In recent years, awareness of adult ADHD has grown significantly, leading to a rise in people seeking assessments. Due to high demand, waiting times for NHS ADHD assessments can be extremely long, sometimes up to five years. As a result, many patients choose to pursue private assessments to obtain a diagnosis more quickly. While this can help expedite care, it’s important to understand how this decision affects access to NHS prescriptions and ongoing support.
What is Shared Care?
Shared care refers to an arrangement where an NHS specialist and a GP work together to manage a patient’s treatment. This often involves the specialist initiating treatment and the GP taking over aspects such as prescribing and monitoring, if they agree to do so.
- A GP is not contractually obligated to enter into a shared care agreement.
- Shared care is only appropriate if a specialist continues to be involved in the patient’s treatment.
- The GP must be satisfied that it’s safe, appropriate, and supported by necessary systems and oversight.
- Shared care must not result in a complete transfer of responsibility to the GP without specialist involvement.
Some private providers have presented these agreements as “shared care” while fully shifting the prescribing burden to the GP – without the necessary expert support or oversight.
Our Policy on Shared Care with Private Providers including NHS Right to Choose Providers
From 14 July 2026 onwards, Saltash Health Centre will not be accepting any shared care agreement requests from private ADHD providers and will no longer enter into any new shared care agreements with private providers for ADHD prescribing including those accessed through the Right to Choose (RTC) pathway.
We Cannot Support Shared Care with Private or RTC ADHD Providers for the following reasons:
- It takes GP time and resources away from NHS-funded care, which is what we are contracted to provide.
- The BMA advises against shared care with private providers in order to keep NHS and private care clearly separate.
- Supporting only those who can self-fund creates unfairness and disadvantages patients who cannot afford private care.
- We cannot always be confident about the standards, safety, or governance of private clinics. In particular we have clinical concerns that the rate of diagnosis and medication recommendation in some private clinics is far higher than in NHS ones.
- There has recently been an explosion in the number of private clinics offering assessments for conditions such as ADHD, and it is impossible for us to assess each of these providers and their individual shared care agreements.
- If a private or RTC company ceases to operate in future in may leave patients and GP without the necessary support.
Patients already receiving medication through a private or RTC shared Care Agreement
- If a patient is joining our surgery where their previous GP had signed a SCA with a private provider, it does not automatically follow that our surgery will enter into a similar agreement.
- We are aware that historically there may have been shared care agreements that our practice may have accepted that would not be agreed to now. Our current position is that we will continue to honour those agreements but will be starting a process of reviewing each agreement to ensure they meet current standards, and will discuss with individual patients if any changes to these agreements are necessary.
Bridging Prescriptions
Saltash Health Centre cannot provide” bridging prescriptions” for specialist medications started by a private provider that is no longer affordable, or where a patient is waiting on an NHS pathway.
The General Medical Council are clear that responsibility for a medication lies with the prescriber, and a doctor should only prescribe within their range of competence. It is therefore not safe or ethical to provide such prescriptions.
We understand the current limitations of local NHS commissioning leave many patients in a difficult situation. Saltash Health Centre and the Local Medical Committee in Cornwall is continuing to press for improvements and increased funding to expand specialist services.
In the meantime, Saltash Health Centre must prioritise safe, equitable care within the NHS framework. We will continue to review this policy if local or national guidance changes.