ADHD service provision

High demand for adult ADHD referrals in Oxfordshire has led to a long waiting list of over two years. The service in its current form cannot manage so has had to pause any new referrals, until the situation improves. It will honour people that have already been referred before 5/2/2024.

National guidance expects long term involvement of specialists in reviewing these patients and their medical treatment, but this does not currently happen in Oxfordshire.

This Practice is therefore not able to provide comprehensive NHS services for adults with ADHD. Care of adults already receiving ADHD treatments remains under careful review. 

If you think you have ADHD, your GP will send you a text questionnaire to check for potential ADHD symptoms which, if responses are consistent with a possible diagnosis, leads to:

  • When possible, completion of local NHS ADHD referral - Not currently available
  • Given above, we signpost you to the Right to Choose option (more information below).
  • You choose an alternative private service yourself; though we cannot recommend a specific service and there are potential significant drawbacks with variability in service quality, we do suggest options on behalf of work done by BOB ICB, our local NHS Integrated Care Board.

What is Right to Choose (RTC)?

If you are based in England under the NHS you have a legal right to choose your mental healthcare provider (since 2018) and your choice of mental healthcare team. The provider must supply the service to the NHS somewhere in England. There are numerous providers, these are constantly changing and is best to get current information online. We have listed some below that give a reasonable quality of service at time of writing, but due to current pressures across the country this is being regularly updated and information may quickly become out of date.

How does RTC work?

You find a private clinic that supports RTC, you download the forms from their website. These forms may vary by provider. As it is a private option, technically we cannot initiate this referral, hence you need to complete the forms and return them to us to pass the referral on. 

Once accepted, the provider will complete a full assessment and diagnose as appropriate. They will discuss medication options, if this includes ADHD medication they will manage this. They will explore options, start medication and adjust to a therapeutic dose, once this is at a stable dose they will ask to discharge you back to the care of the GP. However, the Practice has taken the difficult decision that any new requests from specialists, both NHS and private, to prescribe ADHD medications to adult patients, will be declined. 

We will also be making this clear to providers of ADHD services, at the point we refer patients for a diagnostic assessment and include a copy of this information sheet with any RTC referrals sent to providers for clarity.

Care of adults already receiving ADHD treatments remains under careful review. Patients may be able to access the care they need outside of the NHS, for instance by seeing a referral to a private provider from their NHS GP or NHS specialist. As your NHS GP, we will not enter into "shared care" agreements with private providers. Since this is specialist medication and the prescribing decision rests wholly with the provider and not the GP, our Practice is unable to:

  • Perform baseline tests to establish suitability/safety of medication prior to initiation (eg bloods, ECG). Any such tests remain the responsibility of the prescriber (ie the provider) and we cannot perform these tests on their behalf.
  • Continue specialised ADHD medication. At this point, if a patient wishes to continue medication they will need to fund this privately and the provider will need to perform any associated monitoring checks, not the GP Practice.

RTC Providers for Adult ADHD

Below are the only two providers for adult ADHD which have undergone NHS quality assessment through NHS contracts by BOB ICB that remain open to referrals as of August 2024. Overall, the service must be a consultant-led service with a current NHS contract to be eligible for RTC:

Patients should not be left without the care they need, due to a lack of comprehensive NHS funding, and our local representatives have raised the issue with local funding and decision-making groups. If you also wish to raise this issue, you may want to contact the 'Planned Care Team' at BOB ICB, bobicb.plannedcare@nhs.net, and/or your MP.

Published: February 2025

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