In recent years, awareness of adult ADHD has grown significantly, leading to a rise in people seeking assessments. Due to high demand, waiting times for NHS ADHD assessments can be extremely long, sometimes up to five years.

As a result, many patients choose to pursue private assessments to obtain a diagnosis more quickly. While this can help expedite care, it’s important to understand how this decision affects access to NHS prescriptions and ongoing support.

What is Shared Care?

Shared care refers to an arrangement where an NHS specialist and a GP work together to manage a patient’s treatment. This often involves the specialist initiating treatment and the GP taking over aspects such as prescribing and monitoring, if they agree to do so.

• A GP is not contractually obligated to enter into a shared care agreement.
• Shared care is only appropriate if a specialist continues to be involved in the patient's treatment.
• The GP must be satisfied that it's safe, appropriate, and supported by necessary systems and oversight.
• Shared care must not result in a complete transfer of responsibility to the GP without specialist involvement.

Some private providers have presented these agreements as "shared care" while fully shifting the prescribing burden to the GP - without the necessary expert support or oversight.

Our Policy on Shared Care with Private Providers

The BMA advises 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 is currently set up as an NHS service, and entering into a shared care arrangement may have implications around governance and quality assurance as well as promoting health inequalities. A private patient seeking access to shared care should therefore have their care completely transferred to the NHS. 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. The responsibility for the patient’s care and ongoing prescribing then remains the responsibility of the private provider.

Under the NHS Right to Choose, you have the option to select a provider for your ADHD assessment, including private providers offering NHS-funded services. While this offers greater choice and flexibility, it is important to understand the implications for your ongoing care should you receive a diagnosis and begin treatment.  

We strongly advise checking with your chosen provider about their long-term care arrangements before proceeding with an assessment.  Specifically, you should confirm:

• Whether they will continue overseeing your ADHD treatment and medication management as Brookfield Park Surgery is unable to prescribe ADHD medications for patients who are diagnosed via the right to choose pathway.
• The process for ongoing prescriptions and follow-up appointments.

If a provider does not offer long-term support and the continuation of medication, you may need to explore alternative providers via the Right to Choose pathway to ensure you receive the necessary ongoing care. 

As a result, Brookfield Park Surgery will not be starting any new shared care agreements with private providers. 

We are truly sorry for the inconvenience and impact this may have.

You can now view your GP record online.  You will be able to see information such as your medications, allergies, test results, immunisations, and illnesses.

You can also book and cancel appointments and order repeat prescriptions online. 

Your GP record can be viewed on a computer, a tablet, or a smartphone, using a website or an app.  This means that you can look at your GP record online 

whenever you want, without needing to print it.  Your GP online record is up-to-date and more secure than a printed version which could be lost or seen by others. 

You can also look at your online record after your appointment to make sure you understood what your doctor or nurse told you. 

Your GP record is written to help medical staff look after you.  This means that sometimes you may not understand everything you see.  If you find something you 

don’t understand, you can go to the NHS Choices website - www.nhs.uk.  NHS Choices is the NHS website for patients where you can look for information about illnesses, how to look after yourself, and find NHS services in your local area.  If you have further questions about what you read, you can talk to your doctor or nurse. 

In some cases, your GP may think it would not be good for you to look at your GP record online. If this happens, your GP will talk to you about it.  It is up to your GP to decide if you should be allowed access to your online record.  You cannot change information in your record yourself. 

If you would like to start using online services, see the 'GP online services@ guide for more information www.nhs.uk/GPonlineservices’

We are improving the way we work with patients with long-term conditions

Patients living with certain long-term conditions will be encouraged to attend a Yearly Health Check. Long-term conditions are those that impact over a long period of time, such as diabetes and heart diseases.

 Patients will receive personalised care and support from healthcare professionals from their general practice. This will cover things that patients say matter most to their health and wellbeing, from the best treatment for their condition, to wider things like employment, housing, and mental health.

 Our goal is that by planning care together with care, patients will have the confidence to manage their health, reduce their risk of being admitted to hospital, and have a better quality of life.

Who is this for?

Initially, we will cover nine long-term conditions:

• Cardiovascular disease (for example, strokes, health failure, ischaemic heart disease, and peripheral artery disease)
• Diabetes
• Hypertension (High blood pressure)
• Hyperlipidaemia (High cholesterol)
• Non-alcoholic fatty liver disease
• Atrial fibrillation
• Chronic kidney disease
• Asthma
• Chronic obstructive pulmonary disease.

 In the future, we will look to expand this to cover more long-term conditions.

What can you expect?

If you have one of the long-term conditions listed above, you will be encouraged to have at least three check-ins per year. Each stage is described below for you:

1. Attend your Check and Test Appointment

In your Check and Test Appointment, a health professional will carry out all the checks and tests you need to monitor and manage your long-term condition. You may be sent for a blood test and have other checks like a blood pressure check and weight check. We may discuss lifestyle factors such as smoking and exercise with you too.

 If you need an interpreter, please let us know so we can arrange one for your appointment.

2. Receive your test results and your Care Plan

After two to four weeks, you will receive your test results (by post, text, or email, however you prefer).

We will also send a blank document called a Care Plan.

 A Care Plan is an agreement between you and your healthcare professional to help manage your health and support day to day. In your Care Plan, you can record things that are important to your health and wellbeing. This can include anything from your life, like employment, housing, or mental health.

 A Care Plan covers:

• What is important to you and the goals you have
• How to get the most out of your medication
• The care and support you need from others

 A healthcare professional will review your Care Plan with you in your Discussion Appointment. You can start filling out your Care Plan before your appointment or you can fill it during your appointment.

3. Attend your Discussion Appointment

You will then be invited to a Discussion Appointment with a healthcare professional. This may be another team member (such as a nurse, health care assistant, pharmacist, social prescriber link worker) who is best placed to support your care and can spend more time with you. This appointment will take around 30 minutes.

 You can discuss your long-term conditions, test results, treatment, and anything else that is affecting your health, from housing to employment. Together we will look at what matters most to you and agree some goals. Your Care Plan will be updated with what has been agreed.

4. Attend your Follow-Up Appointment

Three to six months later, you will be invited to a Follow-Up Appointment. This will last up to 15 minutes and is an opportunity to update your Care Plan with a healthcare professional, considering what is going well and where you may need more support. You may have more than one Follow-Up Appointment in a year.

 Watch the short film below to see an example of a patient’s journey through the key stages of the process and help you understand what to expect from your Yearly Health Check.

 With subtitles - https://youtu.be/2uNlBbuHflY

 Without subtitles - https://youtu.be/FhTbMDLpMQ0

 How will I be contacted if this is for me?

We will contact you via text, phone call, or letter to organise your appointments. We will contact patients over the year so please do not worry if you do not hear from us right away. If you are concerned or have questions, please contact us.