FAQ for mid and south Essex residents- ADHD assessment and prescribing

Frequently Asked Questions about ADHD assessment and prescribing for people living in mid and south Essex areas.

In this section:

About ADHD medications

Frequent movement breaks: Movement can help the brain to focus and reset. It may help to provide extra fidget toys or schedule extra breaks throughout the day.

Schedule time for calming activities: ADHD can make it tricky to switch off. Schedule time into the day for calming activities like art, going for a walk, playing football, etc.

Try to stick to a routine: This can be hard for children and young people with ADHD, but it helps the brain to know what’s happening. This includes getting enough sleep. 

ADHD can make it harder to regulate emotions, can speak to friends and family if you are struggling or encourage your child to talk if they are struggling.

Keep in touch with school and make sure they are aware of any unplanned changes or pauses in ADHD medication and the impact of this on your child so they are aware and can look at the support they can provide in school.

Although medication breaks are safe for the majority of ADHD medications, pausing or reducing ADHD medication will have an effect on ADHD symptoms which will impact you or them at home, work or school. 

Please refer to the FAQ below “Is it safe to pause or stop ADHD medication” for more details.

Please be assured that there are no health risks if your child has an unplanned break in taking their ADHD medication, unless they are taking Guanfacine/Intuniv.

We understand that this may be difficult for you or your child but would like to reassure you that a temporary pause in taking ADHD medication won’t cause them any physical harm.

With most ADHD medication, you or your child can stop taking them, or take them on certain days and not others, without any ill effects.

Please see further details below for the different types of ADHD medication:

Atomoxetine: Stopping this will not cause any harm to you or your child and it can be stopped without ill effects. Taking atomoxetine some days and not others may not work well. It is usually best to either stop completely or to continue taking some every day.

Guanfacine / Intuniv: If your child is taking this medication it is very important to reduce slowly before stopping and this must be done under the guidance of your ADHD clinician.

Stimulant medication (Equasym XL, Concerta XL, Xenidate XL, Xaggitin XL, Elvanse): Stopping stimulant medication will not cause any harm to you or your child. You can stop taking this or use it only on certain days without ill effects. For example, you or your child can take medication on weekdays, but not on weekends or during holidays. You may also want to plan well in advance for children so that they have some medication for any significant events such as mock exams.  

Medication breaks are short periods of time when someone with ADHD is not taking their medication. Medication breaks are not appropriate for everyone. It will depend on each adult or child and the type of medication they take.

There are many reasons why a medication break can be helpful for you or your child.

If you are considering a medication break for yourself or your child, speak to your prescriber before stopping the medication.

If your child takes a medication break, make sure to tell their school or educational setting. This makes them aware of the situation and helps them to support you and your child properly. 

Questions about GP withdrawal from ADHD prescribing

ADHD medications require very careful monitoring and management. GP practices want to make sure they have the necessary expertise and resources to keep people safe.

When GPs prescribe ADHD medication they do so under a shared care agreement.

This is a formal local agreement that means the GP accepts responsibility for the safe prescribing and monitoring of specialist medicines. Read more about shared care agreements here.

ADHD prescribing isn’t included within GPs’ core contract. It is an optional service that GP practices can choose to provide.

Some GP practices may choose not to offer this service or may decide to stop offering it as it falls outside of their core contract.

If a GP practice decides to stop delivering this service, patients will be notified first. The responsibility for their prescribing will be transferred back to the patient’s specialist provider. Patients will be given a timeframe on when that would happen.

In the event that your GP practice chooses to withdraw from a Shared Care Agreement with your specialist provider, the following options may apply. These depend on whether you received your ADHD diagnosis from an NHS or a private service provider.

For NHS patients who received diagnosis by the locally commissioned NHS service: You will continue to be reviewed by your specialist provider and the local GP Federation will provide interim health check reviews. Your prescriptions will be managed by the local GP Federation.

You should wait to be contacted by the GP Federation. If you haven’t been contacted by a GP Federation before your current prescription runs out, you should contact your specialist provider.

