Shared care often determines whether your ADHD medication can be prescribed on the NHS after diagnosis. It is one of the most misunderstood parts of the ADHD pathway in the UK.
What is a shared care agreement?
A shared care agreement is a formal arrangement between:
Specialist
A specialist clinician (usually a psychiatrist) diagnoses ADHD, initiates medication, and completes titration.
Titration
The specialist completes titration and the specialist remains responsible for overall ADHD oversight.
GP
Once stable, the GP may take over repeat prescribing under the shared care arrangement.
Shared care is voluntary and at the GP's discretion.
Why shared care matters
Without shared care
- Prescriptions often remain private
- Ongoing costs may be higher
- Follow-ups may stay private
With shared care
- Prescriptions may be issued on the NHS
- You pay standard NHS prescription charges (if applicable)
- Monitoring is managed locally
What is ADHD titration?
Titration is the process of gradually adjusting medication dosage until:
- Symptoms improve
- Side effects are manageable
- A stable dose is reached
- GP may take over prescribing
Common ADHD medications include:
- Methylphenidate
- Lisdexamfetamine (Elvanse)
- Atomoxetine
Most GPs will only consider shared care once titration is complete.
Why do GPs refuse shared care?
Common reasons include:
A refusal does not invalidate a diagnosis. It affects who prescribes.
Struggling with shared care for ADHD?
A care navigator can talk through your options if your GP won't accept shared care - written plan within 48 hours.
20-minute call · Written plan within 48 hours · Independent guidance
Does a private ADHD diagnosis guarantee NHS prescriptions?
No.
A private diagnosis does not automatically guarantee NHS prescribing. NHS prescribing usually depends on GP agreement to shared care or an NHS-funded prescribing pathway.
Already diagnosed, but can't afford private prescribing?
If you were assessed privately and now need an NHS or Right to Choose route for medication, we can help you work out what to say to your GP. Message us on WhatsApp - for free.
Why message us
- Help with what to say to your GP
- Understand your shared care or RTC options
- No sign-up, no commitment
Scan to start a WhatsApp chat
What is a shared care protocol?
A shared care protocol is a written plan outlining:
- Medication details
- Monitoring requirements
- Responsibilities of GP and specialist
- Review timelines
- Escalation plan
If requested, your specialist should provide this.
What happens if shared care is refused?
If your GP declines shared care:
- Ask for clarification
- Confirm titration is complete
- Ensure documentation is complete
- Ask about alternative NHS routes
- Review your treatment pathway
Shared care across the UK
Shared care policies can vary by region and local NHS structures.
Frequently asked questions
Explore ADHD assessment options
If you are comparing ADHD pathways, understanding prescribing structures is an important part of choosing the right route.
Related guides
The Complete Guide to NHS Right to Choose
Understand your legal right to choose your NHS provider and how it can reduce waiting times.
ADHD Diagnosis in the UK: The Complete Guide
How ADHD diagnosis works in the UK, including NHS referral pathways, waiting times, Right to Choose options, and private assessment routes.
NHS ADHD Diagnosis vs Private
Costs, waiting times, medication access and shared care compared across NHS and private pathways.
How to Ask Your GP for an ADHD Referral
A practical step-by-step guide to preparing for your GP appointment and requesting an ADHD assessment.