Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if his Department will issue guidance to (a) GP practices and (b) Integrated Care Boards on shared care agreements for ADHD patients diagnosed privately in line with NICE guidelines.

General practitioners (GPs) are independent contractors that provide services within the National Health Service. The General Medical Council (GMC) has published the guidance, Good practice in proposing, prescribing, providing and managing medicines and devices content. This includes guidance on shared care arrangements between a specialist service and the patient’s GP to help GPs decide whether to accept shared care responsibilities for any condition. The guidance is available at the following link:

https://www.gmc-uk.org/professional-standards/the-professional-standards/good-practice-in-prescribing-and-managing-medicines-and-devices/shared-care

NHS clinicians need to be content that any prescriptions, or referrals for treatment, are clinically appropriate. The British Medical Association has issued guidance, underpinned by the GMC guidance, which outlines that shared care with private providers is not recommended due to the general NHS constitution principle of keeping as clear a separation as possible between private and NHS care. Shared care may be appropriate where private providers are providing commissioned NHS services and where appropriate shared care arrangements are in place. All shared care arrangements are voluntary, so even where agreements are in place, practices can decline shared care requests on clinical and capacity grounds.

If a shared care arrangement cannot be put in place after the treatment has been initiated, the responsibility for continued prescribing falls upon the specialist clinician; this applies to both NHS and private medical care.

We are supporting a cross-sector taskforce that NHS England has established to look at attention deficit hyperactivity disorder (ADHD) service provision and support across sectors, and their impact on patient experience. The taskforce is bringing together expertise from across a broad range of sectors, including the NHS, education and justice, to better understand the challenges affecting people with ADHD including timely access to services and support.