ADHD patients stripped of NHS prescriptions under crackdown

A growing number of GPs are tightening the rules for patients who obtain private diagnoses of attention deficit hyperactivity disorder before returning to the NHS for prescriptions.

Waiting lists of more than a decade in some areas have pushed more patients to seek private ADHD assessments before entering into so-called shared-care agreements between specialists and NHS GPs.

While these agreements are usually only signed with specialist NHS services, in recent years some GPs have agreed to shared care for patients diagnosed by private clinics.

Increasingly, however, GP practices are withdrawing from shared-care arrangements, forcing patients to pay monthly private prescription fees that can total hundreds of pounds.

The withdrawals reflect GPs’ worries about the risks of taking on specialist care and a lack of resources in already overstretched practices.

Henry Shelford, chief executive of charity ADHD UK, warned that the dropping of shared care was dangerous for patients facing uncertainty over their medication, adding that it was “hateful and cruel how badly the overall NHS treats people with ADHD”.

He estimated thousands of patients had lost their shared care agreements in recent months. “We have average waits of eight years for a diagnosis . . . and now we see GPs refusing or dropping our medical care.”

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NHS England data suggests about 700,000 people were on the waiting list for an ADHD assessment in September 2025, a 49 per cent increase from a year before.

Faced with the prospect of a two-year waiting list, Mel Lerway had her then 19-year-old daughter privately diagnosed with ADHD in 2022. 

The diagnosis and treatment were life-changing for her daughter, who was then able to attend university with daily ADHD medication.

She entered into a shared-care agreement with her GP once the medication was stable. However, less than a year later, she said her daughter was told without warning that the practice would no longer support shared care.

Within days, the family was picking up the bill for private monthly prescriptions and six-monthly reviews, totalling £3,000 a year.

“We thought by going private for a diagnosis we were helping by taking the burden off the NHS,” Lerway said. “But now it just feels like we are being punished. To access an NHS prescription, we have been told to go back down the NHS diagnosis path, which means once again we are facing years of waiting.” 

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The availability of shared care arrangements is largely determined by Integrated Care Boards, the organisations responsible for planning each area’s health services. 

GP representatives in Suffolk and Essex advised practices last year to stop prescribing ADHD medication under shared-care agreements for all patients, including those diagnosed through the NHS, exacerbating pressure on the specialist public clinics that manage prescriptions for patients who cannot access shared care.

Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board states it has “no local policy in place that allows shared care between non-NHS commissioned private providers and NHS prescribers”, while Herts and West Essex ICB also advises it does not support shared care with private services.

The change in guidance has overwhelmed specialist ADHD services in some areas, forcing local health boards to pay private providers to ensure patients can continue to access medication and treatment.  

Last year, “urgent” contracts were signed by both Mid and South Essex ICB and Suffolk and North East Essex ICB, worth £20,000 and £711,580 respectively, according to contract databases.

Individual GP surgeries are also under no obligation to accept such arrangements, which sit outside the traditional GP contract.

One London surgery recently warned patients that prescriptions would end after one final 28-day supply if they remained under the care of a private ADHD provider.

Patients have been advised to transfer to NHS ADHD services instead. However, clinicians and patient groups warn this would mean joining lengthy waiting lists in an already overstretched system, even if they have a self-funded diagnosis from a clinic with an NHS contract.

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Dr Adrian Hayter, medical director for clinical policy, Royal College of GPs, said that “when shared care is not adequately resourced, this can create capacity, workforce and resource issues at a time when general practice is already under intense pressure”. He said this could cause a GP practice to withdraw from a shared care agreement “if it cannot be safely managed alongside their current workload”.

He cautioned that there were “also important considerations around clinical responsibility”, as under these arrangements GPs were responsible for managing any risks or side effects.

Lynsey Temple was told it would be two years before her son would receive a diagnosis through the NHS. “I met with the GP and discussed going private,” she said. 

“The advice was that if we could afford private care, we should pursue it, and once he was diagnosed and settled on any recommended medication, we could then apply for shared care through the NHS.”

She and her husband spent virtually all their savings on going private, which led to a diagnosis of autism and ADHD for their son. Each doctor’s visit costs £225, plus £50 each month for prescriptions.

“When I returned to the GP to arrange shared care, I was told they no longer provided it,” she said. “My private doctor suggested calling around other practices, but no local GP was offering it.

“Now, if we want NHS care, we would have to start the referral process over, wait for potentially years, and undergo another diagnosis.”

William Pett, head of policy and research at patient body Healthwatch England, said patients were paying “the ultimate price, having wasted money on a private diagnosis and facing either years-long NHS waits or thousands of pounds in ongoing private treatment costs”.

A Department of Health spokesperson said: “All providers, including those in the independent sector, must meet the same standards for patient safety and quality as the NHS. Where shared care arrangements cannot be agreed, responsibility for prescribing and ongoing oversight remains with the specialist clinician, whether NHS or private.”

An NHS spokesperson said: “We know we have a lot to do to improve ADHD care overall and that patients wait too long for a diagnosis, which is why we commissioned an independent task force and are carefully considering its recommendations.”

The task force has called for significantly more training and support for GPs to recognise and manage ADHD, as well as additional funding for specialist services.