Autism & ADHD

If you feel a referral is needed then you can check out the Right to Choose qualitifed providers

If you’re seeking an ADHD or ASD assessment, there are three main options available to you.

Each option has different waiting times, costs, and referral processes. You can choose the option that best fits your needs. 

Option 1) NHS Neurodevelopmental Service: Free but involves significantly longer waiting times.

Option 2) Right to Choose (NHS-funded): Lets you choose an approved external provider for an NHS-funded assessment, often with shorter waits.

Option 3) Private Assessment: You can self-refer and are usually seen sooner, but you will need to cover the full cost of the assessment and any follow-up care. As a GP practice, we cannot recommend or endorse any private providers. Any private assessment or provider should be researched thoroughly by the patient before choosing.  This can be quite costly.

Why do Shared Care Arrangements (SCA) Matter 

• There are many diferences between providers and their requirements.  In addition, if medication is suggested by the provider then they will have to provide this in future unless there is an appropriate NHS Sussex approved Shared Care Agreement between the provider and the surgery.
• It is not safe for the surgery to prescribe certain medications without such arragements.  You will need to ask the provider if they will be able to use the NHS Sussex Shared Care Agreeement Template.  They will need to research and investigate this for you. A GP practice will only make such an agreement with a provider if it is on an NHS Sussex Template and only after review on each particular case and medication and only if it considers it is able to safely support.
• There are restrictions/criteria for referral, including age and there are potentially quite long waiting times.
• Check that they are currently accepting referrals

What is a SCA?

A Shared Care Agreement is a formal arrangement between your GP and your ADHD specialist.

It ensures your ongoing treatment is safe, consistent, and properly monitored.

The agreement outlines:

• What the GP is responsible for (e.g. repeat prescriptions)
• What the specialist must do (e.g. advice, medication reviews and adjustments)
• What you must do (e.g. attending follow-ups and reviews)

Shared care agreements can be void if terms are not met or adhered to; an example of this is that every patient on ADHD medication requires an annual review with their specialist and if this is not carried out GPs will be unable to continue prescribing where they had previously agreed.

Do GPs accept all SCAs?

No. We can only accept SCAs based on the National Institute of Clinical Excellence (NICE) guidelines. At any point GPs can decline shared care especially if they believe for it to be unsafe for any reason.

Some private assessments cannot be supported under shared care.

Unfortunately, we cannot engage in a shared care agreement from any specialist from abroad.

Why does my GP need an updated SCA?

ADHD medication is controlled, high-risk, and requires specialist supervision.

SCAs must reflect:

• Your current dose
• Stability of medication
• Results of recent health checks
• The provider’s commitment to ongoing specialist support

If your treatment changes, a new SCA is required.

Who prescribes during titration (changing the strength of medication to match your needs)?

Your specialist provider. GPs do not prescribe during titration. We can only take over prescribing once your dose is stable and safe.

How do I get an ADHD assessment through the NHS?

You can request an ADHD assessment by submitting a referral request to the GP. We will ask you to complete a short questionnaire to understand your symptoms. Your GP will then refer you. Previously the only option available to us was to the local NHS Neurodevelopmental Service. This is still available to us but the waiting times are currently long nationally.

What is Right To Choose (RTC)?

Because the NHS Neurodevelopmental Service has a long waiting list, you can use a process called Right to Choose (RTC). This allows you to have an ADHD or ASD assessment through an approved independent provider, funded by the NHS.

The assessment, diagnosis, and initial treatment are covered by the NHS and are free to you.

Once your treatment is stable, your care may be transferred back to your GP under a Shared Care Agreement (SCA) – but only if both the GP and local ICB approve.

Which providers can I choose under RTC?

The following providers are currently approved for shared care under Sussex ICB:

• Psychiatry-UK www.psychiatry-uk.com/right-to-choose
• ADHD 360 www.adhd-360.com/right-to-choose/
• Psicon www.psicon.co.uk/nhs/patients
• Clinical Partners www.clinical-partners.co.uk/nhs-services/right-to-choose

There are many other Right to Choose providers – You can find a list of these here along with their waiting times: www.adhduk.co.uk/right-to-choose/ 

It’s not possible for us to stay fully up-to-date with every provider outside the ICB’s pre-approved list, as their services and policies can change frequently.
We therefore ask patients to do their own research and check the details of any provider before submitting a referral.
If the provider is not compliant with NHS Sussex then we cannot support the care.

If you wish to choose a provider not on the pre-approved list, we recommend contacting them first to ask:

• Do they follow the Sussex Specific Shared Care Protocol?
• Do they meet all the requirements listed

Some providers with shorter waiting times can continue prescribing privately if shared care is declined. We recommend checking directly with the provider if this is an option they offer.

How long does it take the practice to send my referral?