For NHS patients who received diagnosis from a Right to Choose NHS specialist service: Dependent on your Right to Choose specialist provider, there are 2 options:

  • The Right to Choose provider may continue your annual reviews and take on prescribing for your monthly medication, OR
  • Your Right to Choose provider may enter a shared care agreement with the local GP Federation, who will provide the monthly prescribing and six monthly interim health check

Your Right to Choose provider should inform you on the next steps for your healthcare needs following successful titration.

For patients that privately funded their ADHD assessment: Following discussion with your GP, you can choose to either be referred back to the private specialist provider who provided your initial diagnosis, or into an NHS funded service.

Patients now have more choice for their care provider:

More information about this is provided in FAQs below.

Some specialist medications are only safe for GPs to prescribe under a ‘Shared Care Agreement’ – which includes ADHD treatments. 

GPs do not have to prescribe shared care medications if they feel unable to do so or if they are not able to do this in a safe manner.

ADHD prescribing and ongoing monitoring is not part of the core contract the NHS holds with GP practices. This is a core part of the requirements of ADHD specialist services.

Recently, the local medical committees (LMCs) in both Essex and Suffolk recommended that GPs stop prescribing ADHD medications and that responsibility for this should go back to ADHD specialists. As a result, some local GP practices have chosen to withdraw from the service.

This depends on where you live in Essex.

Find out about local arrangements for residents living in the mid and south Essex area.

Find out about local arrangements for residents living in the Colchester and Tendring regions of Essex.

In addition, NHS Essex has commissioned more specialist providers to provide ASD and ADHD assessment, which means patients now have more choice for their care provider.

Some GP practices have shared care agreements with specialist providers.

These are agreements that enable the GP to accept responsibility for the safe prescribing and monitoring of specialist medicines for a patient.

More information about this can be found on Shared Care Agreements.

Questions about private ADHD diagnosis or treatment

GP practices will discuss the following options with patients who have received care from a private provider (not from an NHS funded service):

1. With the patient’s consent, they are referred back to privately funded specialist services for ongoing ADHD medication prescribing and monitoring. The patient would be responsible for continuing payment for private treatment.

2. With the patient’s consent, they are referred to an NHS funded specialist provider.

NHS Essex has commissioned more specialist providers to provide ASD and ADHD assessment, which means patients now have more choice for their care provider. 

Patients may wish to seek further information on Right to Choose and the available providers via the Right to Choose ADHD UK Website. Please note that this is not an NHS website but provides useful information on service provision.

If you wish to be referred under Right To Choose to a provider that is not one of the locally commissioned service providers, you will need to:

  • check what services the provider offers
  • confirm whether treatment (such as medication) is included

If you request a referral to an NHS funded specialist provider you may request your GP practice to continue prescribing in the meantime. The choice to continue prescribing or not would sit with the GP, as it is not part of the core contract the NHS holds with GP practices. 

NHS clinicians are encouraged to follow NICE guidelines where possible. NICE guidelines are evidence based recommendations for health and care in England and Wales. NICE guidelines are developed with the help of health and care professionals, people who use services, and carers. They cover many aspects of a condition, including prevention, treatment, and education. NICE guidelines are subject to regular review and may be updated or withdrawn.

Private specialists do not have to follow the same NICE guidelines as NHS specialists. This means the local NHS cannot always be sure that patients seen privately have had the same assessments, diagnosis, treatment, and care they would have received if they had been seen by an NHS specialist.

That is why assessment by an NHS clinician is required when a patient wishes to transfer from private care to NHS care.

If patients have privately funded care and wish to return to NHS care, they will need to be assessed by an NHS clinician. This can be done via GP referral to an NHS funded service.

Please be aware this would be a new referral, and patients transferring from privately funded care will join the end of any existing waiting list for that service.

No patients can be given preferential treatment on the NHS waiting list. Therefore all new referrals are added to the end of a service’s waiting list, regardless of whether the patient accessed part of their care or diagnosis privately, or otherwise.

