We understand that it is very important to patients and families to get their ADHD medication, and that it can be a struggle to pay for private medication. So why can’t we prescribe it?
ADHD medications are specialist medications with significant potential side-effects and risks. They require additional monitoring tests to make them as safe as possible, and a specialist to interpret these monitoring results and adjust medications accordingly. Therefore, in order to prescribe them, we need a formal agreement called a Shared Care Agreement (SCA) with the specialist. This lists the monitoring required and the duties of the specialist to keep things safe.
Our policy is to only accept SCAs with NHS organisations. This is because NHS organisations are accountable, they are well monitored, and we know that they will still be around in the future should any problems arise (or at the very least there will be a clear transfer of responsibility). By contrast, private clinics can come and go with little warning. This means that we would have no guarantee that we would have a specialist to talk to if problems arose with the prescription. We do not as a GP practice have any way of holding a private clinic accountable in the same way we can for NHS clinics. They can also be variable in quality, which is why NHS ADHD services may reassess people diagnosed privately.
All of this means that even if a private clinic wanted to engage in an SCA with us, we have no way of guaranteeing that they will actually follow the required steps to keep you or your family safe. Unfortunately, ‘right to choose’ clinics are still private clinics, not NHS ones, so the same applies to them.
Choosing to engage with SCAs even with NHS organisations is entirely voluntary on the part of GP practices, but we generally choose to do so unless we have good reason not to because we want to help our patients. We would usually accept SCAs from NHS ADHD services unless we had good reason not to accept.
The right to choose clinics are still able to provide the patient their medication on an on-going basis. Our decision to not accept shared care agreements with the right to choose clinic does not restrict the patient from receiving their medication from this service.
Some practices may have different policies, but we believe that our policy on this is the best option for keeping patients safe.
Dr R Modi & Dr S Waddingham