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Practice Policy for ADHD Diagnosis made Privately, Overseas and newly diagnosed NHS patients.

Newly Diagnosed NHS Patients

Prescribing and titration of ADHD medication is a specialist area.

At present we are awaiting guidance to be agreed between the psychiatry service and general practice to ensure that we are able to prescribe ADHD medications safely and with appropriate monitoring. Psychiatry have advised that an ADHD medication monitoring, and titration, service for newly diagnosed patients should be in place at some point this year in 2024.

Until this time Newburn will be unable to start any new patients on ADHD medications. It may be possible that your psychiatrist will agree to monitor and prescribe this medication in the interim and we would advise you discuss this possibility with them. Our primary aim is to ensure that we prescribe these medications safely with appropriate governance in place. We thank you for your understanding.

Private/Overseas Assessment Vs NHS

There are private services which can offer shorter wait times to assessment. However, these are not regulated and standardised in the same way that NHS services are. This means that any suggestions or medications started by a private provider cannot be continued and prescribed by GPs at our Practice. We do not engage in Shared Care Agreements with private providers.

If you have moved to our practice from a different practice within Aberdeen or other parts of the country/overseas and are looking for a prescription for your ADHD medication, please note that we will only be able to prescribe this if we have clear documentation of your NHS diagnosis. Your previous GP may have agreed to prescribe your medication under a Shared Care Agreement with a private provider. Please note that we do not do this at our Practice and we will not be able to continue your prescription until NHS review has been sought.

What is ADHD?

Attention deficit hyperactivity disorder (ADHD) is a condition which can affect a person’s ability to concentrate and control their own behaviour and impulses. These features generally first appear in childhood, often affecting someone’s school and home life, and often improve with age as the person matures and develops ways to manage these traits.

These traits are very common, and experiencing features such as these does not mean you have ADHD. Most people are able to manage and adapt their thought processes and organisational skills to lead completely normal lives. Referral and other management methods, such as medication, can only be used if these methods are unsuccessful and the person’s life, work, and relationships are significantly affected.

Resources which may help with this can be found further down the page.

Traits and features you might experience

ADHD can be separated into two parts: attention deficit, and hyperactivity. Some people only experience the attention deficit traits, and this is called attention deficit disorder (ADD).

Some of the traits you may have noticed could include:

Attention deficit features: short attention span, being easily distractible, organisation and timekeeping difficulties, seeming forgetful or careless

Hyperactivity features: an inability to sit still, impulsivity, fidgeting and having to be constantly on-the-go, restlessness and risk taking

Self-help and other useful resources

ADHD traits can often be managed by non-medical methods such as self-help, group support, exercise therapy and developing coping strategies. The following links may be helpful in better understanding and managing your condition:

NHS ADHD information page

Royal College of Psychiatry ADHD information

 Scottish ADHD Coalition

Procrastination Station

The ADHD Foundation

We would recommend these resources in the first instance, as many people are able to manage without requiring specialist input. If you find they are not helpful, we may be able to discuss referring you for formal assessment by our specialist colleagues.

How to get a diagnosis

Severe cases of ADHD require specialist assessment and are managed by the psychiatry team. For a referral to be considered, the GP will need to take a history and complete some screening tests. If you think you may have ADHD and would like to be considered for formal assessment, please contact our care navigation team.

The conversation and awareness around ADHD traits has increased massively in recent years. Unfortunately, this means the service is extremely busy and the waiting list time for assessment is over 2 years in Aberdeen.

Following an NHS diagnosis and management plan, the specialist team may request us to continue any monitoring or medication in General Practice. This is normally done using a Shared Care Agreement which is a recommendation by NICE guidance, whereby specialists initiate treatment, and we are able to continue this under their careful guidance and follow up. At present there is no shared care agreement in Grampian, and this is an area being discussed by local policymakers.

As with any medication, it is not without risk of side effects, and they will not work for everyone. There are many other options for self-help

and non-medicinal ways to manage your symptoms, some links to useful websites and resources can be found above.

ADHD Self Help Resources

Medication is just part of the solution for ADHD treatment, a piece of the puzzle, but it is absolutely not the whole picture. There are plenty of non-pharmacological options for treatment which many will find beneficial, and this approach may be suggested by your doctor in addition to, or instead of, taking medication. The ADHD Foundation have a wide range of videos, podcasts and downloads to help with concerns such as sleep support, preparing for exams, impulse control and risk management, supporting social skills and relationships, and staying calm and positive.

CBT is very helpful for many people with neurodiversity. Low self-esteem is prevalent, as many people will have frequently been told that they are lazy or disruptive on a regular basis, and the frustration with not being able to achieve as they would like to can be difficult to come to terms with. CBT can also be helpful for those common issues such productivity, executive function, problem solving, and active listening skills.

There is good range of free CBT modules on CCI and NHS Scotland has a free module on problem-solving.

There is now a plethora of apps to help people with ADHD. Time management is a perennial issue and there are apps that help to organise time, block distractions for a period of time, track how much time is being spent on activity and assist in managing procrastination. There is a good overview of apps on the ADDitude site and a good round up from Devon NHS Trust .

Sleep disturbance is an incredibly common issue in ADHD and the ADDISS website has a very useful download for parents who are struggling to manage their child’s ADHD sleep and the ADHD foundation has a page of different resources here.

Exercise is well recognised for its mental health benefits and anecdotally helps keep the fidgets at bay. In addition, it has become more apparent that the benefits go further than this in ADHD, helping to improve attention, impulsivity and executive functioning. NHS Lothian have put together a useful resource pack for guiding patients through the self-help.