NHS Essex has commissioned more specialist providers to provide ASD and ADHD assessment. This means patients now have more choice for their care providers with shorter waiting times.

Further information for patients considering privately funded care is available on our Private healthcare and NHS care in Essex page.

There are lots of considerations that patients should take into account when considering whether to go private.

Further information for patients considering privately funded care is available on our Private healthcare and NHS care in Essex page.

Questions about ADHD diagnosis or treatment from Right to Choose providers

The ICB has been made aware that Holistic ADHD Solutions Ltd (trading as ADHD.net), an independent Right to Choose provider for Adult ADHD services, has been issued with a Suspension Notice (GC16) by their commissioning ICB. This means they have to pause services immediately. 

GP practices in mid and south Essex have been advised not to action any patient requests for referrals to this Right to Choose provider. This provider is not commissioned to provide services for mid and south Essex patients. 

Patients have the right to choose who provides their ADHD care. The ICB has commissioned additional Adult ADHD specialist service providers offering patients have more choice for their care provider.

Patients are encouraged to select providers that are commissioned within our local care system. While patients’ right to choose remains protected, choosing a provider that is part of the locally approved network means patient care is safe, coordinated, and aligned with local NHS pathways.

If a patient is diagnosed and prescribed medication by a provider (either private or NHS) under the NHS Right to Choose scheme and they request ongoing prescribing from the patient’s GP, it is up to the GP to decide whether to accept this or not.

If the patient’s GP does choose to take on the ongoing ADHD medication prescribing, the practice would enter into a shared care arrangement with the Right to Choose provider.

Find out more information about Shared Care agreements.

There are many service providers available to patients under Right to Choose (RTC).

Some of these providers offer private service, some offer NHS services, and some providers offer both.

You may wish to seek further information on RTC and the available providers via the Right to Choose ADHD UK Website. This website lists providers and shows if they offer private or NHS RTC services. Please be aware that this is not an NHS website, but it provides useful information on services.

If you wish to be referred under RTC, you will need to research what services the provider offers. Some providers only offer assessment and diagnosis, which may mean you need a further GP referral to a different service provider for treatment.

Referrals for RTC must come from a GP. Patients choosing a RTC provider should undertake their own research into available providers to make sure they are suitable.

Find out more about Right to Choose.

In many cases patients have the legal right to choose where they have their NHS treatment.

The NHS is offering more and more options to enable patients to make choices that best suit their circumstances and give them greater control of their care.

Referrals for Right to Choose (RTC) must come from a GP.

Patients can choose a clinical team led by a consultant or named healthcare professional, if that service provides the treatment you require, and they have an NHS contract.

Patients choosing a RTC provider should undertake their own research into available providers to ensure they are suitable.

Find out more about Right to Choose.

Other resources and contact information

Pupils with ADHD may experience additional challenges when taking exams.

Reasonable adjustments can be requested to support pupils with ADHD.

The ADHD UK website has a template letter to use when requesting additional time or a separate examination room. The Young Minds website has tips for managing exam pressures.

ADHD Support for additional exam time

Support for separate exam room

Exam Tips for Neurodivergent and Disabled Students | YoungMinds

Essex Partnership University Trust (EPUT) offers Attention Deficit Hyperactivity Disorder (ADHD) Services in Essex.

Visit the EPUT website for information about the different services, and the areas of Essex they cover.

There are four services that EPUT provide for neurodevelopmental conditions within Essex and they all differ slightly.

Families can look at the relevant authority local offer pages and/or NHS provider websites for additional advice and support.

North East London Foundation Trust’s Community paediatric services

Essex Partnership University Trust: Neurodevelopmental support

Provide’s Community Paediatrician Service

We hope you have been able to find the information you needed on these FAQs.

Please note that NHS Essex is unable to answer questions about individual patient’s circumstances, or offer clinical advice.

If you would like to raise a Complaint, please contact the NHS Essex Patient Experience team: Feedback about NHS services in Essex | NHS Essex