This page sets out how ADHD and Autism assessments and treatment are commissioned and delivered within the NHS, and what this GP practice is able and not able to provide.

The practice follows NICE guidance, NHS England policy, and local Integrated Care Board (ICB) commissioning arrangements.

Please read this information carefully before contacting the surgery.

Children and Young People (Under 18 Years)

ADHD and Autism Assessment Pathway

For school-aged children, ADHD and Autism assessments are not initiated by the GP practice.

Referrals must be made via the school-led pathway, as schools are required to provide the detailed educational, behavioural and developmental evidence necessary for assessment. Referrals are made through CAMHS or Community Paediatrics.

Parents/carers should contact:

• The child’s school SENCo, or
• For pre-school children, the child’s Health Visitor or Early Years setting

The GP practice cannot initiate these referrals in place of the school.

Current NHS waiting times for ADHD and Autism assessments via Bedfordshire Community Paediatrics are approximately 3 years.

Right to Choose – Children

The GP practice does not routinely make Right to Choose referrals for children for ADHD or Autism assessments.

Right to Choose does not override locally commissioned children’s pathways. In Bedfordshire, ADHD and Autism assessments for children are commissioned through school-led services.

Requests for GP-initiated Right to Choose referrals for children will not usually be supported, as this falls outside the commissioned pathway and commonly results in delays.

Private or GP-Initiated Assessments (Children)

If parents/carers choose to pursue a private assessment or a GP-initiated Right to Choose referral for a child, please note:

• The practice does not enter shared care agreements with private providers
• The practice does not arrange or undertake blood tests, ECGs, physical monitoring, or baseline investigations for private services
• The practice does not complete forms or provide reports requested by private clinics
• All assessment, treatment, medication, monitoring, and follow-up costs remain the responsibility of the family

Following Diagnosis (Children)

If ADHD is diagnosed by an NHS specialist service:

• Treatment and medication are initiated and monitored by the specialist team
• The GP may only consider prescribing once a formal NHS shared care agreement has been issued

Shared care agreements from private providers are not accepted.

Adults (18 Years and Over)

Requesting an ADHD Assessment

Adults requesting assessment for ADHD must first complete an Adult ADHD Questionnaire.

Once returned, a GP appointment will be arranged to determine whether referral criteria are met and to discuss available pathways.

Due to demand, NHS waiting times for adult ADHD assessment in Bedfordshire and Luton currently exceed 5 years.

Right to Choose – Adults

Adults may request referral under NHS Right to Choose, where clinically appropriate.

Within Bedfordshire, Luton and Milton Keynes (BLMK), the only NHS-approved Right to Choose provider for adult ADHD is Psychiatry-UK.

Accordingly, referrals can be made to:

• Local NHS services, or
• Psychiatry-UK under Right to Choose

Referrals to other providers are treated as private assessments.

Medication and Prescribing (Adults)

Where ADHD is diagnosed by an NHS specialist:

• Medication is initiated and stabilised by the specialist service
• The GP may continue prescribing only once a formal NHS shared care agreement is received and accepted

The practice:

• Does not accept shared care agreements from private providers
• Does not carry out investigations or monitoring unless specified within an NHS shared care agreement

Shared Care Agreements – Processing Time

Patients sometimes request that shared care agreements from specialist providers are signed Patients sometimes request that shared care agreements from specialist providers are signed immediately. Unfortunately, this is not possible.

Before any shared care agreement can be accepted, the GP must carry out a clinical review of the patient’s medical record and the documentation provided by the specialist service. This review ensures that the diagnosis, treatment plan, and monitoring arrangements are safe and appropriate.

Because this requires a clinical review by a GP, shared care agreements:

• Cannot be signed immediately
• Cannot be processed during routine appointments
• Cannot be reviewed while a patient waits

Due to GP workload and the need for a full clinical review, the practice is unable to provide a specific timeframe for when a shared care agreement will be reviewed or completed.

Once the review has been completed, the GP will decide whether it is appropriate to enter into the shared care agreement. If accepted, the agreement will be completed and returned to the specialist provider.

Please note:

• Shared care agreements are not guaranteed
• The GP may decline if the criteria for shared care are not met

Patients should continue to follow the advice of their specialist provider while this review takes place.

Private ADHD Assessments (Adults and Children)

Where a patient chooses to access private ADHD assessment or treatment, the practice is not commissioned to support private care.

This means the practice will not:

• Provide blood pressure, weight, ECGs, blood tests, or other monitoring
• Complete forms or arrange investigations for private clinics
• Offer GP appointments for the purpose of supporting private treatment

All monitoring and treatment must be arranged privately.

This policy ensures NHS resources are used for NHS-commissioned care.

Important Information

• A private diagnosis does not guarantee acceptance by NHS services
• GPs are not obliged to enter shared care agreements
• Shared care is supported only with locally commissioned NHS services or Psychiatry-UK
• The practice acts in accordance with NICE guidance, NHS England policy, and local ICB commissioning decisions

If a Referral Is Not Accepted

If a referral is declined, the reason will be explained.

Where appropriate, advice will be given on whether further information can be provided or alternative support services accessed. The practice cannot progress referrals that fall outside commissioned pathways.

Useful Links

• NHS England – Right to Choose
• Psychiatry-UK – NHS Right to Choose (Adults)
• Adult ADHD Questionnaire (download)
• NICE Guidance: ADHD (NG87)
• ADHD UK – Right to Choose
• Bedfordshire & Luton Community Paediatrics – Referral Portal (for schools and professionals)
• Bedfordshire & Luton Community Paediatrics – Service Information