Understanding shared care agreements

If a private ADHD assessment leads to a medication recommendation, you'll often hear the term "shared care." Understanding what this actually means, and its limits, helps you plan realistically for what happens after diagnosis.

What shared care is

Shared care is an arrangement where a specialist, such as a private psychiatrist, starts and monitors a medication, while a patient's GP takes on responsibility for ongoing prescribing once the dose is stable. The idea is that the specialist provides expertise on diagnosis and titration, and the GP provides convenient, ongoing local access to prescriptions and general oversight, working within local guidance and any shared care agreement or protocol used in that area.

Shared care is not automatic

This is one of the most important realities to understand: a GP practice is not obliged to accept a shared care request. Whether they do depends on the individual practice, local Integrated Care Board policies, and sometimes on how the diagnosis was reached. Some GPs are comfortable with shared care for private diagnoses, others are more cautious, and some decline it altogether, particularly if they feel they don't have enough specialist support locally.

Because of this, it's sensible to speak to your own GP practice about their general approach to shared care before you commit to a private assessment, rather than assuming it will be arranged automatically afterwards.

Why this matters for planning

If shared care isn't agreed, your options may include continuing to have prescriptions issued privately, which typically involves an ongoing cost, or exploring other routes such as NHS pathways. This is a genuine practical consideration for many people, not a technicality, so it's worth thinking through before you begin the private assessment process.

What a clinic can and can't guarantee

A reputable clinic can explain how they typically approach shared care requests, what information they usually provide to GPs, and how they support the process. What they cannot do is guarantee that any individual GP practice will agree, because that decision sits with the GP, not the clinic. Be cautious of any provider that suggests shared care is certain or automatic.

Right to choose and the NHS route

Some people explore the NHS "Right to Choose" pathway as an alternative or alongside private options, which can affect how assessment and ongoing care are organised. Rules and local availability vary, so it's worth discussing this with your GP directly if you want to understand your options.

Questions worth asking early on

• Does my GP practice have a shared care policy, and are they generally willing to consider it?
• Does the clinic I'm considering have experience working with GPs in my area?
• What would happen, practically and financially, if shared care isn't agreed?
• Is there a written shared care agreement or protocol that would be used?

A realistic, informed approach

Shared care can work well and is a common route for people diagnosed privately, but it depends on cooperation between the clinic, the GP and sometimes the local health system. Going in with realistic expectations, and having an early conversation with your GP, can help you avoid surprises later.

If you're currently taking medication or considering starting it, always follow the guidance of your prescribing clinician, and speak to your GP about any changes to your care plan.