ADHD Shared Care Agreements: How to Get NHS Prescriptions After a Private Diagnosis

What is a shared care agreement?

Shared care is a formal arrangement between a specialist (your private psychiatrist or ADHD clinic) and your GP, where the responsibility for prescribing your medication is transferred from the specialist to your GP practice once your treatment is established.

It works like this: the private clinic conducts the assessment, makes the diagnosis, and manages the initial stage of treatment — which includes titration, the process of finding the right medication and dose. Once your dose is stable and you are responding well, they write formally to your GP with the diagnosis, the medication, the dose, and a shared care protocol for ongoing prescribing and monitoring.

From that point, your GP takes over prescribing. The specialist remains available for complex queries or medication changes, but the day-to-day prescribing relationship is with your GP, who issues NHS prescriptions at standard rates. It is the same medication — just significantly cheaper.

The financial case for shared care

The numbers make a compelling argument for pursuing shared care rather than staying on private prescriptions long-term.

The NHS Prescription Prepayment Certificate (PPC) is worth knowing about. Check the NHS Business Services Authority for current prices, and covers an unlimited number of prescription items during that period. If you take more than one prescription item per month — for example, two different medications, or a medication plus a monitoring blood pressure check — the annual PPC saves money from day one.

Even if you are only on one item, a prepayment certificate may still be cheaper than paying individual NHS charges of £9.90 per item. Check current prices on the NHS Business Services Authority website. Apply for it via the NHS Business Services Authority website or at your pharmacy.

For context on what different types of ADHD medication cost and how titration works, see our full ADHD medication guide. For the overall cost of assessment and treatment, see our ADHD assessment cost guide.

How to set up shared care

The process is largely driven by your private clinic, not you — but knowing the steps helps you ask the right questions and chase things up if they stall.

1. 1
   Assessment and diagnosis. Your private clinic completes the assessment and provides a written diagnosis report. This goes to you and, with your consent, to your GP.
2. 2
   Titration (usually 4–12 weeks). The clinic manages the initial titration process — starting medication at a low dose and adjusting until you reach a stable, effective dose. This stage is typically handled by the private clinic and billed at their rates. Some clinics include titration in their assessment fee; others charge separately.
3. 3
   Shared care letter to your GP. Once your dose is stable, the clinic writes to your GP with your diagnosis, the medication name and dose, monitoring requirements (blood pressure checks, annual reviews), and a shared care protocol document. Good clinics use protocols aligned with local ICB (Integrated Care Board) guidelines, which makes acceptance much more likely.
4. 4
   GP accepts shared care. Your GP practice reviews the request and agrees to prescribe. From this point, you collect prescriptions from your GP at NHS rates. Your GP will typically require an annual medication review, which they conduct as part of their normal service.

The total timeline from assessment to shared care being established is typically typically several months, depending on how quickly titration stabilises and how responsive your GP is to the shared care request.

Shared care request letter template

Use this template to formally request that your GP takes over prescribing under a shared care arrangement.

What if your GP refuses shared care?

GPs are not legally obligated to accept shared care arrangements, and refusals do happen. It is frustrating, but it is not necessarily the end of the road. Understanding why they refuse often points to the solution.

Common reasons for refusal:

• The clinic's shared care protocol does not match local ICB guidelines
• The GP is unfamiliar with prescribing controlled stimulant medication
• The practice has a blanket policy against shared care from private providers
• Concerns about monitoring responsibility and liability
• The diagnosis letter is incomplete or not in the expected format

What to do:

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  Ask your clinic for a more detailed protocol letter. Many refusals are resolved when the clinic provides additional documentation — specifically, a protocol aligned to the GP's local ICB guidance. A good clinic will do this as a matter of course.
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  Contact your ICB. Your Integrated Care Board (the NHS organisation responsible for commissioning services in your area) may have a shared care policy that GPs are expected to follow. Some ICBs have issued explicit guidance that GPs should accept shared care for ADHD. Quoting this guidance in a letter to your GP practice can shift the outcome.
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  Consider changing GP practice. If your current practice has a blanket refusal policy and will not engage, registering with a different GP in your area who is more familiar with ADHD shared care is a practical solution that many people take.
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  Raise a formal complaint. If your GP refuses without providing a clinical reason, and your ICB has guidance supporting shared care, you can raise a formal complaint via NHS England. This is a longer route, but it has resulted in GPs reversing decisions in documented cases.

Which clinics get shared care accepted more easily?

Not all private ADHD clinics are equal when it comes to shared care. The clinics with the highest acceptance rates share a few characteristics:

• CQC registration — Care Quality Commission registration signals that the clinic meets NHS-equivalent standards, which GPs trust
• NICE-guideline-aligned assessments — clinics that follow NICE NG87 produce reports that GPs recognise and accept
• Established shared care protocols — clinics with pre-existing relationships with ICBs, or who use standardised protocol letters
• Consultant psychiatrists — reports from a consultant (rather than a non-consultant specialist) carry more weight with GPs
• Transparent shared care policies — clinics that actively advertise their shared care process and support patients through it

Before booking an assessment, it is worth asking the clinic directly: “What is your shared care process, and what is your acceptance rate with GPs?” A clinic that cannot answer this question clearly is worth treating with caution.

You can compare UK private ADHD clinics on our site, or see our online assessment options — several of which have strong shared care track records.

Tips for making shared care work

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  Ask before you book. Contact your shortlisted clinics and ask about their shared care process before committing. Ask whether they provide ICB-aligned shared care letters and whether they charge extra for this.
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  Check with your GP surgery first. Before you book your assessment, speak to your GP practice about their stance on shared care from private ADHD clinics. If they are resistant, it is better to know now — either to manage expectations or to consider registering elsewhere.
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  Keep copies of everything. Retain your diagnosis report, medication plan, titration records, and any shared care correspondence. If your GP changes or the practice loses paperwork, having your own complete record avoids months of delays.
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  Do not stop medication while waiting. Shared care takes time to set up. If you stop medication during the transition because you cannot afford private prescriptions, discuss this with your clinic — some offer bridging prescriptions or can expedite the process.
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  Buy a prepayment certificate as soon as shared care is agreed. A prepayment certificate can be cheaper than paying per prescription for most people on long-term medication. You can spread the cost in monthly instalments via NHS BSAS.