My GP won't do shared care for ADHD medication. What now?

A shared care agreement lets your GP take over ADHD prescribing after diagnosis. Some GPs refuse. Here's why it happens and what your actual options are.

You've gone through the assessment, received a diagnosis, been through titration with a private clinic, and finally found a medication that works. Then your GP says they won't take over prescribing. It's a genuinely frustrating and surprisingly common problem.

What shared care is meant to do

A shared care agreement is a formal arrangement between a specialist (often a private psychiatrist) and your GP. The specialist manages diagnosis and titration, and once your dose is stable, the GP takes over routine prescribing under the specialist's ongoing guidance.

It exists so patients don't have to keep paying private prescription costs indefinitely once the hard work of finding the right medication is done. In theory, it should be a fairly routine handover.

Why some GPs say no

GPs aren't legally obliged to accept a shared care agreement, and individual practices set their own policies. Reasons for refusal vary, and knowing which one applies to you can help you decide what to do next.

• •Practice policy: some GP practices have a blanket policy against shared care for controlled medications, regardless of the specialist involved
• •Unfamiliarity with the private provider: GPs are sometimes more cautious about accepting shared care from clinics they don't have an existing relationship with
• •Workload and resourcing: monitoring controlled medications takes time, and some practices are simply stretched too thin to take on additional shared care patients
• •Clinical caution: occasionally a GP wants more information about the diagnosis or treatment plan before agreeing

"Nobody told me to check this before I paid for the assessment. I assumed shared care was automatic."

— A patient who discovered their GP's policy after diagnosis

What you can actually do

Ask for the reason in writing

A clear, specific reason makes it much easier to know what to do next. "Practice policy" is different from "we need more information from the specialist", and the right next step depends on which one you're dealing with.

Ask the specialist to contact the GP directly

Many private clinics are used to this situation and will proactively contact a hesitant GP with detailed clinical letters, monitoring plans, and reassurance about their processes. This resolves the issue more often than patients expect.

Check before you commit to a clinic

If you haven't started the assessment process yet, it's worth calling your GP practice in advance and asking directly whether they accept shared care agreements, and whether that depends on which clinic is involved. This single phone call can save a lot of frustration later.

Consider the NHS Right to Choose route

Assessments carried out through NHS-funded Right to Choose providers are generally easier to get shared care agreements for, since they're part of the NHS system rather than fully private.

Continue with private prescribing if needed

If shared care genuinely isn't available, some specialists will continue prescribing privately on an ongoing basis. This costs more than an NHS prescription, but keeps you on stable treatment while you explore other options.

If nothing changes

You can register with a different GP practice, since not every practice in your area will have the same policy. It's also worth raising the issue with your local Integrated Care Board if you feel you're being unfairly denied access to ongoing treatment, particularly if the refusal seems inconsistent with NHS guidance on shared care.

This is a genuinely difficult position to be in after doing everything right, but it's rarely a dead end. Most people find a workable path through with a bit of persistence.