What Happens if Your GP Refuses an ADHD Shared Care Agreement?

A refusal doesn't mean treatment has to stop. This guide explains what happens next, who's responsible for your medication, the options you may have, and the questions worth asking.

A GP may decline an ADHD shared care agreement for a number of reasons, such as:

• they don't feel they have the expertise to manage the medication safely
• local NHS policies don't support shared care with your provider
• they need more information about your assessment, treatment or monitoring
• the specialist can't commit to ongoing reviews and support
• the practice doesn't have capacity to take on the extra monitoring

A refusal is usually about whether the arrangement is safe and workable. It isn't a judgement about you, your child, or whether the diagnosis is real.

If your GP declines, the specialist who started the medication usually remains responsible for prescribing and monitoring. This might be an NHS service, a Right to Choose provider or a private clinic.

This is why it's important to know, before you start medication, what your specialist will do if shared care isn't agreed. Some will continue prescribing for as long as needed. Others may have limits on how long they can provide prescriptions.

1. Ask for the reason

Ask your GP practice to explain why shared care was declined, ideally in writing. Knowing the reason helps you work out your next step.

2. Ask what might change the decision

Sometimes the issue can be resolved. For example, your GP may need a fuller report, clearer monitoring plans, or confirmation that the specialist will keep reviewing your care.

3. Contact your specialist

Let your specialist know straight away. They can confirm they'll keep prescribing, send further information to your GP, or talk through other options.

4. Check your medication supply

Many ADHD medicines are controlled drugs, so prescriptions are usually limited to a set supply. Check how much you have left, and make sure your next prescription is arranged.

The most important thing is avoiding unplanned gaps in medication. Try to:

• keep your specialist prescriber involved until a new arrangement is confirmed
• order prescriptions in good time
• keep up with monitoring, such as blood pressure, heart rate and weight checks
• speak to your specialist before making any changes to your medication

Never buy ADHD medication online without a valid prescription. It can be unsafe, and many ADHD medicines are controlled drugs.

Depending on where you live and how you started treatment, you may be able to:

Continue with your specialist

Your current specialist keeps prescribing and monitoring. If this is a private provider, you'll usually pay for prescriptions and reviews. Some NHS-funded Right to Choose providers can also continue prescribing.

Ask for an NHS referral

Your GP can refer you to your local NHS ADHD service. There may be a wait, and the service may want to carry out its own assessment before taking over. If they start or take over your treatment, your GP may then be more comfortable with shared care.

Use Right to Choose (England only)

In England, you can ask your GP to refer you to an NHS-funded provider of your choice for ADHD assessment and treatment. Shared care may be more likely afterwards, but it still isn't guaranteed.

Children and young people

For children, medication is often managed by CAMHS or a community paediatrician. If your child's GP declines shared care, ask whether a referral to these services is possible, and talk to your child's specialist about how they can continue prescribing in the meantime.

Register with a different GP practice

Some people consider moving practice. Practices can have different policies, but there's no guarantee a new practice will agree, and local NHS rules may still apply. It's worth checking the new practice's policy first.

You can ask your GP practice to reconsider, especially if you can provide extra information. If you feel your request wasn't handled fairly, you can use the practice's complaints process.

If you're still not satisfied, you can take your complaint further:

• in England, to your local Integrated Care Board, then the Parliamentary and Health Service Ombudsman
• in Scotland, to the Scottish Public Services Ombudsman
• in Wales, to the Public Services Ombudsman for Wales
• in Northern Ireland, to the Northern Ireland Public Services Ombudsman

A complaint can't force a GP to prescribe. But it can make sure your request was considered properly and the reasons were explained clearly.

Your GP practice

• Why was shared care declined?
• Is there anything that would change your decision?
• Is this a practice policy, or a local NHS policy?
• Can you refer me to an NHS ADHD service or, in England, a Right to Choose provider?

Your specialist

• Will you continue prescribing if my GP declines?
• How long can you provide prescriptions for, and what will it cost?
• Can you send my GP any further information?
• What happens if I'm referred to an NHS service?

Raiys doesn't currently prescribe ADHD medication, so we don't offer titration or shared care agreements ourselves. After your assessment, you'll receive a detailed written report, usually within 14 days, which you can share with your GP to talk about next steps, such as a referral for medication.

Everyone diagnosed at Raiys can also use BeChange, our digital programme designed to help you build practical, everyday strategies at your own pace.

Raiys works nationwide, offering online ADHD assessments for adults and for children and young people aged 5 to 17 across the UK. Our experienced, specialist ADHD team follows NICE guidelines and provides a clear, detailed report designed to be shared with your GP.

If you're in crisis right now, call 999, go to A&E, or call Samaritans free on 116 123, any time of day or night.

Ready to take the next step? Find out more about our adult ADHD assessment or child ADHD assessment.

A shared care refusal can feel like a setback, but it's rarely the end of the road. Knowing your options, and asking the right questions, can help you keep treatment and support on track.