A guide to ADHD and Autism assessment referrals.
An increasing number of patients are requesting referrals for ADHD and ASD assessment. Haxby Group Practice must follow the NHS guidelines in how we refer. These are explained below.
Haxby patients can choose to be referred to the usual local service or be referred via Right to Choose to any service in England that offers Right to Choose assessments.
Option 1) Local Referral
We will send you a link to an online pre-assessment to see if you meet the criteria for onward referral. You then follow this process, which includes referral to the local service. This is the local NHS process.
Option 2) Right to Choose Referral.
You (the patient) need to choose a service that offers Right to Choose assessments. If a service does offer Right to Choose, it means they are the recognised NHS service for their area and have an NHS contract so you can be assured they are qualified, are CQC registered, have good data protection processes etc just like any NHS service. The local NHS are responsible for ensuring this for you.
The benefits of using a Right to Choose service somewhere else is that the waiting list may be shorter than your local service. The assessments and advice will generally be very similar.
Restrictions:
The NHS in our area has put one restriction in place for Right to Choose. Any service you choose must also be able to prescribe your medication. We are not permitted to refer you to a service that does not prescribe. However, we are not always aware of which services do and which do not prescribe, so the onus is on you to ensure this is the case.
Next steps:
Let us know which service you want to be referred to and make sure you have completed all the pre-referral paperwork. This is often an online form. Let us know how to make the referral – is it a link, a form, a letter? Who do we write to. We need this information to be able to make the referral for you as we do not have a database of all services in England.
Shared Care Prescribing for ADHD.
Once a diagnosis of ADHD has been made it is common for patients to be started on medication to help symptoms. It is not always possible for your GP to continue these medications. There are lots of NHS restrictions that we have to abide by. Please note, these are not our restrictions, they are the restrictions put in place by the local NHS authority.
In order to for us to be able to prescribe ADHD medication all the following must be true.
- The diagnosis must have been made by an NHS funded service
- The medication must have been started by an NHS funded service
- The medication must have been started by the same service that completed your assessment. This is why you must choose a service that offers both assessment and prescribing.
- You must not be discharged from the service at any point while you are on medication. This means you will be under their care for many years, sometimes decades, and need to factor this into your decision. You may have to travel there a few times a year for your reviews.
- The chosen ADHD service must provide clear and robust shared care guidelines, and stick to them, forever.
If all this is true, then we can ‘share care’ with your ADHD service, which means we can prescribe medication for you on their behalf. We can carry out any monitoring needed if this is requested (usually blood pressure, heart rate, body weight etc).
If any of these factors is not true, then we cannot ‘share care’. It is not that we do not want to, it is that we cannot do so within our NHS contract.
FAQs
I had a private diagnosis, but went Right to Choose for medication. Can the GP do my prescription?
- No, if you had a private diagnosis we are not able to share care with your NHS-provided service that has done your medication.
I had a diagnosis outside the UK, can I be referred locally to Right to Choose
- Yes. Diagnosis by services is generally only recognised if it is has been made within the UK. The only way through the system is to start again with a new referral, as if no diagnosis has been made. You can do this locally, or through Right to Choose.
I have an NHS diagnosis and medication but I am no longer under their care, can you continue my medication.
- No. As soon as you are discharged from the ADHD service your prescription from us must stop. We are only allowed to prescribe on behalf of the ADHD service, and are technically under their supervision. As soon as this stops, we have to stop your prescription. If this has happened we will act on your behalf to try and get your care reinstated with the service as soon as possible.