If you are considering or have already been referred for an ADHD or Autism assessment through the NHS, you will have been sent to the NHS Neurodevelopmental service. This service provides diagnostic assessments of neurodevelopmental conditions in adults based in Brighton. This includes autism spectrum conditions, ADHD, and Tourette’s Syndrome.
Recently, there has been a significant increase in the number of people, both nationally and locally, seeking an assessment, which has led to substantial delays.
The Right to Choose
As part of the NHS Choice Framework, if you are based in England and under the NHS, you now have a legal right to choose your mental healthcare provider as well as your choice of mental healthcare team. This allows you to select another provider, should you feel that the waiting time for your current assessment is too long.
Some General Practices (GPs) will allow you to request this referral without an appointment; the University of Sussex Health Centre is one of these practices. If you are registered at another practice, you will need to contact them directly to inquire about their Right to Choose process for ADHD & Autism referrals. Each organisation may have its own questionnaire that needs to be submitted alongside the referral, so it is recommended to research which organisation you wish to be referred to prior to submitting a request.
ADHD Prescribing Information
If ADHD is diagnosed, and if medication is recommended, it will be the responsibility of your chosen specialist to initiate, prescribe, and monitor the medication initially (at least for 3 months) and not in general practice. This will include private clinics, and you should ensure that you can afford initial prescription charges and ongoing private consultations during the length of your treatment- this includes mandatory annual reviews. Check that your specialist can offer all aspects of prescribing and relevant monitoring before requesting a referral.
GP practices will only prescribe ADHD medication for a patient (under an NHS or UK private consultant psychiatrist) where a valid Shared Care Agreement (SCA), which adheres to the NICE guidelines, is in place. This requires both the psychiatry consultant specialist and the GP to sign.
If you are diagnosed and treated under the NHS (or NHS commissioned services), then the GP practice can adopt the SCA provided by your NHS consultant psychiatrist, if it meets the expected terms as set out in the NICE Guidelines.
If you are seen and diagnosed under a UK private consultant psychiatrist, then your private Psychiatrist will need to agree to, adopt, and sign the Sussex Specific NHS SCA for your GP practice to safely take over the prescribing. Without this, prescribing in general practice will not be possible. Your consultant psychiatrist needs to request this from the GP practice only at the point at which prescribing is desirable to be shared.
Shared Care Agreements
A “shared care agreement” (SCA) in the NHS is a formal arrangement between your GP and a private or hospital consultant specialist, allowing them to jointly manage a specific health condition. The GP takes on some responsibility for prescribing and monitoring specialist medications under the guidance of the specialist, ensuring you receive coordinated care. GPs are entitled to refuse an SCA if they are not happy with the burden of responsibility it puts on them. You will be required to attend annual reviews with your specialist and agree to this as part of the SCA. Failure to attend regular monitoring may lead to the SCA being suspended.
Useful Information
ADHDUK has a webpage dedicated to the Right to Choose process. This includes not only the latest Right to Choose Providers, but their average waiting times and a summary table with their full details. This can be accessed via this link: https://adhduk.co.uk/right-to-choose/.
