We hope that you find the following helpful and may answer some questions for you. If, after reading this, you still have further question or query, do book an appointment with your GP.
What is ADHD:
Attention deficit hyperactivity disorder (ADHD) is a condition that affects people’s behaviour. People with ADHD can seem restless, may have trouble concentrating and may act on impulse.
Symptoms of ADHD tend to be noticed at an early age and may become more noticeable when a child’s circumstances change, such as when they start school.
Most cases are diagnosed when children are under 12 years old, but sometimes it’s diagnosed later in childhood.
Sometimes ADHD was not recognised when someone was a child, and they are diagnosed later as an adult.
The symptoms of ADHD usually improve with age, but many adults who were diagnosed with the condition at a young age continue to experience problems.
People with ADHD may also have additional problems, such as sleep and anxiety disorders.
Children under 18 years:
The best way to refer a child under 18years old is via their school, to CAMHS. This is because the teachers see the child every day and the combination of reports from the school and parent are most comprehensive for assessment. There is a long wait for assessment, but there is an NHS service at the end of it.
Adults over 18 years:
The adult ADHD service in Oxfordshire is currently very limited and waiting times are extremely long (currently 3.5 years). This is as frustrating for us as it may be for you.
The adult clinic will make an initial assessment but unfortunately there is no comprehensive specialist follow-up after this. Without this ongoing specialist provision, your GP is unable to safely manage / prescribe for adult ADHD in the NHS.
Families with children turning 18 years are encouraged to have an early discussion with their paediatric specialist about ongoing adult care.
If you still feel you wish to proceed and be referred into this very limited NHS adult service, you will need to fill out the two questionnaires below and return them to the surgery so that your doctor can refer you.
Private Care option:
It is no surprise that many choose the Private Care option. If you decide to go down this route here are some helpful pointers:
You can self refer to the private clinic of your choice. You do not need a GP referral.
National and local guidance make it very clear that, for reasons of safety and equity, the private and NHS sectors should be kept separated as much as possible; that it can’t be assumed possible to “pick and mix” parts of care from each. For example, expecting an NHS GP to be able to prescribe medications on the NHS that have been advised by a private doctor.
If you choose to go privately, this means that you should not rely on the NHS sharing ADHD care (and costs) at any future date; please do consider from the outset that you may need to be paying all private costs into the long term.
It is of course possible to refer you back into the NHS, if/ when there is an appropriate service to refer you to. Your private consultant can do this directly at any stage.
Shared Care:
If you receive an ADHD diagnosis, you may hear about “shared care”. If appropriate for you, this is based on a tight and specific Abingdon Surgery Shared Care Agreement that your consultant, you, and your GP sign. (As explained, GP shared care is unfortunately not a current option for NHS adult ADHD.)
After stabilisation on medication, it may allow your GP to (i) support the specialist by providing physical monitoring data to the specialist to assess/ advise ongoing care; and (ii) issue the monthly NHS prescriptions under the specialist guidance.
However, for many reasons, including clinical safety and limited NHS capacity, you need to know that Shared Care is just not always be possible. ADHD is a specialist field, and not considered to be part of usual core NHS GP work. Notwithstanding this, given the hugely difficult current circumstances, the Partners at Abingdon Surgery have given much consideration as to what we can offer that is possible, safe and equitable within such severely limited NHS capacity. Please, however, understand that, if your GP is unable to support share care, this is a carefully considered partnership decision, and we respectfully ask that you accept the decision.
Limited ADHD provision in Oxfordshire is a very difficult situation over which your GP has no control. We ask please, rather than direct understandable frustrations to your GP and Abingdon staff, help us instead by directing your concerns to the commissioners and your MP!
Regards
The Partners at Abingdon Surgery