment.

If requesting further treatment through the NHS, the patient may be transferred to the NHS and should be re-assessed for NHS treatment within the same regime of priorities applicable to NHS patients. Patients will need referring into the appropriate clinic for confirmation of diagnosis according to ICD-10 diagnostic criteria. Where medication is indicated, the most appropriate treatment for that individual will be initiated or existing medication continued, if appropriate, according to locally produced guidelines.

Commissioning Policy 67 (TVP35) Managing the boundaries of NHS and privately funded healthcare should be considered:

• The NHS should not subsidise private care; and private and NHS care should be kept separate as clearly as is possible
• There is no obligation for the GP to prescribe treatment recommended by a private practitioner if it is contrary to local agreement or outside normal clinical practice
• The NHS will not normally fund treatments that have been recommended by a private practitioner if that treatment is not normally commissioned within the local area
• The fact that a patient can demonstrate they have benefited from the private treatment does not necessarily provide grounds for continuing the treatment in the NHS as an exception

It is important that patients, parents or guardians understand that when a patient is referred to the NHS provider, they will be added to the waiting list. Alternatively, the patient can continue receiving their medication from their private provider.

The BMA have issued guidance (July 2023) on ‘“shared care” with private providers’:
“Most shared care arrangements are commissioned by NHS commissioners and may not be funded for patients seeking private treatment. If this is not funded by local commissioners, the prescriptions and investigations should remain the responsibility of the private provider.”