ADULTS – GPs are not able to directly refer adults for NHS ADHD/Autism assessments and diagnosis. The current self-referral pathway put in place by our local ICB (Humber and North Yorkshire Health and Care Partnership), requires patients to complete a self-assessment tool online (The Do IT Profiler), to assess eligibility.
If the details provided by you meet their acceptance criteria, your referral will be sent on to the The Retreat (who run The Tuke Centre in York) for triage (this is the designated provider in our region for NHS assessments for ADHD and Autism). If the criteria are not met, you will be given the option of remaining on a waiting list which is managed by the ICB.
If your wish to complete this self-assessment pathway, please follow the link below to log onto The Do IT Profiler
https://doitprofiler.net//account/clientlogin/aa73218c-7caa-4b81-93fc-c7f5da0691be?a=Register
This cannot be completed by your GP.
Right To Choose
We are aware that NHS services for ADHD/Autism assessment, diagnosis and treatment are unfortunately limited, with extensive waiting times. An increasing number of patients are therefore choosing to access private providers, sometimes under the NHS “Right to Choose” rules. More information available here regarding “Right to Choose”.
Before using the “Right to Choose” please be aware of the following:
- Previously we had been advised that in this area adults were only eligible to use the NHS “Right to Choose” pathway if the Do IT Profiler tool identified someone as eligible for assessment on the NHS – as of 21/11/24 we have been advised this is no the longer the case.
- However, the provider you are choosing must have a contract with NHS England for the required service.
- However, the provider you are choosing must have a contract with NHS England for the required service.
- The “Right to Choose” pathway will not fund subsequent non-NHS prescribing costs or review appointments, only the initial assessment and diagnosis is funded by the NHS.
- The GP practice would not be able to perform any investigations, physical health checks or ongoing monitoring on behalf of a private provider (whether or not you were referred under the NHS “Right to Choose”), as this is the specialist provider’s contractual responsibility, even if they operate a remote access tele-health service.
Shared Care Prescribing for ADHD medication
Medication for ADHD can only be initiated by a specialist and must continue to be supervised long term by a specialist. Most of the medications used are legally classified as Controlled Drugs, which means that a maximum of 28 days prescription can be issued at a time.
What if I am seen under the NHS? – If you are assessed under the NHS pathway at The Retreat clinic in York, they may initiate you on medication if considered appropriate. Once a patient has been on a stable dose of medication for at least 3 months, we will usually take over ongoing prescribing from The Retreat, under a “Shared Care Agreement”. Patients remain under the care of the specialist and will be required to have ongoing reviews (usually annually and additional interim reviews if deemed necessary due to change of symptoms, side effects, or other medication queries). We will only be able to continue prescribing if you keep up-to-date with the required physical monitoring and reviews.
What if I am seen privately or as a ‘Right to choose’ referral? In deciding whether we are able to undertake shared care with a provider we are informed by BMA guidance on GP responsibilities working with private providers, as well as the detailed NHS England guidance on prescribing between providers.
Due to these considerations we are therefore unable to enter into a “Shared Care Agreement” with any private provider without careful consideration.
The only private provider with who we do have a “Shared Care agreement” in place for adults is PsychiatryUK. This is because we are satisfied that their level of monitoring and follow up meets the standards needed for us to safely undertake shared care.
This means that if you choose to initiate medication in the private sector (even if this was through a NHS “Right to Choose” referral), you will be required to continue to fund this long term, whilst you remain under their care, with periodic reviews by that provider. Please ensure that the private provider has a copy of this information, if you go ahead with your assessment, so that they are fully informed.
Please remember that a “Right to choose” referral only covers NHS funding for the assessment but not any prescribing or monitoring.
Can I transfer to the NHS for my prescriptions? Referrals for Medication monitoring and Shared Care at the The Retreat in York (NHS)
If in the future, you wish to transfer your care to the NHS, we can refer you to the local NHS commissioned service (The Retreat clinic at The Tuke Centre in York), at your request, so long as you provide the information listed below, and they agree to enter a shared care arrangement with us.
Please be aware that the NHS service will assess what you have been prescribed and ensure it fits with national guidance. It is not guaranteed they will support all drugs initiated by a private specialist
In order for The Retreat to share care with us on the NHS, you must provide us with all of the following:
- Your original ADHD diagnostic report.
- A full medication and prescribing history from your current specialist.
- The most recent clinic letter from your last review with them, with details of your most up-to-date physical monitoring.
Once we have received all this, we can then make a shared care referral to The Retreat.
Depending on the source of your diagnosis, it is possible that The Retreat will not recognise this and may not agree to take over prescribing on the NHS. If all the necessary information is received by The Retreat and they are satisfied, then they will sign a shared care agreement, and return this back to us (this process may take a few weeks).
Once we have received the “Shared Care agreement”, we will be able to take over the prescribing of your medication on a monthly prescription. Until we have received approval for shared care from them, you will be required to continue to obtain your prescriptions from your original provider.
Please note that we will only be able to continue ongoing NHS prescriptions of your medication if you keep up-to-date with the required physical monitoring and reviews. If we do not have this information we will no longer be able to safely prescribe for you.
Disabled Students’ Allowance applications – GP practices are not able to provide evidence for Disabled Students’ Allowance (DSA) applications. If you are waiting for assessment through this route, the Do-IT-Profiler will provide a standard letter, signed by an ICB GP, which patients can then pass to the University.