Frequently Asked Questions 

Who are your regulated by? 

Our clinicians are qualified pharmacist independent prescribers who are regulated by the General Pharmaceutical Council. 

Under what professional and legal frameworks can you assess and treat ADHD? 

All our clinicians go through a rigorous and clinically supported probation period of six months upon joining our service. Prior to assessing and treating ADHD, we ensure that clinicians have the necessary skills, knowledge and confidence to work independently and manage your care to a high standard. 
 
The NHS guidelines for Attention deficit hyperactivity disorder: diagnosis and management (NICE guideline [NG87]) advises that 'a diagnosis of ADHD should only be made by a specialist psychiatrist, paediatrician or other appropriately qualified healthcare professional with training and expertise in the diagnosis of ADHD’. All our clinicians have completed further training on assessment of ADHD in line with national best practice to ensure they can accurately diagnose the condition. Thus, we are 'appropriately qualified healthcare professional with training and expertise in the diagnosis of ADHD'. 
 
Pharmacists who have completed the independent prescriber training can legally prescribe autonomously for any condition within their clinical competence. All our clinicians have a scope of practice covering the management of ADHD and associated co-morbidities and can therefore manage your ADHD medication treatment. This enables them to assess and prescribe medication within a specialist area without the supervision from a psychiatrist or other suitably qualified professional. 

Are your assessment reports approved by NICE? 

There is no approval process for completing ADHD assessments in the UK. There are a set of recommended guidelines produced by NICE and groups of healthcare professionals who can appropriately complete ADHD assessments. We have never had the validity or quality of our ADHD assessment reports refuted by a GP, NHS organisation or educational institution. Our assessments are performed to a high standard and meet the recommendations set out in the National Institute for Health and Care Excellence (NICE) guideline 87; Attention deficit hyperactivity disorder: diagnosis and management. 
 
We have a robust process for completing assessments which involves collecting information for parents and family members and past school reports, even in adult assessments. For all children and adolescent assessments, we complete a computer-based performance test known as Qb Check for all patients. We often do this test for adults as well when collateral information from third parties is not available. On average, our assessments take between 4-5 hours to complete and are very detailed, covering all aspects of the patient's personal history, medical and psychiatric history, substance use issues, medication, family and developmental history. 

Once we agree to start medication how is it supplied to me? 

Due to the risk of diversion and loss of prescriptions associated with using multiple pharmacies, we use Signature Pharmacy as our single pharmacy provider to ensure the safe and timely dispensing and delivery of medication. Under exceptional circumstances, a prescription may be posted to a different pharmacy following a discussion between the patient or their parents and the clinician. If you wish to take medication to a pharmacy of your choosing, you can arrange to collect the prescription directly from our registered address in Redhill at a time which is mutually convenient for you and our staff. 
 
Common medications used to treat ADHD (e.g. methylphenidate, lisdexamfetamine) are classed as ‘controlled drugs’, meaning that there are specific legal stipulations about prescribing and supply. Outside of the NHS, prescriptions for Controlled Drugs can only be done on specific paper forms (FP10PCD), provided to us on behalf of our local NHS Controlled Drugs Accountable Officer. The original copy of each prescription must be posted to the supplying pharmacy before this can be legally dispensed. Therefore, controlled drug medication is usually delivered to you 3 working days after the prescription has been written. 
 
Prescriptions for non-controlled drugs (e.g. atomoxetine) are issued electronically through an electronic prescribing system, Signature Rx. These do not require an original copy to be posted to the pharmacy and the medication will usually be delivered to you within 1-2 working days. . 

What is the cost of ADHD medication on private prescription? 

All prescriptions issued do not include the cost of the medication or dispensing fee which is arranged by Signature Pharmacy. Below is a list of commonly prescribed ADHD medications and the monthly cost for each (accurate in November 2022). Note; these can vary month to month depending on supply shortages and manufacturing factors. 
Lisdexamfetamine 
£90 - £125 
Equasym XL 
£40-£110 
Concerta XL 
£54 - £115 
Methylphenidate I/R 
£35 - £50 
Affenid XL 
£25 - £60 
Dexamfetamine 
£65 - £120 
Xenidate XL 
£50 - £70 
Atomoxetine 
£100 
Medikinet XL 
£42-£110 
Guanfacine M/R 
£80 - £120 

Why can’t you send my ADHD report to my GP, so that they prescribe the medication instead? 

ADHD medications are designated as those which require specialist initiation and oversight which means that most GPs will not feel confident to start these medications. In most areas of the UK, GPs will have Shared Care Agreements with the local NHS mental health or ADHD service in which they will agree to continue ADHD medication once it has been started and/or stabilised by a specialist. The majority of these agreements do not specify that the specialist needs to work for an NHS organisation but some GPs will only accept shared care requests from NHS bodies. Therefore, you may want to check with your GP whether they are happy to accept a shared care request from a private provider before starting medication with us. 

How soon can my GP take over prescribing of this medication? 

It will usually take between three to four months to get the correct dose of medication once it has been started. If multiple medications need to be trialled due to problems with side effects or lack of effect then this period will be extended. Once ADHD medication is stable and effective, we can make a request to your GP for them to continue ADHD medication under a Shared Care Agreement. This agreement broadly outlines a request for the GP to prescribe your ADHD medication at a dose that works for you and complete certain physical observations at the correct intervals. We will continue to supervise your ADHD care and will meet every 6-12 months for a follow-up review to ensure that the medication is still effective and no intolerable side effects have developed. These reviews will need to continue as long as you are on ADHD medication. Although shared care is common practice across the NHS, you should note that GPs are not under any obligation to continue medication that has been prescribed privately for you or your child and may refuse to do so. 

How much can I expect to spend from the assessment to the point when I am stable on medication? 

Approximately £1500-£2000 for most people who are assessed and stabilised on the first medication that is trialled. 
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