Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps his Department is taking to ensure that patients continue to receive ADHD medication without cost when their shared care agreement has come to an unpredicted end.

It is the responsibility of integrated care boards in England to make available appropriate provision to meet the health and care needs of their local population, including access to medication services for attention deficit hyperactivity disorder (ADHD). Services are underpinned by relevant guidance from the National Institute for Health and Care Excellence (NICE), which provides evidence-based guidance for the health and care system on best practice.

It is for the responsible clinician to decide on the most appropriate treatment plan to manage ADHD, in discussion with their patient. This decision is based on the clinician’s expertise regarding treatment options, evidence, risk and benefits and the patient’s personal circumstances as part of a shared decision-making process. The NICE guideline on the diagnosis and management of ADHD provides recommendations that healthcare professionals should account for when considering treatment options.

Shared care within the National Health Service refers to an arrangement whereby a specialist doctor formally transfers responsibility for all or some aspects of their patient’s care, such as prescription of medication, over to the patient’s general practitioner (GP).

The General Medical Council (GMC), which regulates and sets standards for doctors in the United Kingdom, has made it clear that GPs cannot be compelled to enter into a shared care agreement. Shared care is not part of the GP contract and as such, participation is voluntary. GP practices may decline such requests on clinical or capacity grounds. A GP who has previously agreed to a shared care agreement but can no longer support it must provide a clear rationale for their decision. Both the GP and the specialist clinician share responsibility for ensuring continuity of care for the patient.

ADHD medication prescribed by an NHS doctor is subject to prescription charging, unless the patient meets the criteria for a prescription charge exemption. This is the case regardless of a shared care agreement being in place.