When information is needed from a GP, please bring all the information you have gathered including your fully completed forms and supporting evidence. This may include a school report if the person is in education. Only once all the information is available will a GP be able to review for onward referral.

Once we receive your completed questionnaire, it usually takes up to two weeks to send your referral. We will text you to confirm once it has been submitted.  Note that we cannot send referrals until all the required information is provided.  Patients will need to complete all the necessary paperwork themselves.

How will I know my referral has been accepted?

The provider you chose will contact you directly with next steps. Timescales vary by provider.

What happens after my ADHD assessment?

Your provider will send you:

• A diagnostic report
• A treatment plan
• A prescribing / titration plan (if medication is recommended)

They should also send this information to the GP.

Can the GP start prescribing ADHD medication straight after diagnosis?

No. We can only take over prescribing after:

1. Your dose has been fully optimised and stable for at least 12 weeks
2. We have received a complete Shared Care Agreement (SCA)
3. Your physical health checks (BP, pulse, weight) are up to date
4. The specialist provides ongoing titration and monitoring until stability is reached

Until then, the specialist must prescribe.

What if my provider hasn’t sent enough information?

We cannot prescribe until all required documents are received.
If information is missing, you will be asked to contact your provider directly.

What physical checks do I need before starting ADHD medication?

Most providers require:

• Blood pressure
• Pulse
• Weight
• Sometimes cardiac history or ECG (if clinically indicated)

These checks must be carried out by the provider and be up to date.

How often do I need monitoring once stable?

Usually every 6–12 months, depending on the medication. Your GP will ask you to book routine monitoring appointments to maintain safe prescribing.

You will require an annual review with the specialist to maintain the terms of the SCA and enable a GP to continue to prescribe.

What happens if I run out of medication during titration?

You must contact the specialist provider, not the GP. We are unable to issue prescriptions until your dose is stable and shared care is agreed.

What if I already have an ADHD diagnosis and want to be referred for medication titration-only?

If you have a diagnosis from a private provider or from overseasand you would like to be referred to the NHS or Right to Choose for medication then you will need to submit a new referral.

If you have a diagnosis from the NHS or a Right to Choose provider then it is recommended to go back to that provider to start titration.

NHS RTC generally do not accept a diagnosis or treatment plan from another provider. They consider it too risky to prescribe controlled medication based on another provider’s assessment or titration plan. The only options are a new referral and full assessment, or returning to your original provider if they accept this.

Can I be referred to more than one provider?

No. You can only be on one waiting list at a time – this includes the NHS Neurodevelopmental Service.

Can I change provider after my referral is sent?

Yes. You can request a new referral but this will reset waiting times.

My provider hasn’t contacted me – what should I do?

Please contact the provider directly. They manage their own waiting lists and appointment booking.

Can the GP prescribe after a private diagnosis without shared care?

No. We cannot prescribe any ADHD medication without:

1. A valid SCA
2. A stable dose
3. Required monitoring results
4. Ongoing specialist support

I can no longer afford private costs – can I transfer my care to NHS/RTC?

If you wish to move to an NHS or RTC service, you can submit a new referral. However, you would need to start at the beginning of that waiting list, as NHS and RTC services cannot take over care part-way through private treatment. This is to make sure the process is fair for all patients and that no one is able to skip ahead on the waiting list.

If you move to a new area or register with a new GP, your ADHD care and medication arrangements may change.

Shared care agreements

A shared care agreement is a local arrangement between:

• your ADHD specialist service, and
• your GP practice

This agreement allows your GP to prescribe ADHD medication on the advice of the specialist.

If you move to a different area (for example, from Kent to Sussex), your shared care agreement does not automatically transfer to your new GP or local ADHD service. Your new GP is not required to accept a shared care agreement set up elsewhere.

What this means for your medication

Your new GP may agree to take on prescribing only after a new shared care agreement is in place with a local ADHD specialist.

If your new GP does not accept shared care, they may be unable to continue prescribing your ADHD medication.

In some cases, the specialist service may continue prescribing temporarily, but this depends on the service and local arrangements.

Referral to a new ADHD service

When you move area, the local NHS ADHD service may:

• require a new referral, even if you already have an ADHD diagnosis
• place you on their local waiting list

Your previous diagnosis and reports are helpful background information but do not guarantee immediate transfer of care.

What we recommend

To avoid disruption to your medication:

1. Register with your new GP as soon as possible.
2. Ask your previous ADHD service to send your assessment reports and treatment details to your new GP.
3. Discuss shared care arrangements with your new GP early.
4. If shared care cannot be agreed, your GP can advise on referral options, including NHS or Right to Choose pathways.

If you are unsure how a move may affect your ADHD treatment, please contact us for advice before changing GP or moving area.