Private ADHD Diagnosis
The NICE-Compliant Report and NHS Shared Care
The NICE-Compliant Report and NHS Shared Care
Parents considering a private ADHD diagnosis often do so to move faster than local NHS waiting lists permit. In the UK it’s possible for a privately diagnosed child to have their medication prescribing transferred to the NHS under a local NHS shared care protocol, but success depends on the quality of the private report and local NHS policy. This article explains how shared care works, why acceptance varies by trust and region, and exactly what a private ADHD report needs to contain (with reference to NICE guideline NG87) so a GP and local NHS team can realistically consider taking over prescribing and monitoring.
A shared care arrangement (sometimes called a shared care agreement or protocol) formalises how responsibility for prescribing and monitoring ADHD medication moves from a specialist clinic to a GP. The specialist (psychiatrist, paediatrician or ADHD clinic) usually initiates treatment and provides a clear letter and shared-care paperwork to the GP once the child is stable on a maintenance dose. After the GP agrees to the shared care, routine prescriptions and monitoring (weight, blood pressure, heart rate and review) are usually done in primary care while the specialist retains overall responsibility for complex decisions. Local shared care templates and responsibilities are set out by Integrated Care Boards and area prescribing committees and can differ considerably between regions.
Not all NHS trusts treat private diagnoses the same. Some trusts will accept a high-quality private assessment and then set up shared care; others insist on an NHS re-assessment before any NHS prescribing is considered. Differences stem from local policies on governance, workforce capacity, safeguarding, and how strictly the trust interprets NICE standards. Many regions have published guidance to help clinicians decide when private diagnoses can transfer to NHS care — for example, some ICBs ask that a private provider be an approved Right to Choose provider or that the private assessment explicitly demonstrates adherence to NG87 diagnostic standards. In short: acceptance is local, so the private report needs to meet or exceed local expectations to maximise the chance of shared care. All of the assessors we work with conform to these standards.
To give your GP and the NHS the best chance of accepting a transfer, a private diagnostic report should be complete, transparent and clearly mapped to the NICE diagnostic framework. While formats vary, the following items are routinely requested by NHS services and appear in local guidance:
1. A clear statement of diagnosis and diagnostic rationale. The report should explicitly state whether the clinician used DSM-5 or ICD criteria and explain how the child meets those criteria, referencing the NICE guideline approach to diagnosis. This is the single most important element.
NICE
2. Comprehensive developmental and medical history. Include prenatal, early development, schooling history and relevant family history. Note any factors that could mimic ADHD (sleep problems, hearing/vision issues, trauma) and how they were considered.
3. Multi-informant symptom evidence. Completed, dated rating scales from parents and teachers (for example Conners, Strengths & Difficulties Questionnaire or age-appropriate ADHD scales), plus a summary of responses from school or nursery observations. Raw scores or scanned forms are very helpful to NHS teams.
4. Functional impairment description. A standardised, age-appropriate functional assessment (how symptoms affect learning, behaviour, relationships and daily living) with examples across settings — home, school and social situations. Many trusts explicitly require evidence of impairment across settings.
Right Decisions
5. Assessment of co-existing conditions. Clear documentation of screening for anxiety, depression, autism, learning differences, sleep problems and substance misuse, with recommendations for any further investigation or referral.
6. Physical baseline and safety checks. Record baseline blood pressure, heart rate and (where relevant) height and weight. NICE and many local shared care protocols advise that an ECG is not routinely required unless there is a clinical indication (family history of cardiac disease or abnormal cardiovascular exam). The report should state what checks were done and whether any cardiac risk factors exist.
7. Medication history and treatment plan. If medication has already been started privately, the report must detail the drug, dose, formulation, titration schedule, response and any adverse effects. If medication is being recommended but not yet started, the clinician should provide a proposed titration plan and monitoring schedule aligned to local shared care expectations. Shared care paperwork or a template letter for the GP helps the process.
8. Copies of assessments and contactable clinician details. Appendices should include all rating scales, cognitive or educational reports, school letters and the full contact details of the diagnosing clinician (clinic address, professional registration number). An offer to discuss the case with the GP or local NHS team is useful.
9. Explicit recommendation for shared care. Where appropriate, the private clinician should state that they are willing to support a shared care arrangement and outline the specialist’s responsibilities (e.g. advice availability, annual review). Local shared care forms are often attached to simplify GP sign-up.
A practical, stepwise approach improves the chances of success:
1. Book a GP appointment and bring the full private report plus completed rating scales and school reports. Explain you’d like your GP to consider a shared care arrangement based on the private diagnosis.
2. Ask your private clinician to send a formal letter to the GP including a proposed shared care agreement, medication details, monitoring schedule and an invitation to discuss. Many GPs will not take over prescribing unless they receive this clear, professional correspondence.
3. Be prepared for local processes. The GP may seek advice from the local Community Mental Health Team (CMHT) or medicines management team; some areas require an NHS review before accepting shared care. If the GP declines, ask for written reasons and whether an NHS review would be possible (or how to seek re-assessment through Right to Choose).
4. Continue private prescriptions if needed. Until a shared care agreement is in place, you should continue with private prescribing as instructed by your clinician — the GP should not be expected to prescribe until they have formally agreed.
Keep copies of every report, dated rating scale and school communication. Ask your private clinician to use explicit NG87 language (diagnostic criteria met, functional impairment demonstrated across settings) and to attach all raw data and a clear shared care template. If you meet resistance from a GP, request liaison with the specialist or the local medicines optimisation team to clarify safety and responsibilities.
Transferring ADHD medication from a private service to NHS prescribing is achievable, but it depends on local policy and the detail and standard of the private report. A NICE-compliant assessment that is transparent, multi-source, and includes a clear medication and monitoring plan gives the NHS and your GP the best possible foundation to agree to shared care. If you’re planning a private assessment, discuss the requirements for NHS acceptance with your assessor in advance — it can save weeks or months in the transfer process and help ensure continuity of care for your child.
Written by Ben Friedman, Founder of Atypically.
Ben has years of first hand experience as a father of an autistic son and a SEND advocate. All content is thoroughly researched to help parents to be as informed as possible when navigating private assessments and meaningful interventions for their neurodiverse children. Ben also holds a CPD Accredited Certification in the Treatment and Management of Additional Needs Children with Neurodevelopmental Disorders.
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