What is a Shared Care Agreement for ADHD?

It's an arrangement where an ADHD specialist starts and stabilises your medication, then your NHS GP takes over the routine prescribing and monitoring at NHS prescription cost. It's how people avoid paying private prices for medication long-term.

Can a GP refuse a Shared Care Agreement?

Yes. Shared care is voluntary for GPs, and some decline — often citing workload, lack of confidence with ADHD medication, or local policy. If yours refuses, you can ask why in writing, try another GP in the practice, or raise it with your Integrated Care Board.

How much does ADHD medication cost with shared care?

With a Shared Care Agreement, you pay the standard NHS prescription charge (or nothing if you're exempt or have a prepayment certificate). Without it, private ADHD prescriptions can cost considerably more each month.

Do I need a Shared Care Agreement if I was diagnosed privately?

Only if you want your NHS GP to take over prescribing. Many people get a private or Right to Choose diagnosis, then request shared care to bring medication costs down to NHS levels. It's worth checking your GP's willingness before you pay privately.

ADHD Shared Care Agreements, Explained

A Shared Care Agreement is an arrangement where an ADHD specialist starts and stabilises your medication, then hands the routine prescribing and monitoring to your NHS GP — so you pay NHS prescription prices, not private ones. It's how most people make ADHD medication affordable long-term. The catch: shared care is voluntary for GPs, and not all of them accept it.

Why shared care exists

ADHD medications need careful initiation and dose-finding (titration), which a specialist does. But once you're stable, that ongoing monthly prescription is routine — and there's no reason to keep paying a specialist (or a private pharmacy) for it. Shared care lets your everyday GP take it over at NHS cost, with the specialist available for advice if needed.

How it works

1. A specialist diagnoses you and starts your medication, adjusting the dose until you're stable.
2. The specialist writes to your GP proposing a Shared Care Agreement, with the details and monitoring plan.
3. If your GP accepts, they take over prescribing — you collect NHS prescriptions as normal.
4. You have periodic reviews (blood pressure, heart rate, height/weight, effectiveness).

The part to check before you pay for a private assessment

Here's the trap people fall into: they pay for a fast private diagnosis, start medication, and then discover their GP won't accept shared care — leaving them paying private prescription prices indefinitely. Ask your GP surgery whether they accept shared care for ADHD before you commit to a private route. Some practices have a blanket policy; some decide case by case.

What if my GP refuses?

GPs can decline shared care, often citing workload or lack of confidence with controlled drugs. If yours does:

Ask for the reason in writing.
See whether another GP in the practice will.
Raise it with your Integrated Care Board (ICB) — they commission the service and can sometimes help.
Note that a Right to Choose NHS assessment can make shared care more straightforward than a fully private one, because it's already within the NHS.

Where this fits in the bigger picture

Shared care is the last piece of the diagnosis-to-treatment journey. If you're at the start of it, the full guide to getting an adult ADHD diagnosis in the UK covers all three routes, and what to expect in the assessment itself covers the appointment.

A note for parents

Sorting medication is one piece; living and parenting well with ADHD is another. Present: Parenting with ADHD is the warm, practical companion for the rest of it.

> Nothing here is medical advice — it's lived experience, meant to sit alongside real support, not replace it. If you're struggling, please see the support resources. If you're in crisis in the UK, call Samaritans free on 116 123, or dial 999 in an emergency.